ParkinsonCanadaV1, PascalFrancis, Curation, bibRecord, 000555

Statistical determination of the optimal subthalamic nucleus stimulation site in patients with Parkinson disease

Identifieur interne : 000555 ( PascalFrancis/Curation ); précédent : 000554; suivant : 000556

Statistical determination of the optimal subthalamic nucleus stimulation site in patients with Parkinson disease

Auteurs : Dominique Guehl [France] ; Roderick Edwards [Canada] ; Emmanuel Cuny [France] ; Pierre Burbaud [France] ; Alain Rougier [France] ; Julien Modolo [France] ; Anne Beuter [France]

Source :

Journal of neurosurgery [ 0022-3085 ] ; 2007.

RBID : Pascal:07-0153227

Descripteurs français

Pascal (Inist)
- Parkinson maladie, Noyau sousthalamique, Homme.
Wicri :
- topic : Homme.

English descriptors

KwdEn :
- Human, Parkinson disease, Subthalamic nucleus.

Abstract

Object. The subthalamic nucleus (STN) is currently recognized as the preferred target for deep brain stimulation (DBS) in patients with Parkinson disease (PD). If there is agreement in the literature that DBS improves motor symptoms significantly, the situation is less clear with respect to the side effects of this procedure. The goal of this study was to correlate the coordinate values of active electrode contacts with the amplitude of residual clinical symptoms and side effects using a mathematical approach. Methods. In this study the investigators examined a cohort of 41 patients with PD who received clinical benefits from DBS after stimulating electrodes had been implanted bilaterally into the STN. The combined scores of residual clinical symptoms plus side effects, including speech disturbance, postural instability, and weight gain, were fitted by using either inverted ellipsoidal exponentials or smooth splines. These analyses showed evidence of lower combined scores for stimulating contacts at an x coordinate approximately 12.0 to 12.3 mm lateral to the anterior commissure-posterior commissure (AC-PC) line and at a z coordinate approximately 3.1 to 3.3 mm under the AC-PC line. There was insufficient evidence for a preferred y coordinate location. Conclusions. The authors propose a "best" therapeutic ellipse area that is centered at an x, z location of 12.5 mm, -3.3 mm and characterized by an extension of 1.85 mm in the x direction and 2.22 mm in the z direction. Therapeutic electrode contacts located within this area are well correlated with the lowest occurrence of residual symptoms and the lowest occurrence of side effects independent of STN anatomical considerations. The lack of a significant result in the y direction remains to be explored further.

