Normative connectomes and their use in DBS

Deep brain stimulation (DBS) is known to both modulate local circuits and impact distributed brain networks. These networks can be studied in vivo using functional MRI (fMRI) and diffusion-weighted MRI (dMRI), although these sequences are not routinely acquired in DBS patients. Normative connectomes—aggregate connectivity datasets assembled from the scans of multiple individuals—offer a means to investigate the network properties of DBS treatment even in patients who lack native fMRI/dMRI acquisitions. Here, we outline the rationale for normative connectomes, discuss their various strengths and weaknesses, and review the burgeoning normative connectomic literature as it intersects with DBS. We also describe practical approaches to conducting normative connectomic analyses in the Lead Connectome Mapper software tool. While limited by insensitivity to interindividual differences, normative connectomes have emerged as useful research tools for exploring—especially in larger cohorts—the relationship between DBS network influences and a variety of clinical and neurobehavioral phenomena.