Document Detail


Microelectrode recording can be a good adjunct in magnetic resonance image-directed subthalamic nucleus deep brain stimulation for parkinsonism.
MedLine Citation:
PMID:  16488244     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The contribution of MER to improving bilateral STN-DBS is debatable. To resolve the controversy and elucidate the role of MER in DBS, we compared the outcome of bilateral STN-DBS surgery with and without MER in parkinsonian patients. METHODS: From February 2002 to November 2002, the first 7 of 13 consecutive parkinsonian patients received STN-DBS without MER (group A), and the last 6 received STN-DBS with MER (group B). Pre- and postoperative assessments included scoring of UPDRS with video taping, and MR images. RESULTS: The mean Hoehn and Yahr stage was 3.6 in group A and 4.0 in group B. The mean follow-up was 7.4 months for group A and 5.3 months for group B. The mean coordinates of the tip of the permanent electrode relative to the mid-commissural point were x = 8.1 mm, y = 4.3 mm, and z = 5.9 mm for group A and x = 10.6 mm, y = 4.1 mm, and z = 6.9 mm for group B. When levodopa was withdrawn from group A for 12 hours at follow-up, the postoperative UPDRS total score improved by 27.6% (P = .01) and the motor score by 25.4% (P = .02); their LEDD decreased by 17.5% (P = .03). In group B, the postoperative UPDRS total score improved by 49.3% (P = .00002) and the motor score by 45.2% (P = .0004); LEDD decreased by 48.5% (P = .01). CONCLUSIONS: Although STN-DBS is a promising surgical modality for advanced parkinsonian patients, there is an inevitable learning curve associated with adopting this new procedure. Intraoperative MER is an effective way to ensure correct electrode placement in the STN. With the assistance of intraoperative MER, the outcome of STN-DBS can be improved significantly.
Authors:
Shin-Yuan Chen; Chao-Chin Lee; Sheng-Huang Lin; Yue-Long Hsin; Tien-Wen Lee; Pao-Sheng Yen; Yu-Cheng Chou; Chi-Wei Lee; Wanhua Annie Hsieh; Chain-Fa Su; Shinn-Zong Lin
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Surgical neurology     Volume:  65     ISSN:  0090-3019     ISO Abbreviation:  Surg Neurol     Publication Date:  2006 Mar 
Date Detail:
Created Date:  2006-02-20     Completed Date:  2006-04-10     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0367070     Medline TA:  Surg Neurol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  253-60; discussion 260-1     Citation Subset:  IM    
Affiliation:
Division of Functional Neuroscience, Department of Neurosurgery, Neuro-Medical Scientific Center, Tzu Chi General Hospital, Hualien 97002, Taiwan.
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MeSH Terms
Descriptor/Qualifier:
Aged
Antiparkinson Agents / administration & dosage
Combined Modality Therapy
Dominance, Cerebral / physiology
Electric Stimulation Therapy*
Electroencephalography*
Female
Follow-Up Studies
Humans
Levodopa / administration & dosage
Magnetic Resonance Imaging*
Male
Microelectrodes*
Middle Aged
Outcome Assessment (Health Care)
Parkinsonian Disorders / physiopathology,  therapy*
Retrospective Studies
Stereotaxic Techniques
Subthalamic Nucleus / physiopathology*
Surgery, Computer-Assisted*
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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