Document Detail


Electrode position determined by fused images of preoperative and postoperative magnetic resonance imaging and surgical outcome after subthalamic nucleus deep brain stimulation.
MedLine Citation:
PMID:  19005383     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: The electrode position is important to the surgical outcome after subthalamic nucleus (STN) deep brain stimulation (DBS). The aim of this study was to compare the surgical outcome of bilateral STN DBS with the electrode position estimated using fused magnetic resonance imaging. METHODS: Bilateral STN DBS was performed in 60 patients with advanced Parkinson's disease. Patients were evaluated with the Unified Parkinson's Disease Rating Scale, Hoehn and Yahr staging, Schwab and England Activities of Daily Living, L-dopa equivalent dose, and Short Form-36 Health Survey before and at 3 and 6 months after surgery. Brain magnetic resonance imaging (1.5-T) was performed in 53 patients at 6 months after STN DBS. The electrode position was estimated in the fused pre- and postoperative magnetic resonance images and correlated with the surgical results. RESULTS: As a group, the Unified Parkinson's Disease Rating Scale, Hoehn and Yahr staging, Schwab and England Activities of Daily Living, and Short Form-36 Health Survey scores improved at 3 and 6 months after STN DBS. The L-dopa equivalent dose decreased by 60% at 3 and 6 months after STN DBS. The electrode position was divided into 6 types according to its relationship to the STN and the red nucleus. Most off-medication Unified Parkinson's Disease Rating Scale motor subscale scores improved regardless of the type of electrode position. The off-medication speech subscale score improved only in the patients whose electrodes were correctly positioned in the STN bilaterally. CONCLUSION: The electrodes accurately positioned in the STN led to improved speech after bilateral STN DBS. An effort should be made in each patient to document the electrode position to monitor surgical performance and to improve the surgical outcome after STN DBS.
Authors:
Sun Ha Paek; Jung Ho Han; Jee-Young Lee; Cheolyoung Kim; Beom Seok Jeon; Dong Gyu Kim
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Neurosurgery     Volume:  63     ISSN:  1524-4040     ISO Abbreviation:  Neurosurgery     Publication Date:  2008 Nov 
Date Detail:
Created Date:  2008-11-13     Completed Date:  2008-12-22     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7802914     Medline TA:  Neurosurgery     Country:  United States    
Other Details:
Languages:  eng     Pagination:  925-36; discussion 936-7     Citation Subset:  IM    
Affiliation:
Department of Neurosurgery, Seoul National University College of Medicine, Seoul, Republic of Korea. paeksh@snu.ac.kr
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Antiparkinson Agents / therapeutic use
Deep Brain Stimulation / adverse effects,  instrumentation*
Electrodes, Implanted
Female
Functional Laterality
Humans
Image Processing, Computer-Assisted* / methods
Levodopa / therapeutic use
Magnetic Resonance Imaging
Male
Middle Aged
Neuropsychological Tests
Neurosurgical Procedures* / adverse effects,  methods
Parkinson Disease / diagnosis,  surgery,  therapy*
Severity of Illness Index
Speech Disorders / diagnosis,  etiology
Subthalamic Nucleus / pathology*,  surgery
Treatment Outcome
Chemical
Reg. No./Substance:
0/Antiparkinson Agents; 0/Levodopa

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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