BACKGROUND/AIMS: In subthalamic nucleus (STN) deep brain stimulation (DBS) lead implantation, it is still controversial whether it is more appropriate to employ indirect or direct methods in magnetic resonance imaging (MRI)-based tentative targeting and to select single- or multiple-track recording in electrophysiological definitive targeting. The efficacy of single-track electrophysiological recording through direct targeting was compared with the conventional indirect targeting methods in light of the identified STN thickness and clinical results. METHODS: The identified mean STN thickness, pre- and 6-month postoperative Unified Parkinson's Disease Rating Scale (UPDRS), dose change of L-dopa and dopaminergic agonists were compared in indirect (midcommissural point-based, 44 procedures) and direct (image-based, 44 procedures) targeting methods. RESULTS: The identified mean STN thickness was significantly greater in the group employing direct methods. For evaluation of the UPDRS, a significant scale improvement was noted in part 2 OFF for both groups. Significant scale improvements occurred in parts 3 and 4 in the group employing the direct method. Both groups revealed significant L-dopa dose reduction with the tendency towards a greater reduction in the group employing the direct method. CONCLUSION: MRI-based direct targeting supplemented by single-track recording could be justified as a standard for DBS lead implantation to achieve better clinical results. 2008 S. Karger AG, Basel.
BACKGROUND/AIMS: In subthalamic nucleus (STN) deep brain stimulation (DBS) lead implantation, it is still controversial whether it is more appropriate to employ indirect or direct methods in magnetic resonance imaging (MRI)-based tentative targeting and to select single- or multiple-track recording in electrophysiological definitive targeting. The efficacy of single-track electrophysiological recording through direct targeting was compared with the conventional indirect targeting methods in light of the identified STN thickness and clinical results. METHODS: The identified mean STN thickness, pre- and 6-month postoperative Unified Parkinson's Disease Rating Scale (UPDRS), dose change of L-dopa and dopaminergic agonists were compared in indirect (midcommissural point-based, 44 procedures) and direct (image-based, 44 procedures) targeting methods. RESULTS: The identified mean STN thickness was significantly greater in the group employing direct methods. For evaluation of the UPDRS, a significant scale improvement was noted in part 2 OFF for both groups. Significant scale improvements occurred in parts 3 and 4 in the group employing the direct method. Both groups revealed significant L-dopa dose reduction with the tendency towards a greater reduction in the group employing the direct method. CONCLUSION: MRI-based direct targeting supplemented by single-track recording could be justified as a standard for DBS lead implantation to achieve better clinical results. 2008 S. Karger AG, Basel.
Authors: Young Jin Heo; Sang Joon Kim; Ho Sung Kim; Choong Gon Choi; Seung Chai Jung; Jung Kyo Lee; Chong Sik Lee; Sun J Chung; So Hyun Cho; Gyoung Ro Lee Journal: Neuroradiology Date: 2015-07-09 Impact factor: 2.804
Authors: Rahul S Shah; Su-Youne Chang; Hoon-Ki Min; Zang-Hee Cho; Charles D Blaha; Kendall H Lee Journal: J Clin Neurol Date: 2010-12-31 Impact factor: 3.077