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To elucidate the systemic mechanisms of DBS, we analysed cerebral grey matter properties using cortical thickness measurements and addressed the dependence of structural integrity on clinical outcome. Thirty one patients with idiopathic PD without dementia (23 males, age: 63.4\u2009\u00b1\u20099.3, Hoehn and Yahr: 3.5\u2009\u00b1\u20090.8) were selected for DBS treatment. The patients underwent whole-brain preoperative T1 MR-Imaging at 3\u2009T. Grey matter integrity was assessed by cortical thickness measurements with FreeSurfer. The clinical motor outcome markedly improved after STN-DBS in comparison to the preoperative condition. The cortical thickness of the frontal lobe (paracentral area and superior frontal region) predicted the clinical improvement after STN-DBS. Moreover, in patients with cortical atrophy of these areas a higher stimulation voltage was needed for an optimal clinical response. Our data suggest that the effects of STN-DBS in PD directly depend on frontal lobe grey matter integrity. Cortical atrophy of this region might represent a distinct predictor of a poor motor outcome after STN-DBS in PD patients.<\/jats:p>","DOI":"10.1038\/srep43571","type":"journal-article","created":{"date-parts":[[2017,3,6]],"date-time":"2017-03-06T10:13:32Z","timestamp":1488795212000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":54,"title":["Effects of DBS in parkinsonian patients depend on the structural integrity of frontal cortex"],"prefix":"10.1038","volume":"7","author":[{"given":"Muthuraman","family":"Muthuraman","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G\u00fcnther","family":"Deuschl","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nabin","family":"Koirala","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Riedel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jens","family":"Volkmann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sergiu","family":"Groppa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2017,3,6]]},"reference":[{"key":"BFsrep43571_CR1","doi-asserted-by":"publisher","first-page":"2701","DOI":"10.1007\/s00415-012-6798-6","volume":"260","author":"J Volkmann","year":"2013","unstructured":"Volkmann, J. et al. Selecting deep brain stimulation or infusion therapies in advanced Parkinson\u2019s disease: an evidence-based review. Journal of neurology 260, 2701\u20132714, doi: 10.1007\/s00415-012-6798-6 (2013).","journal-title":"Journal of neurology"},{"key":"BFsrep43571_CR2","doi-asserted-by":"publisher","first-page":"137","DOI":"10.1007\/s00115-013-3876-7","volume":"85","author":"R Erasmi","year":"2014","unstructured":"Erasmi, R., Deuschl, G. & Witt, K. Deep brain stimulation for Parkinson\u2019s disease: timing and patient selection. Der Nervenarzt 85, 137\u2013146, doi: 10.1007\/s00115-013-3876-7 (2014).","journal-title":"Der Nervenarzt"},{"key":"BFsrep43571_CR3","doi-asserted-by":"publisher","first-page":"2038","DOI":"10.1056\/NEJMc1303485","volume":"368","author":"G Deuschl","year":"2013","unstructured":"Deuschl, G., Schade-Brittinger, C. & Agid, Y. Neurostimulation for Parkinson\u2019s disease with early motor complications. 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