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Electrode position determined by fused images of preoperative and postoperative magnetic resonance imaging and surgical outcome after subthalamic nucleus deep brain stimulation.
Neurosurgery. 2008 Nov; 63(5):925-36; discussion 936-7.N

Abstract

OBJECTIVE

The electrode position is important to the surgical outcome after subthalamic nucleus (STN) deep brain stimulation (DBS). The aim of this study was to compare the surgical outcome of bilateral STN DBS with the electrode position estimated using fused magnetic resonance imaging.

METHODS

Bilateral STN DBS was performed in 60 patients with advanced Parkinson's disease. Patients were evaluated with the Unified Parkinson's Disease Rating Scale, Hoehn and Yahr staging, Schwab and England Activities of Daily Living, L-dopa equivalent dose, and Short Form-36 Health Survey before and at 3 and 6 months after surgery. Brain magnetic resonance imaging (1.5-T) was performed in 53 patients at 6 months after STN DBS. The electrode position was estimated in the fused pre- and postoperative magnetic resonance images and correlated with the surgical results.

RESULTS

As a group, the Unified Parkinson's Disease Rating Scale, Hoehn and Yahr staging, Schwab and England Activities of Daily Living, and Short Form-36 Health Survey scores improved at 3 and 6 months after STN DBS. The L-dopa equivalent dose decreased by 60% at 3 and 6 months after STN DBS. The electrode position was divided into 6 types according to its relationship to the STN and the red nucleus. Most off-medication Unified Parkinson's Disease Rating Scale motor subscale scores improved regardless of the type of electrode position. The off-medication speech subscale score improved only in the patients whose electrodes were correctly positioned in the STN bilaterally.

CONCLUSION

The electrodes accurately positioned in the STN led to improved speech after bilateral STN DBS. An effort should be made in each patient to document the electrode position to monitor surgical performance and to improve the surgical outcome after STN DBS.

Authors+Show Affiliations

Department of Neurosurgery, Seoul National University College of Medicine, Seoul, Republic of Korea. paeksh@snu.ac.krNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

19005383

Citation

Paek, Sun Ha, et al. "Electrode Position Determined By Fused Images of Preoperative and Postoperative Magnetic Resonance Imaging and Surgical Outcome After Subthalamic Nucleus Deep Brain Stimulation." Neurosurgery, vol. 63, no. 5, 2008, pp. 925-36; discussion 936-7.
Paek SH, Han JH, Lee JY, et al. Electrode position determined by fused images of preoperative and postoperative magnetic resonance imaging and surgical outcome after subthalamic nucleus deep brain stimulation. Neurosurgery. 2008;63(5):925-36; discussion 936-7.
Paek, S. H., Han, J. H., Lee, J. Y., Kim, C., Jeon, B. S., & Kim, D. G. (2008). Electrode position determined by fused images of preoperative and postoperative magnetic resonance imaging and surgical outcome after subthalamic nucleus deep brain stimulation. Neurosurgery, 63(5), 925-36; discussion 936-7. https://doi.org/10.1227/01.NEU.0000334045.43940.FB
Paek SH, et al. Electrode Position Determined By Fused Images of Preoperative and Postoperative Magnetic Resonance Imaging and Surgical Outcome After Subthalamic Nucleus Deep Brain Stimulation. Neurosurgery. 2008;63(5):925-36; discussion 936-7. PubMed PMID: 19005383.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Electrode position determined by fused images of preoperative and postoperative magnetic resonance imaging and surgical outcome after subthalamic nucleus deep brain stimulation. AU - Paek,Sun Ha, AU - Han,Jung Ho, AU - Lee,Jee-Young, AU - Kim,Cheolyoung, AU - Jeon,Beom Seok, AU - Kim,Dong Gyu, PY - 2008/11/14/pubmed PY - 2008/12/23/medline PY - 2008/11/14/entrez SP - 925-36; discussion 936-7 JF - Neurosurgery JO - Neurosurgery VL - 63 IS - 5 N2 - OBJECTIVE: The electrode position is important to the surgical outcome after subthalamic nucleus (STN) deep brain stimulation (DBS). The aim of this study was to compare the surgical outcome of bilateral STN DBS with the electrode position estimated using fused magnetic resonance imaging. METHODS: Bilateral STN DBS was performed in 60 patients with advanced Parkinson's disease. Patients were evaluated with the Unified Parkinson's Disease Rating Scale, Hoehn and Yahr staging, Schwab and England Activities of Daily Living, L-dopa equivalent dose, and Short Form-36 Health Survey before and at 3 and 6 months after surgery. Brain magnetic resonance imaging (1.5-T) was performed in 53 patients at 6 months after STN DBS. The electrode position was estimated in the fused pre- and postoperative magnetic resonance images and correlated with the surgical results. RESULTS: As a group, the Unified Parkinson's Disease Rating Scale, Hoehn and Yahr staging, Schwab and England Activities of Daily Living, and Short Form-36 Health Survey scores improved at 3 and 6 months after STN DBS. The L-dopa equivalent dose decreased by 60% at 3 and 6 months after STN DBS. The electrode position was divided into 6 types according to its relationship to the STN and the red nucleus. Most off-medication Unified Parkinson's Disease Rating Scale motor subscale scores improved regardless of the type of electrode position. The off-medication speech subscale score improved only in the patients whose electrodes were correctly positioned in the STN bilaterally. CONCLUSION: The electrodes accurately positioned in the STN led to improved speech after bilateral STN DBS. An effort should be made in each patient to document the electrode position to monitor surgical performance and to improve the surgical outcome after STN DBS. SN - 1524-4040 UR - https://www.unboundmedicine.com/medline/citation/19005383/Electrode_position_determined_by_fused_images_of_preoperative_and_postoperative_magnetic_resonance_imaging_and_surgical_outcome_after_subthalamic_nucleus_deep_brain_stimulation_ L2 - https://academic.oup.com/neurosurgery/article-lookup/doi/10.1227/01.NEU.0000334045.43940.FB DB - PRIME DP - Unbound Medicine ER -