A01	`01`	`1`		`@0 0022-3085`
A02	`01`			`@0 JONSAC`
A03		`1`		`@0 J. neurosurg.`
A05				`@2 106`
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A08	`01`	`1`	`ENG`	`@1 Statistical determination of the optimal subthalamic nucleus stimulation site in patients with Parkinson disease`
A11	`01`	`1`		`@1 GUEHL (Dominique)`
A11	`02`	`1`		`@1 EDWARDS (Roderick)`
A11	`03`	`1`		`@1 CUNY (Emmanuel)`
A11	`04`	`1`		`@1 BURBAUD (Pierre)`
A11	`05`	`1`		`@1 ROUGIER (Alain)`
A11	`06`	`1`		`@1 MODOLO (Julien)`
A11	`07`	`1`		`@1 BEUTER (Anne)`
A14	`01`			`@1 Service de Neurophysiologie Clinique, Hôpital Pellegrin, Université de Bordeaux @3 FRA @Z 1 aut. @Z 4 aut.`
A14	`02`			`@1 Department of Mathematics and Statistics, University of Victoria @2 British Columbia @3 CAN @Z 2 aut.`
A14	`03`			`@1 Service de Neurochirurgie, et Service de Neurologie, Hôpital Pellegrin, Université de Bordeaux @3 FRA @Z 3 aut. @Z 5 aut.`
A14	`04`			`@1 Institut de Cognitique, Université Victor Segalen Bordeaux @2 Bordeaux @3 FRA @Z 6 aut. @Z 7 aut.`
A20				`@1 101-110`
A21				`@1 2007`
A23	`01`			`@0 ENG`
A43	`01`			`@1 INIST @2 6023 @5 354000159766090170`
A44				`@0 0000 @1 © 2007 INIST-CNRS. All rights reserved.`
A45				`@0 29 ref.`
A47	`01`	`1`		`@0 07-0153227`
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A64	`01`	`1`		`@0 Journal of neurosurgery`
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C01	`01`		`ENG`	@0 Object. The subthalamic nucleus (STN) is currently recognized as the preferred target for deep brain stimulation (DBS) in patients with Parkinson disease (PD). If there is agreement in the literature that DBS improves motor symptoms significantly, the situation is less clear with respect to the side effects of this procedure. The goal of this study was to correlate the coordinate values of active electrode contacts with the amplitude of residual clinical symptoms and side effects using a mathematical approach. Methods. In this study the investigators examined a cohort of 41 patients with PD who received clinical benefits from DBS after stimulating electrodes had been implanted bilaterally into the STN. The combined scores of residual clinical symptoms plus side effects, including speech disturbance, postural instability, and weight gain, were fitted by using either inverted ellipsoidal exponentials or smooth splines. These analyses showed evidence of lower combined scores for stimulating contacts at an x coordinate approximately 12.0 to 12.3 mm lateral to the anterior commissure-posterior commissure (AC-PC) line and at a z coordinate approximately 3.1 to 3.3 mm under the AC-PC line. There was insufficient evidence for a preferred y coordinate location. Conclusions. The authors propose a "best" therapeutic ellipse area that is centered at an x, z location of 12.5 mm, -3.3 mm and characterized by an extension of 1.85 mm in the x direction and 2.22 mm in the z direction. Therapeutic electrode contacts located within this area are well correlated with the lowest occurrence of residual symptoms and the lowest occurrence of side effects independent of STN anatomical considerations. The lack of a significant result in the y direction remains to be explored further.
C02	`01`	`X`		`@0 002B25J`
C03	`01`	`X`	`FRE`	`@0 Parkinson maladie @5 01`
C03	`01`	`X`	`ENG`	`@0 Parkinson disease @5 01`
C03	`01`	`X`	`SPA`	`@0 Parkinson enfermedad @5 01`
C03	`02`	`X`	`FRE`	`@0 Noyau sousthalamique @5 09`
C03	`02`	`X`	`ENG`	`@0 Subthalamic nucleus @5 09`
C03	`02`	`X`	`SPA`	`@0 Núcleo subtalámico @5 09`
C03	`03`	`X`	`FRE`	`@0 Homme @5 10`
C03	`03`	`X`	`ENG`	`@0 Human @5 10`
C03	`03`	`X`	`SPA`	`@0 Hombre @5 10`
C07	`01`	`X`	`FRE`	`@0 Encéphale pathologie @5 37`
C07	`01`	`X`	`ENG`	`@0 Cerebral disorder @5 37`
C07	`01`	`X`	`SPA`	`@0 Encéfalo patología @5 37`
C07	`02`	`X`	`FRE`	`@0 Extrapyramidal syndrome @5 38`
C07	`02`	`X`	`ENG`	`@0 Extrapyramidal syndrome @5 38`
C07	`02`	`X`	`SPA`	`@0 Extrapiramidal síndrome @5 38`
C07	`03`	`X`	`FRE`	`@0 Maladie dégénérative @5 39`
C07	`03`	`X`	`ENG`	`@0 Degenerative disease @5 39`
C07	`03`	`X`	`SPA`	`@0 Enfermedad degenerativa @5 39`
C07	`04`	`X`	`FRE`	`@0 Système nerveux central pathologie @5 40`
C07	`04`	`X`	`ENG`	`@0 Central nervous system disease @5 40`
C07	`04`	`X`	`SPA`	`@0 Sistema nervosio central patología @5 40`
C07	`05`	`X`	`FRE`	`@0 Système nerveux pathologie @5 41`
C07	`05`	`X`	`ENG`	`@0 Nervous system diseases @5 41`
C07	`05`	`X`	`SPA`	`@0 Sistema nervioso patología @5 41`
N21				`@1 099`
N44	`01`			`@1 OTO`
N82				`@1 OTO`

