TY  - JOUR
AU  - Bahners, Bahne H
AU  - Lofredi, Roxanne
AU  - Voss, Hannah
AU  - de Almeida Marcelino, Ana Luísa
AU  - Goede, Lukas L
AU  - Feldmann, Lucia K
AU  - Schnitzler, Alfons
AU  - Sander, Tilmann H
AU  - Florin, Esther
AU  - Kühn, Andrea A
TI  - Spatial signature of low-frequency network changes accounts for pallidal stimulation outcome in cervical dystonia.
JO  - EBioMedicine
VL  - 124
SN  - 2352-3964
CY  - Amsterdam [u.a.]
PB  - Elsevier
M1  - DZNE-2026-00192
SP  - 106140
PY  - 2026
AB  - Pallidal deep brain stimulation (DBS) has remarkable effects in patients with cervical dystonia. Yet, its neurophysiological mechanisms are not fully resolved to date. Converging evidence suggests that pallidal DBS modulates sensorimotor and cerebellar network activity in dystonia, possibly by disrupting pathologically enhanced low-frequency oscillations in the basal ganglia. Still, anatomical and electrophysiological findings have rarely been linked, and it is unclear whether oscillatory changes occur in the same network identified in neuroimaging studies.In this cross-sectional study, we investigate the effects of pallidal DBS in patients with cervical dystonia using magnetoencephalography recordings on and off stimulation. We correlated DBS outcomes to the whole-cortex pattern of DBS-induced power changes in each cortical vertex.This analysis revealed a distinct low-frequency electrophysiological signature that accounted for significant amounts of variance in DBS improvements across the cohort. The signature was characterised by negative peaks within the supplementary motor area and the motor cortex as well as positive peaks in prefrontal and cerebellar areas.Our study sheds light on the cortical and cerebellar effects of pallidal DBS on a whole-cortex level and puts emphasis on low-frequency power modulation as a mechanism of effective stimulation beyond the basal ganglia in patients with cervical dystonia. Our findings might inform DBS programming and targeting as well as non-invasive stimulation strategies in the future.Deutsche Forschungsgemeinschaft (DFG, German Research Foundation)-Project-ID 424778381-TRR 295.
KW  - Humans
KW  - Torticollis: therapy
KW  - Torticollis: physiopathology
KW  - Torticollis: diagnosis
KW  - Torticollis: etiology
KW  - Deep Brain Stimulation: methods
KW  - Male
KW  - Female
KW  - Globus Pallidus: physiopathology
KW  - Middle Aged
KW  - Magnetoencephalography
KW  - Adult
KW  - Treatment Outcome
KW  - Cross-Sectional Studies
KW  - Aged
KW  - Brain Mapping
KW  - Biomarker (Other)
KW  - Electrophysiology effect mapping (Other)
KW  - Globus pallidus internus (Other)
KW  - Magnetoencephalography (Other)
KW  - Network mapping (Other)
LB  - PUB:(DE-HGF)16
C6  - pmid:41611586
C2  - pmc:PMC12905622
DO  - DOI:10.1016/j.ebiom.2026.106140
UR  - https://pub.dzne.de/record/285250
ER  -