Universität zu Köln

Dafsari, Haidar Salimi, Petry-Schmelzer, Jan Niklas ORCID: 0000-0003-0749-3840, Ray-Chaudhuri, K., Ashkan, Keyoumars, Weis, Luca ORCID: 0000-0002-2286-0795, Dembek, Till A., Samuel, Michael, Rizos, Alexandra, Silverdale, Monty ORCID: 0000-0002-3295-6897, Barbe, Michael T., Fink, Gereon R. ORCID: 0000-0002-8230-1856, Evans, Julian, Martinez-Martin, Pablo ORCID: 0000-0003-0837-5280, Antonini, Angelo ORCID: 0000-0003-1040-2807, Visser-Vandewalle, Veerle and Timmermann, Lars (2018). Non-motor outcomes of subthalamic stimulation in Parkinson's disease depend on location of active contacts. Brain Stimul., 11 (4). S. 904 - 913. NEW YORK: ELSEVIER SCIENCE INC. ISSN 1876-4754

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Abstract

Background: Subthalamic nucleus (STN) deep brain stimulation (DBS) improves quality of life (QoL), motor, and non-motor symptoms (NMS) in Parkinson's disease (PD). Few studies have investigated the influence of the location of neurostimulation on NMS. Objective: To investigate the impact of active contact location on NMS in STN-DBS in PD. Methods: In this prospective, open-label, multicenter study including 50 PD patients undergoing bilateral STN-DBS, we collected NMSScale (NMSS), NMSQuestionnaire (NMSQ), Hospital Anxiety and Depression Scale (anxiety/depression, HADS-A/-D), PDQuestionnaire-8 (PDQ-8), Scales for Outcomes in PD-motor examination, motor complications, activities of daily living (ADL), and levodopa equivalent daily dose (LEDD) preoperatively and at 6 months follow-up. Changes were analyzed with Wilcoxon signed-rank/t-test and Bonferroni-correction for multiple comparisons. Although the STN was targeted visually, we employed an atlas-based approach to explore the relationship between active contact locations and DBS outcomes. Based on fused MRI/CT-images, we identified Cartesian coordinates of active contacts with patient-specific Mai-atlas standardization. We computed linear mixed-effects models with x-/y-/z-coordinates as independent, hemispheres as within-subject, and test change scores as dependent variables. Results: NMSS, NMSQ PDQ-8, motor examination, complications, and LEDD significantly improved at follow-up. Linear mixed-effect models showed that NMS and QoL improvement significantly depended on more medial (HADS-D, NMSS), anterior (HADS-D, NMSQ PDQ-8), and ventral (HADS-A/-D, NMSS, PDQ-8) neurostimulation. ADL improved more in posterior, LEDD in lateral neurostimulation locations. No relationship was observed for motor examination and complications scores. Conclusions: Our study provides evidence that more anterior, medial, and ventral STN-DBS is significantly related to more beneficial non-motor outcomes. (C) 2018 Published by Elsevier Inc.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Dafsari, Haidar Salimi UNSPECIFIED UNSPECIFIED UNSPECIFIED Petry-Schmelzer, Jan Niklas UNSPECIFIED orcid.org/0000-0003-0749-3840 UNSPECIFIED Ray-Chaudhuri, K. UNSPECIFIED UNSPECIFIED UNSPECIFIED Ashkan, Keyoumars UNSPECIFIED UNSPECIFIED UNSPECIFIED Weis, Luca UNSPECIFIED orcid.org/0000-0002-2286-0795 UNSPECIFIED Dembek, Till A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Samuel, Michael UNSPECIFIED UNSPECIFIED UNSPECIFIED Rizos, Alexandra UNSPECIFIED UNSPECIFIED UNSPECIFIED Silverdale, Monty UNSPECIFIED orcid.org/0000-0002-3295-6897 UNSPECIFIED Barbe, Michael T. UNSPECIFIED UNSPECIFIED UNSPECIFIED Fink, Gereon R. UNSPECIFIED orcid.org/0000-0002-8230-1856 UNSPECIFIED Evans, Julian UNSPECIFIED UNSPECIFIED UNSPECIFIED Martinez-Martin, Pablo UNSPECIFIED orcid.org/0000-0003-0837-5280 UNSPECIFIED Antonini, Angelo UNSPECIFIED orcid.org/0000-0003-1040-2807 UNSPECIFIED Visser-Vandewalle, Veerle UNSPECIFIED UNSPECIFIED UNSPECIFIED Timmermann, Lars UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-180251
DOI:	10.1016/j.brs.2018.03.009
Journal or Publication Title:	Brain Stimul.
Volume:	11
Number:	4
Page Range:	S. 904 - 913
Date:	2018
Publisher:	ELSEVIER SCIENCE INC
Place of Publication:	NEW YORK
ISSN:	1876-4754
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language DEEP-BRAIN-STIMULATION; QUALITY-OF-LIFE; NUCLEUS STIMULATION; ELECTRODE POSITION; RANDOMIZED-TRIAL; SYMPTOMS; MOTOR; LOCALIZATION; DBS; MRI Multiple languages Clinical Neurology; Neurosciences Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/18025