Universität zu Köln

Reck, Christiane, Maarouf, Mohammad, Wojtecki, Lars, Groiss, Stefan Jun, Florin, Esther ORCID: 0000-0001-8276-2508, Sturm, Volker, Fink, Gereon R. ORCID: 0000-0002-8230-1856, Schnitzler, Alfons ORCID: 0000-0002-6414-7939 and Timmermann, Lars (2012). Clinical Outcome of Subthalamic Stimulation in Parkinson's Disease is Improved by Intraoperative Multiple Trajectories Microelectrode Recording. J. Neurol. Surg. Part A, 73 (6). S. 377 - 387. NEW YORK: THIEME MEDICAL PUBL INC. ISSN 2193-6323

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Abstract

Background and Study Aims The use of multiple trajectories microelectrode recording (MER) during implantation of deep brain stimulation (DBS) electrodes into the subthalamic nucleus (STN) in patients with Parkinson's disease (PD) is discussed controversially because of possible risks and unclear benefits. The aim of the study is to investigate whether MER combined with intraoperative evaluation of stimulation effects improve clinical outcome in PD patients undergoing STN DBS surgery. Material and Methods Prior to final DBS electrode implantation, we performed multiple trajectories MER and intraoperative test stimulations after magnetic resonance imaging (MRI)-guided planning in 32 PD patients. In further 10 patients no MER (only intraoperative test stimulation) was used. Results We found a significantly better clinical outcome (Unified Parkinson's Disease Rating Scale [UPDRS] III) in patients undergoing MER compared with non-MER patients. In MER patients, DBS electrode placement was performed using the central trajectory in 73%. Another than the central trajectory was taken in 27% of the patients. No difference in clinical outcome between DBS electrodes implanted on the central or a decentral trajectory was observed. Conclusions DBS surgery based on intraoperative multiple trajectories MER and test stimulation improves clinical outcome if compared with intraoperative test stimulation alone. The data suggest that DBS surgery solely based on MRI and intraoperative test stimulation without MER may lead to nonoptimal placement of DBS electrodes and consequently poorer clinical outcome.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Reck, Christiane UNSPECIFIED UNSPECIFIED UNSPECIFIED Maarouf, Mohammad UNSPECIFIED UNSPECIFIED UNSPECIFIED Wojtecki, Lars UNSPECIFIED UNSPECIFIED UNSPECIFIED Groiss, Stefan Jun UNSPECIFIED UNSPECIFIED UNSPECIFIED Florin, Esther UNSPECIFIED orcid.org/0000-0001-8276-2508 UNSPECIFIED Sturm, Volker UNSPECIFIED UNSPECIFIED UNSPECIFIED Fink, Gereon R. UNSPECIFIED orcid.org/0000-0002-8230-1856 UNSPECIFIED Schnitzler, Alfons UNSPECIFIED orcid.org/0000-0002-6414-7939 UNSPECIFIED Timmermann, Lars UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-479168
DOI:	10.1055/s-0032-1326957
Journal or Publication Title:	J. Neurol. Surg. Part A
Volume:	73
Number:	6
Page Range:	S. 377 - 387
Date:	2012
Publisher:	THIEME MEDICAL PUBL INC
Place of Publication:	NEW YORK
ISSN:	2193-6323
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language DEEP-BRAIN-STIMULATION; NUCLEUS STIMULATION; ELECTRICAL-STIMULATION; ELECTRODE; SHIFT; PALLIDOTOMY; IMPLANTATION; HEMORRHAGE; SURGERY; TREMOR Multiple languages Clinical Neurology; Surgery Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/47916