Universität zu Köln

Neudorfer, Clemens, Hinzke, Markus, Hunsche, Stefan, El Majdoub, Faycal, Lozano, Andres ORCID: 0000-0001-8257-3694 and Maarouf, Mohammad (2019). Combined Deep Brain Stimulation of Subthalamic Nucleus and Ventral Intermediate Thalamic Nucleus in Tremor-Dominant Parkinson's Disease Using a Parietal Approach. Neuromodulation, 22 (4). S. 493 - 503. HOBOKEN: WILEY. ISSN 1525-1403

Full text not available from this repository.

Abstract

Objectives Despite its efficacy in tremor-suppression, the ventral intermediate thalamic (VIM) nucleus has largely been neglected in deep brain stimulation (DBS) for tremor-dominant Parkinson's disease (tdPD). The employment of a parietal approach, however, allows stimulation of VIM and subthalamic nucleus (STN) using one trajectory only and thus constitutes a promising alternative to existing strategies. In the present study, we investigate safety and efficacy of combined lead implantation and stimulation of STN and VIM using a parietal approach. Materials and Methods Retrospective analysis of five patients with tdPD was performed who underwent DBS using a parietal approach. Changes in symptom severity, disease-specific health-related quality of life and l-dopa equivalent doses (LED) were evaluated over a total time course of 12 months. Results DBS within both targets yielded significant improvement of parkinsonian symptoms (median: 40.0%, p = 0.04) in the first 6 months of continuous stimulation and remained stable thereafter (median improvement at 12 months: 43.2%, p = 0.07). Sustained improvement of tremor (median at 6 months: 100.0%, p = 0.04; median at 12 months 83.3%, p = 0.04) and quality of life scores (median at 6 months: 29.8%, p = 0.04; median at 12 months: 32.6%, p = 0.04) was noted throughout the follow-up period. No significant change of LEDs was observed by the end of follow-up (median decrease: 2.2%, p = 0.89). Conclusions Simultaneous DBS of VIM and STN using one trajectory is safe, yielding good control of parkinsonian tremors. Further studies, however, are necessary to determine whether a parietal trajectory affords better control over tremor symptoms than established strategies and hence justifies the potential risks associated with the alternative approach.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Neudorfer, Clemens UNSPECIFIED UNSPECIFIED UNSPECIFIED Hinzke, Markus UNSPECIFIED UNSPECIFIED UNSPECIFIED Hunsche, Stefan UNSPECIFIED UNSPECIFIED UNSPECIFIED El Majdoub, Faycal UNSPECIFIED UNSPECIFIED UNSPECIFIED Lozano, Andres UNSPECIFIED orcid.org/0000-0001-8257-3694 UNSPECIFIED Maarouf, Mohammad UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-146413
DOI:	10.1111/ner.12943
Journal or Publication Title:	Neuromodulation
Volume:	22
Number:	4
Page Range:	S. 493 - 503
Date:	2019
Publisher:	WILEY
Place of Publication:	HOBOKEN
ISSN:	1525-1403
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language ELECTRICAL-STIMULATION; AREA; LOCALIZATION; ELECTRODES Multiple languages Medicine, Research & Experimental; Clinical Neurology Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/14641