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Routine neuroimaging can be used to estimate location and volume of activated tissue (VTA), by modeling the type of stimulator and stimulation parameters. We aimed here at developing a strategy based on clinical brain MRI scans to predict motor and non-motor outcomes of STN-DBS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and methods<\/jats:title>\n                    <jats:p>We included 25 consecutive patients with advanced PD eligible for STN-DBS. At baseline, patients underwent a comprehensive motor and cognitive\/behavioral assessment, and conventional MRI. They underwent STN-DBS surgery, followed by a CT scan. Patients were reassessed 1\u00a0year later, while STN-DBS was active. Their neuroimaging data were used to calculate individual VTAs. The voxel-lesion-symptom-mapping (VLSM) toolbox, which allows to associate clinical variables with brain features of interest, was used to investigate associations between changes (in either direction) of motor, cognitive\/behavioral scores between baseline and follow-up, and VTA subregions. Six newly enrolled patients were used to test the predictive value of this approach at a single subject level.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      VLSM analysis (\n                      <jats:italic>p<\/jats:italic>\n                      values corrected for multiple comparisons\u2009&lt;\u20090.05) identified specific VTA subclusters associated with improved bradykinesia, verbal fluency, and mood state, and some others associated with worsening of tremor, long-term memory, and apathy. When considering cognitive\/behavioral changes, an effect of hemisphere lateralization was observed, with modulation of the right basal ganglia being associated with symptoms\u2019 worsening, and left-side modulation associated with improvements. VTA subclusters predictive for clinical changes were mostly located outside the STN, indicating the importance of networks over single nuclei simulation.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This approach suggests a possible way to personalize surgical planning, DBS-implant choice, and stimulation programing in the framework of precision medicine.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s11547-025-02025-8","type":"journal-article","created":{"date-parts":[[2025,6,9]],"date-time":"2025-06-09T08:47:24Z","timestamp":1749458844000},"page":"1263-1274","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Clinical MRI to predict motor and non-motor effects of deep brain stimulation in Parkinson disease"],"prefix":"10.1007","volume":"130","author":[{"given":"Corrado","family":"Campisi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni","family":"Giulietti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlo Alberto","family":"Artusi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Federico","family":"D\u2019Agata","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni","family":"Morana","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia","family":"Ledda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisa","family":"Montanaro","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mario","family":"Coriasco","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leonardo","family":"Lopiano","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0568-2026","authenticated-orcid":false,"given":"Marco","family":"Bozzali","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,6,9]]},"reference":[{"key":"2025_CR1","doi-asserted-by":"publisher","first-page":"1529","DOI":"10.1056\/NEJMct1208070","volume":"367","author":"MS Okun","year":"2012","unstructured":"Okun MS (2012) Deep-brain stimulation for Parkinson\u2019s disease. 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