| Microelectrode recording can be a good adjunct in magnetic resonance image-directed subthalamic nucleus deep brain stimulation for parkinsonism. | |
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MedLine Citation:
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PMID: 16488244 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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mm, y = 4.3 mm, and z = 5.9 mm for group A and x = 10.6 mm, y = 4.1 mm, and z = 6.9 mm for group B. When levodopa was withdrawn from group A for 12 hours at follow-up, the postoperative UPDRS total score improved by 27.6% (P = .01) and the motor score by 25.4% (P = .02); their LEDD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. |
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Authors:
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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:
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Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Surgical neurology Volume: 65 ISSN: 0090-3019 ISO Abbreviation: Surg Neurol Publication Date: 2006 Mar |
Date Detail:
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Created Date: 2006-02-20 Completed Date: 2006-04-10 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 0367070 Medline TA: Surg Neurol Country: United States |
Other Details:
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Languages: eng Pagination: 253-60; discussion 260-1 Citation Subset: IM |
Affiliation:
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Division of Functional Neuroscience, Department of Neurosurgery, Neuro-Medical Scientific Center, Tzu Chi General Hospital, Hualien 97002, Taiwan. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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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:
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0/Antiparkinson Agents; 0/Levodopa |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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