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<author><name sortKey="Edwards, Roderick" sort="Edwards, Roderick" uniqKey="Edwards R" first="Roderick" last="Edwards">Roderick Edwards</name>
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<series><title level="j" type="main">Journal of neurosurgery</title>
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<front><div type="abstract" xml:lang="en">Object. The subthalamic nucleus (STN) is currently recognized as the preferred target for deep brain stimulation (DBS) in patients with Parkinson disease (PD). If there is agreement in the literature that DBS improves motor symptoms significantly, the situation is less clear with respect to the side effects of this procedure. The goal of this study was to correlate the coordinate values of active electrode contacts with the amplitude of residual clinical symptoms and side effects using a mathematical approach. Methods. In this study the investigators examined a cohort of 41 patients with PD who received clinical benefits from DBS after stimulating electrodes had been implanted bilaterally into the STN. The combined scores of residual clinical symptoms plus side effects, including speech disturbance, postural instability, and weight gain, were fitted by using either inverted ellipsoidal exponentials or smooth splines. These analyses showed evidence of lower combined scores for stimulating contacts at an x coordinate approximately 12.0 to 12.3 mm lateral to the anterior commissure-posterior commissure (AC-PC) line and at a z coordinate approximately 3.1 to 3.3 mm under the AC-PC line. There was insufficient evidence for a preferred y coordinate location. Conclusions. The authors propose a "best" therapeutic ellipse area that is centered at an x, z location of 12.5 mm, -3.3 mm and characterized by an extension of 1.85 mm in the x direction and 2.22 mm in the z direction. Therapeutic electrode contacts located within this area are well correlated with the lowest occurrence of residual symptoms and the lowest occurrence of side effects independent of STN anatomical considerations. The lack of a significant result in the y direction remains to be explored further.</div>
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<fA14 i1="01"><s1>Service de Neurophysiologie Clinique, Hôpital Pellegrin, Université de Bordeaux</s1>
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<sZ>1 aut.</sZ>
<sZ>4 aut.</sZ>
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<fA14 i1="02"><s1>Department of Mathematics and Statistics, University of Victoria</s1>
<s2>British Columbia</s2>
<s3>CAN</s3>
<sZ>2 aut.</sZ>
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<fA14 i1="03"><s1>Service de Neurochirurgie, et Service de Neurologie, Hôpital Pellegrin, Université de Bordeaux</s1>
<s3>FRA</s3>
<sZ>3 aut.</sZ>
<sZ>5 aut.</sZ>
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<fA14 i1="04"><s1>Institut de Cognitique, Université Victor Segalen Bordeaux</s1>
<s2>Bordeaux</s2>
<s3>FRA</s3>
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<fC01 i1="01" l="ENG"><s0>Object. The subthalamic nucleus (STN) is currently recognized as the preferred target for deep brain stimulation (DBS) in patients with Parkinson disease (PD). If there is agreement in the literature that DBS improves motor symptoms significantly, the situation is less clear with respect to the side effects of this procedure. The goal of this study was to correlate the coordinate values of active electrode contacts with the amplitude of residual clinical symptoms and side effects using a mathematical approach. Methods. In this study the investigators examined a cohort of 41 patients with PD who received clinical benefits from DBS after stimulating electrodes had been implanted bilaterally into the STN. The combined scores of residual clinical symptoms plus side effects, including speech disturbance, postural instability, and weight gain, were fitted by using either inverted ellipsoidal exponentials or smooth splines. These analyses showed evidence of lower combined scores for stimulating contacts at an x coordinate approximately 12.0 to 12.3 mm lateral to the anterior commissure-posterior commissure (AC-PC) line and at a z coordinate approximately 3.1 to 3.3 mm under the AC-PC line. There was insufficient evidence for a preferred y coordinate location. Conclusions. The authors propose a "best" therapeutic ellipse area that is centered at an x, z location of 12.5 mm, -3.3 mm and characterized by an extension of 1.85 mm in the x direction and 2.22 mm in the z direction. Therapeutic electrode contacts located within this area are well correlated with the lowest occurrence of residual symptoms and the lowest occurrence of side effects independent of STN anatomical considerations. The lack of a significant result in the y direction remains to be explored further.</s0>
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<fC02 i1="01" i2="X"><s0>002B25J</s0>
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<s5>37</s5>
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<s5>38</s5>
</fC07>
<fC07 i1="03" i2="X" l="FRE"><s0>Maladie dégénérative</s0>
<s5>39</s5>
</fC07>
<fC07 i1="03" i2="X" l="ENG"><s0>Degenerative disease</s0>
<s5>39</s5>
</fC07>
<fC07 i1="03" i2="X" l="SPA"><s0>Enfermedad degenerativa</s0>
<s5>39</s5>
</fC07>
<fC07 i1="04" i2="X" l="FRE"><s0>Système nerveux central pathologie</s0>
<s5>40</s5>
</fC07>
<fC07 i1="04" i2="X" l="ENG"><s0>Central nervous system disease</s0>
<s5>40</s5>
</fC07>
<fC07 i1="04" i2="X" l="SPA"><s0>Sistema nervosio central patología</s0>
<s5>40</s5>
</fC07>
<fC07 i1="05" i2="X" l="FRE"><s0>Système nerveux pathologie</s0>
<s5>41</s5>
</fC07>
<fC07 i1="05" i2="X" l="ENG"><s0>Nervous system diseases</s0>
<s5>41</s5>
</fC07>
<fC07 i1="05" i2="X" l="SPA"><s0>Sistema nervioso patología</s0>
<s5>41</s5>
</fC07>
<fN21><s1>099</s1>
</fN21>
<fN44 i1="01"><s1>OTO</s1>
</fN44>
<fN82><s1>OTO</s1>
</fN82>
</pA>
</standard>
</inist>
</record>

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   |texte=   Statistical determination of the optimal subthalamic nucleus stimulation site in patients with Parkinson disease
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	La maladie de Parkinson au Canada (serveur d'exploration)
	Attention, ce site est en cours de développement ! Attention, site généré par des moyens informatiques à partir de corpus bruts. Les informations ne sont donc pas validées.

La maladie de Parkinson au Canada (serveur d'exploration)

Statistical determination of the optimal subthalamic nucleus stimulation site in patients with Parkinson disease

Statistical determination of the optimal subthalamic nucleus stimulation site in patients with Parkinson disease

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