PURPOSE: The aim of this study was to investigate the predictive potential of pre-operative regional cerebral blood flow (rCBF) in the pre-supplementary motor area (pre-SMA) and clinical factors in Parkinson's disease (PD) patients treated with subthalamic nucleus (STN) stimulation. METHODS: Ten patients underwent rCBF SPECT and motor Unified Parkinson's Disease Rating Scale (UPDRS) pre- and post-operatively during stimulation at 5 and 42 months. Statistical parametric mapping (SPM) was used to extract rCBF values in the pre-SMA because it is related with motor improvement. Post-operative outcomes included motor response to stimulation and percent improvement in UPDRS. Pre-operative predictors were explored by correlation test, linear regression and multivariate analyses. RESULTS: Higher pre-operative rCBF in the pre-SMA and younger age were associated with favourable outcomes at 5 and 42 months. Pre-operative rCBF results were significantly associated with baseline clinical factors. CONCLUSION: This study shows that PD patients with younger age have higher rCBF values in the pre-SMA and better outcome, thus giving the rationale to the hypothesis that STN stimulation could be considered early in the course of disease.
PURPOSE: The aim of this study was to investigate the predictive potential of pre-operative regional cerebral blood flow (rCBF) in the pre-supplementary motor area (pre-SMA) and clinical factors in Parkinson's disease (PD) patients treated with subthalamic nucleus (STN) stimulation. METHODS: Ten patients underwent rCBF SPECT and motor Unified Parkinson's Disease Rating Scale (UPDRS) pre- and post-operatively during stimulation at 5 and 42 months. Statistical parametric mapping (SPM) was used to extract rCBF values in the pre-SMA because it is related with motor improvement. Post-operative outcomes included motor response to stimulation and percent improvement in UPDRS. Pre-operative predictors were explored by correlation test, linear regression and multivariate analyses. RESULTS: Higher pre-operative rCBF in the pre-SMA and younger age were associated with favourable outcomes at 5 and 42 months. Pre-operative rCBF results were significantly associated with baseline clinical factors. CONCLUSION: This study shows that PDpatients with younger age have higher rCBF values in the pre-SMA and better outcome, thus giving the rationale to the hypothesis that STN stimulation could be considered early in the course of disease.
Authors: Galit Kleiner-Fisman; Jan Herzog; David N Fisman; Filippo Tamma; Kelly E Lyons; Rajesh Pahwa; Anthony E Lang; Günther Deuschl Journal: Mov Disord Date: 2006-06 Impact factor: 10.338
Authors: H Russmann; J Ghika; J-G Villemure; B Robert; J Bogousslavsky; P R Burkhard; F J G Vingerhoets Journal: Neurology Date: 2004-11-23 Impact factor: 9.910
Authors: Jurg L Jaggi; Atsushi Umemura; Howard I Hurtig; Andrew D Siderowf; Amy Colcher; Matthew B Stern; Gordon H Baltuch Journal: Stereotact Funct Neurosurg Date: 2004-04-26 Impact factor: 1.875