Stéphane Thobois1,2,3, Chloé Laurencin4,5, Shams Ribault1,6, Emile Simon7,8, Julien Berthiller9, Gustavo Polo7, Adélaïde Nunes1, Andrei Brinzeu9, Patrick Mertens7,8, Teodor Danaila1. 1. Service de Neurologie C, Centre Expert Parkinson, Hôpital Neurologique et Neurochirurgical Pierre Wertheimer, Hospices Civils de Lyon, 69003, Lyon, France. 2. CNRS, Institut des Sciences Cognitives Marc Jeannerod, UMR 5229, 69675, Lyon, France. 3. Faculté de Médecine et de Maïeutique Lyon Sud Charles Mérieux, Université de Lyon, Université Claude Bernard Lyon 1, 69373, Lyon, France. 4. Service de Neurologie C, Centre Expert Parkinson, Hôpital Neurologique et Neurochirurgical Pierre Wertheimer, Hospices Civils de Lyon, 69003, Lyon, France. chloe.laurencin@chu-lyon.fr. 5. Centre de Recherche en Neuroscience de Lyon, INSERM U1028, UMR 5292, 69000, Lyon, France. chloe.laurencin@chu-lyon.fr. 6. Service de Médecine Physique et de Réadaptation, Hôpital Henry Gabrielle, Hospices Civils de Lyon, 69230, Saint-Genis-Laval, France. 7. Service de Neurochirurgie Fonctionnelle, Hôpital Neurologique et Neurochirurgical Pierre Wertheimer, Hospices Civils de Lyon, 69003, Lyon, France. 8. Laboratoire d'Anatomie, Faculté de Médecine Lyon Est, Université de Lyon, Université Claude Bernard Lyon 1, 69003, Lyon, France. 9. Service de Recherche et d'Épidémiologie Clinique, Pôle de Santé Publique, Hospices Civils de Lyon, 69003, Lyon, France.
Abstract
BACKGROUND: Several surgical methods are used for deep brain stimulation (DBS) of the subthalamic nucleus (STN) in Parkinson's disease (PD). This study aimed to compare clinical outcomes and electrode placement accuracy after robot-assisted (RAS) versus frame-based stereotactic (FSS) STN DBS in Parkinson's disease. METHODS: In this single-center open-label study, we prospectively collected data from 48 consecutive PD patients who underwent RAS (Neuromate®; n = 20) or FSS (n = 28) STN DBS with the same MRI-based STN targeting between October 2016 and December 2018 in the university neurological hospital of Lyon, France. Clinical variables were assessed before and 1 year after surgery. The number of electrode contacts within the STN was determined by merging post-operative CT and pre-operative MRI using Brainlab® GUIDE™XT software. RESULTS: One year after surgery, the improvement of motor manifestations (p = 0.18), motor complications (p = 0.80), and quality of life (p= 0.30) and the reduction of dopaminergic treatment (p = 0.94) and the rate of complications (p = 0.99) were similar in the two groups. Surgery duration was longer in the RAS group (p = 0.0001). There was no difference in the number of electrode contacts within the STN. CONCLUSION: This study demonstrates that RAS and FSS STN DBS for PD provide similar clinical outcomes and accuracy of electrode placement.
BACKGROUND: Several surgical methods are used for deep brain stimulation (DBS) of the subthalamic nucleus (STN) in Parkinson's disease (PD). This study aimed to compare clinical outcomes and electrode placement accuracy after robot-assisted (RAS) versus frame-based stereotactic (FSS) STN DBS in Parkinson's disease. METHODS: In this single-center open-label study, we prospectively collected data from 48 consecutive PDpatients who underwent RAS (Neuromate®; n = 20) or FSS (n = 28) STN DBS with the same MRI-based STN targeting between October 2016 and December 2018 in the university neurological hospital of Lyon, France. Clinical variables were assessed before and 1 year after surgery. The number of electrode contacts within the STN was determined by merging post-operative CT and pre-operative MRI using Brainlab® GUIDE™XT software. RESULTS: One year after surgery, the improvement of motor manifestations (p = 0.18), motor complications (p = 0.80), and quality of life (p= 0.30) and the reduction of dopaminergic treatment (p = 0.94) and the rate of complications (p = 0.99) were similar in the two groups. Surgery duration was longer in the RAS group (p = 0.0001). There was no difference in the number of electrode contacts within the STN. CONCLUSION: This study demonstrates that RAS and FSS STN DBS for PD provide similar clinical outcomes and accuracy of electrode placement.
Entities:
Keywords:
Deep brain stimulation; Electrode placement; Parkinson’s disease; Robot-assisted surgery