• Juan Carlos Baldermann, Katja Hardenacke, Xiaochen Hu, Phillip Köster, Andreas Horn, Hans-Joachim Freund, Karl Zilles, Volker Sturm, Veerle Visser-Vandewalle, Frank Jessen, David Maintz, and Jens Kuhn.
• Department of Psychiatry and Psychotherapy, Medical Faculty, University of Cologne, Cologne, Germany.
• Neuromodulation. 2018 Feb 1; 21 (2): 184-190.

ObjectivesFirst reports on the application of deep brain stimulation (DBS) of the Nucleus basalis of Meynert (NBM) showed feasibility and safety of the intervention in patients with Alzheimer´s disease. However, clinical effects vary and the mechanisms of actions are still not well understood. The aim of this study was to characterize neuroimaging changes that are associated with the responsiveness to the treatment.Materials And MethodsWe examined preoperative T1-weighted MR images of ten patients with Alzheimer's disease (AD) treated with DBS of the NBM and correlated the clinical outcome with volumetric differences of cortical thickness. Subsequently, we sought to identify brain regions that carry out the clinical effects by correlating the outcome with streamlines connected to the volume of activated tissue. Clinical assessments at baseline, 6 and 12 months after the intervention included the AD Assessment Scale as well as the mini mental status examination.ResultsA fronto-parieto-temporal pattern of cortical thickness was found to be associated with beneficial outcome. Modulation of streamlines connected to left parietal and opercular cortices was associated with better response to the intervention.ConclusionOur results indicate that patients with less advanced atrophy may profit from DBS of the NBM. We conclude that beneficial effects of the intervention are related to preserved fronto-parieto-temporal interplay.© 2017 International Neuromodulation Society.

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