Maarten Bot1, Pepijn van den Munckhof1, Ben A Schmand2, Rob M A de Bie3, P Richard Schuurman1. 1. Department of Neurosurgery, Academic Medical Center, Amsterdam, the Netherlands. 2. Department of Psychology, Academic Medical Center, Amsterdam, the Netherlands. 3. Department of Neurology, Academic Medical Center, Amsterdam, the Netherlands.
Abstract
OBJECTIVE: To evaluate the possible influence of electrode trajectories penetrating the caudate nucleus (CN) on cognitive outcomes in deep brain stimulation (DBS) surgery for Parkinson's disease (PD). BACKGROUND: It is currently unclear how mandatory CN avoidance during trajectory planning is. DESIGN/ METHODS: Electrode trajectories were determined to be inside, outside, or in border region of the CN. Pre- and postoperative neuropsychological tests of each trajectory group were compared in order to evaluate possible differences in cognitive outcomes 12 months after bilateral STN DBS. RESULTS: One hundred six electrode tracks in 53 patients were evaluated. Bilateral penetration of the CN occurred in 15 (28%) patients, while unilateral penetration occurred in 28 (53%). In 19 (36%) patients tracks were located in the border region of the CN. There was no electrode penetration of the CN in 10 (19%) patients. No difference in cognitive outcomes was found between the different groups. CONCLUSION: Cognitive outcome was not influenced by DBS electrode tracks penetrating the CN. It is both feasible and sensible to avoid electrode tracks through the CN when possible, considering its function and anatomical position. However, penetration of the CN can be considered without major concerns regarding cognitive decline when this facilitates optimal trajectory planning due to specific individual anatomical variations.
OBJECTIVE: To evaluate the possible influence of electrode trajectories penetrating the caudate nucleus (CN) on cognitive outcomes in deep brain stimulation (DBS) surgery for Parkinson's disease (PD). BACKGROUND: It is currently unclear how mandatory CN avoidance during trajectory planning is. DESIGN/ METHODS: Electrode trajectories were determined to be inside, outside, or in border region of the CN. Pre- and postoperative neuropsychological tests of each trajectory group were compared in order to evaluate possible differences in cognitive outcomes 12 months after bilateral STN DBS. RESULTS: One hundred six electrode tracks in 53 patients were evaluated. Bilateral penetration of the CN occurred in 15 (28%) patients, while unilateral penetration occurred in 28 (53%). In 19 (36%) patients tracks were located in the border region of the CN. There was no electrode penetration of the CN in 10 (19%) patients. No difference in cognitive outcomes was found between the different groups. CONCLUSION: Cognitive outcome was not influenced by DBS electrode tracks penetrating the CN. It is both feasible and sensible to avoid electrode tracks through the CN when possible, considering its function and anatomical position. However, penetration of the CN can be considered without major concerns regarding cognitive decline when this facilitates optimal trajectory planning due to specific individual anatomical variations.
Authors: Yakov Gologorsky; Sharona Ben-Haim; Erin L Moshier; James Godbold; Michele Tagliati; Donald Weisz; Ron L Alterman Journal: Neurosurgery Date: 2011-08 Impact factor: 4.654
Authors: Natalie S Ryan; Shiva Keihaninejad; Timothy J Shakespeare; Manja Lehmann; Sebastian J Crutch; Ian B Malone; John S Thornton; Laura Mancini; Harpreet Hyare; Tarek Yousry; Gerard R Ridgway; Hui Zhang; Marc Modat; Daniel C Alexander; Martin N Rossor; Sebastien Ourselin; Nick C Fox Journal: Brain Date: 2013-03-28 Impact factor: 13.501