Xiaobin Zheng1, Lianghong Yu1, Xinlong Wan2, Huiqing Wang1, Ting Yu1, Qiu He1, Zhangya Lin1, Dezhi Kang1. 1. Department of Neurosurgery, Neuromedicine Center of Fujian Province, First Affiliated Hospital of Fujian Medical University, Fuzhou 350000, China. 2. Department of Spinal Surgery, People's Hospital of Yuanzhou District, Guyuan 756000, China.
Abstract
OBJECTIVE: To evaluate the feasibility of applying intracranial lead reconstruction in deep brain stimulation (DBS) therapy for Parkinsonism. METHODS: We retrospectively collected the clinical data from 27 patients with Parkinson's disease (PD), who received bilateral subthalamic nucleus (STN) DBS therapy between January, 2016 and December, 2017. According to the position of the selected optimal stimulating contact of the implanted leads, the patients were divided into group A with the stimulating contacts of the bilateral leads in the STN, group B with unilateral stimulating contacts in the STN, and group C with bilateral stimulating contacts outside the STN. All the patients were assessed for improvement using Hoehn-Yahr stage, the third part of United Parkinson's Disease Rating Scale (UPDRS Ⅲ), Schwab and England Activities of Daily Living (SE-ADL), and L-dopa equivalent daily dose (LEDD). The consistency between the optimal stimulating contact selected by lead reconstruction and that by standard postoperative programming procedure was also evaluated. RESULTS: The patients in all the 3 groups showed postoperative improvements in Hoehn-Yahr stage, UPDRS Ⅲ score, SE-ADL score, and LEDD in the medication-off state. But at 12 months of the follow-up, such improvements were maintained only in the patients of group A. The optimal stimulating contacts selected by lead reconstruction and standard postoperative programming procedure had a matching rate of up to 77.78% (42/54), and the coordinates of the optimal contacts selected by the two methods showed no significant difference. CONCLUSIONS: Intracranial lead reconstruction facilitates the study of the association between the implant site of the leads and the clinical outcome of DBS therapy for PD and allows the precise selection of the optimal contact of the implanted leads in postoperative programming of DBS.
OBJECTIVE: To evaluate the feasibility of applying intracranial lead reconstruction in deep brain stimulation (DBS) therapy for Parkinsonism. METHODS: We retrospectively collected the clinical data from 27 patients with Parkinson's disease (PD), who received bilateral subthalamic nucleus (STN) DBS therapy between January, 2016 and December, 2017. According to the position of the selected optimal stimulating contact of the implanted leads, the patients were divided into group A with the stimulating contacts of the bilateral leads in the STN, group B with unilateral stimulating contacts in the STN, and group C with bilateral stimulating contacts outside the STN. All the patients were assessed for improvement using Hoehn-Yahr stage, the third part of United Parkinson's Disease Rating Scale (UPDRS Ⅲ), Schwab and England Activities of Daily Living (SE-ADL), and L-dopa equivalent daily dose (LEDD). The consistency between the optimal stimulating contact selected by lead reconstruction and that by standard postoperative programming procedure was also evaluated. RESULTS: The patients in all the 3 groups showed postoperative improvements in Hoehn-Yahr stage, UPDRS Ⅲ score, SE-ADL score, and LEDD in the medication-off state. But at 12 months of the follow-up, such improvements were maintained only in the patients of group A. The optimal stimulating contacts selected by lead reconstruction and standard postoperative programming procedure had a matching rate of up to 77.78% (42/54), and the coordinates of the optimal contacts selected by the two methods showed no significant difference. CONCLUSIONS: Intracranial lead reconstruction facilitates the study of the association between the implant site of the leads and the clinical outcome of DBS therapy for PD and allows the precise selection of the optimal contact of the implanted leads in postoperative programming of DBS.
Entities:
Keywords:
Parkinson's disease; deep brain stimulation; electrode implantation position; lead reconstruction
Authors: Shearwood McClelland; Blair Ford; Patrick B Senatus; Linda M Winfield; Yunling E Du; Seth L Pullman; Qiping Yu; Steven J Frucht; Guy M McKhann; Robert R Goodman Journal: Neurosurg Focus Date: 2005-11-15 Impact factor: 4.047
Authors: Maarten Bot; P Richard Schuurman; Vincent J J Odekerken; Rens Verhagen; Fiorella Maria Contarino; Rob M A De Bie; Pepijn van den Munckhof Journal: J Neurol Neurosurg Psychiatry Date: 2018-01-20 Impact factor: 10.154
Authors: Fritz Wodarg; Jan Herzog; René Reese; Daniela Falk; Markus O Pinsker; Frank Steigerwald; Olav Jansen; Günther Deuschl; H Maximillian Mehdorn; Jens Volkmann Journal: Mov Disord Date: 2012-04-19 Impact factor: 10.338