From Network to Needle: Integrating Structural and Functional Connectivity for DBS

We read with great interest the recent work by Santyr et al. [1], who present the first prospective trial of a methodologically innovative evaluation of fMRI-guided DBS programming in Parkinson's disease.Their demonstration that early fMRI-informed parameter selection achieves motor outcomes non-inferior to prolonged standard-of-care programming represents an important step toward objective, data-driven DBS optimisation.The capacity to capture stimulation-induced whole-brain network responses at the individual level is a genuine technical achievement.We wish to offer several observations that contextualise these findings and point toward a complementary structural framework.We argue that its full clinical impact depends on integration with patient-specific structural targeting strategies.