Haidar Salimi Dafsari1, Jan Niklas Petry-Schmelzer2, K Ray-Chaudhuri3, Keyoumars Ashkan4, Luca Weis5, Till A Dembek2, Michael Samuel4, Alexandra Rizos4, Monty Silverdale6, Michael T Barbe2, Gereon R Fink7, Julian Evans5, Pablo Martinez-Martin8, Angelo Antonini5, Veerle Visser-Vandewalle9, Lars Timmermann10. 1. Department of Neurology, University Hospital Cologne, Cologne, Germany; National Parkinson Foundation International Centre of Excellence, King's College Hospital, London, United Kingdom. Electronic address: haidar.dafsari@uk-koeln.de. 2. Department of Neurology, University Hospital Cologne, Cologne, Germany. 3. National Parkinson Foundation International Centre of Excellence, King's College Hospital, London, United Kingdom; The Maurice Wohl Clinical Neuroscience Institute, King's College London, London, United Kingdom. 4. National Parkinson Foundation International Centre of Excellence, King's College Hospital, London, United Kingdom. 5. Department of Neurology, IRCCS, San Camillo, Venice, Italy. 6. Department of Neurology and Neurosurgery, Salford Royal Foundation Trust, Manchester Academic Health Science Centre, University of Manchester, Greater Manchester, United Kingdom. 7. Department of Neurology, University Hospital Cologne, Cologne, Germany; Cognitive Neuroscience, Institute of Neuroscience and Medicine (INM-3), Research Center Jülich, Jülich, Germany. 8. National Center of Epidemiology and CIBERNED, Carlos III Institute of Health, Madrid, Spain. 9. Department of Stereotaxy and Functional Neurosurgery, University Hospital Cologne, Cologne, Germany. 10. Department of Neurology, University Hospital Cologne, Cologne, Germany; Department of Neurology, University Hospital Giessen and Marburg, Campus Marburg, Germany.
Abstract
BACKGROUND: Subthalamic nucleus (STN) deep brain stimulation (DBS) improves quality of life (QoL), motor, and non-motor symptoms (NMS) in Parkinson's disease (PD). Few studies have investigated the influence of the location of neurostimulation on NMS. OBJECTIVE: To investigate the impact of active contact location on NMS in STN-DBS in PD. METHODS: In this prospective, open-label, multicenter study including 50 PD patients undergoing bilateral STN-DBS, we collected NMSScale (NMSS), NMSQuestionnaire (NMSQ), Hospital Anxiety and Depression Scale (anxiety/depression, HADS-A/-D), PDQuestionnaire-8 (PDQ-8), Scales for Outcomes in PD-motor examination, motor complications, activities of daily living (ADL), and levodopa equivalent daily dose (LEDD) preoperatively and at 6 months follow-up. Changes were analyzed with Wilcoxon signed-rank/t-test and Bonferroni-correction for multiple comparisons. Although the STN was targeted visually, we employed an atlas-based approach to explore the relationship between active contact locations and DBS outcomes. Based on fused MRI/CT-images, we identified Cartesian coordinates of active contacts with patient-specific Mai-atlas standardization. We computed linear mixed-effects models with x-/y-/z-coordinates as independent, hemispheres as within-subject, and test change scores as dependent variables. RESULTS: NMSS, NMSQ, PDQ-8, motor examination, complications, and LEDD significantly improved at follow-up. Linear mixed-effect models showed that NMS and QoL improvement significantly depended on more medial (HADS-D, NMSS), anterior (HADS-D, NMSQ, PDQ-8), and ventral (HADS-A/-D, NMSS, PDQ-8) neurostimulation. ADL improved more in posterior, LEDD in lateral neurostimulation locations. No relationship was observed for motor examination and complications scores. CONCLUSIONS: Our study provides evidence that more anterior, medial, and ventral STN-DBS is significantly related to more beneficial non-motor outcomes.
BACKGROUND: Subthalamic nucleus (STN) deep brain stimulation (DBS) improves quality of life (QoL), motor, and non-motor symptoms (NMS) in Parkinson's disease (PD). Few studies have investigated the influence of the location of neurostimulation on NMS. OBJECTIVE: To investigate the impact of active contact location on NMS in STN-DBS in PD. METHODS: In this prospective, open-label, multicenter study including 50 PDpatients undergoing bilateral STN-DBS, we collected NMSScale (NMSS), NMSQuestionnaire (NMSQ), Hospital Anxiety and Depression Scale (anxiety/depression, HADS-A/-D), PDQuestionnaire-8 (PDQ-8), Scales for Outcomes in PD-motor examination, motor complications, activities of daily living (ADL), and levodopa equivalent daily dose (LEDD) preoperatively and at 6 months follow-up. Changes were analyzed with Wilcoxon signed-rank/t-test and Bonferroni-correction for multiple comparisons. Although the STN was targeted visually, we employed an atlas-based approach to explore the relationship between active contact locations and DBS outcomes. Based on fused MRI/CT-images, we identified Cartesian coordinates of active contacts with patient-specific Mai-atlas standardization. We computed linear mixed-effects models with x-/y-/z-coordinates as independent, hemispheres as within-subject, and test change scores as dependent variables. RESULTS: NMSS, NMSQ, PDQ-8, motor examination, complications, and LEDD significantly improved at follow-up. Linear mixed-effect models showed that NMS and QoL improvement significantly depended on more medial (HADS-D, NMSS), anterior (HADS-D, NMSQ, PDQ-8), and ventral (HADS-A/-D, NMSS, PDQ-8) neurostimulation. ADL improved more in posterior, LEDD in lateral neurostimulation locations. No relationship was observed for motor examination and complications scores. CONCLUSIONS: Our study provides evidence that more anterior, medial, and ventral STN-DBS is significantly related to more beneficial non-motor outcomes.
Authors: Ian H Kratter; Ahmed Jorge; Michael T Feyder; Ashley C Whiteman; Yue-Fang Chang; Luke C Henry; Jordan F Karp; R Mark Richardson Journal: Transl Psychiatry Date: 2022-05-27 Impact factor: 7.989
Authors: Jan Bardon; Sandra Kurcova; Monika Chudackova; Pavel Otruba; David Krahulik; Martin Nevrly; Petr Kanovsky; Jana Zapletalova; Jan Valosek; Petr Hlustik; Miroslav Vastik; Marketa Vecerkova; Lenka Hvizdosova; Katerina Mensikova; Egon Kurca; Stefan Sivak Journal: Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub Date: 2020-12-07 Impact factor: 1.245
Authors: Gregory M Pontone; Nadeeka Dissanayka; Liana Apostolova; Richard G Brown; Roseanne Dobkin; Kathy Dujardin; Joseph H Friedman; Albert F G Leentjens; Eric J Lenze; Laura Marsh; Lynda Mari; Oury Monchi; Irene H Richard; Anette Schrag; Antonio P Strafella; Beth Vernaleo; Daniel Weintraub; Zoltan Mari Journal: NPJ Parkinsons Dis Date: 2019-12-11
Authors: Stefanie T Jost; Veerle Visser-Vandewalle; Alexandra Rizos; Philipp A Loehrer; Monty Silverdale; Julian Evans; Michael Samuel; Jan Niklas Petry-Schmelzer; Anna Sauerbier; Alexandra Gronostay; Michael T Barbe; Gereon R Fink; Keyoumars Ashkan; Angelo Antonini; Pablo Martinez-Martin; K Ray Chaudhuri; Lars Timmermann; Haidar S Dafsari Journal: NPJ Parkinsons Dis Date: 2021-06-08