Electrophysiological mapping for the implantation of deep brain stimulators for Parkinson's disease and tremor.
Identifieur interne : 000055 ( Hal/Checkpoint ); précédent : 000054; suivant : 000056Electrophysiological mapping for the implantation of deep brain stimulators for Parkinson's disease and tremor.
Auteurs : Robert Gross [États-Unis] ; Paul Krack [France] ; Maria Rodriguez-Oroz [Espagne] ; Ali Rezai [États-Unis] ; Alim-Louis Benabid [France]Source :
- Movement Disorders [ 0885-3185 ] ; 2006-06.
Abstract
The vast majority of centers use electrophysiological mapping techniques to finalize target selection during the implantation of deep brain stimulation (DBS) leads for the treatment of Parkinson's disease and tremor. This review discusses the techniques used for physiological mapping and addresses the questions of how various mapping strategies modify target selection and outcome following subthalamic nucleus (STN), globus pallidus internus (GPi), and ventralis intermedius (Vim) deep brain stimulation. Mapping strategies vary greatly across centers, but can be broadly categorized into those that use microelectrode or semimicroelectrode techniques to optimize position prior to implantation and macrostimulation through a macroelectrode or the DBS lead, and those that rely solely on macrostimulation and its threshold for clinical effects (benefits and side effects). Microelectrode criteria for implantation into the STN or GPi include length of the nucleus recorded, presence of movement-responsive neurons, and/or distance from the borders with adjacent structures. However, the threshold for the production of clinical benefits relative to side effects is, in most centers, the final, and sometimes only, determinant of DBS electrode position. Macrostimulation techniques for mapping, the utility of microelectrode mapping is reflected in its modification of electrode position in 17% to 87% of patients undergoing STN DBS, with average target adjustments of 1 to 4 mm. Nevertheless, with the absence of class I data, and in consideration of the large number of variables that impact clinical outcome, it is not possible to conclude that one technique is superior to the other in so far as motor Unified Parkinson's Disease Rating Scale outcome is concerned. Moreover, mapping technique is only one out of many variables that determine the outcome. The increase in surgical risk of intracranial hemorrhage correlated to the number of microelectrode trajectories must be considered against the risk of suboptimal benefits related to omission of this technique.
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DOI: 10.1002/mds.20960
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38041 Grenoble Cedex 9</addrLine><country key="FR"></country></address><ref type="url">http://www.ujf-grenoble.fr/</ref></desc></org></tutelle><tutelle active="#struct-300071" type="direct"><org type="institution" xml:id="struct-300071" status="VALID"><orgName>CHU Grenoble</orgName><desc><address><country key="FR"></country></address></desc></org></tutelle></tutelles></hal:affiliation><country>France</country><placeName><settlement type="city">Grenoble</settlement><region type="region" nuts="2">Auvergne-Rhône-Alpes</region><region type="old region" nuts="2">Rhône-Alpes</region></placeName><orgName type="university">Université Joseph Fourier</orgName><orgName type="institution" wicri:auto="newGroup">Université de Grenoble</orgName></affiliation></author></analytic><idno type="DOI">10.1002/mds.20960</idno><series><title level="j">Movement Disorders</title><idno type="ISSN">0885-3185</idno><imprint><date type="datePub">2006-06</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">The vast majority of centers use electrophysiological mapping techniques to finalize target selection during the implantation of deep brain stimulation (DBS) leads for the treatment of Parkinson's disease and tremor. This review discusses the techniques used for physiological mapping and addresses the questions of how various mapping strategies modify target selection and outcome following subthalamic nucleus (STN), globus pallidus internus (GPi), and ventralis intermedius (Vim) deep brain stimulation. Mapping strategies vary greatly across centers, but can be broadly categorized into those that use microelectrode or semimicroelectrode techniques to optimize position prior to implantation and macrostimulation through a macroelectrode or the DBS lead, and those that rely solely on macrostimulation and its threshold for clinical effects (benefits and side effects). Microelectrode criteria for implantation into the STN or GPi include length of the nucleus recorded, presence of movement-responsive neurons, and/or distance from the borders with adjacent structures. However, the threshold for the production of clinical benefits relative to side effects is, in most centers, the final, and sometimes only, determinant of DBS electrode position. Macrostimulation techniques for mapping, the utility of microelectrode mapping is reflected in its modification of electrode position in 17% to 87% of patients undergoing STN DBS, with average target adjustments of 1 to 4 mm. Nevertheless, with the absence of class I data, and in consideration of the large number of variables that impact clinical outcome, it is not possible to conclude that one technique is superior to the other in so far as motor Unified Parkinson's Disease Rating Scale outcome is concerned. Moreover, mapping technique is only one out of many variables that determine the outcome. The increase in surgical risk of intracranial hemorrhage correlated to the number of microelectrode trajectories must be considered against the risk of suboptimal benefits related to omission of this technique.</div></front></TEI><hal api="V3"><titleStmt><title xml:lang="en">Electrophysiological mapping for the implantation of deep brain stimulators for Parkinson's disease and tremor.</title><author role="aut"><persName><forename type="first">Robert</forename><forename type="middle">E.</forename><surname>Gross</surname></persName><email></email><idno type="halauthor">409449</idno><affiliation ref="#struct-95818"></affiliation></author><author role="aut"><persName><forename type="first">Paul</forename><surname>Krack</surname></persName><email></email><idno type="halauthor">296412</idno><affiliation ref="#struct-14242"></affiliation></author><author role="aut"><persName><forename type="first">Maria</forename><forename type="middle">C.</forename><surname>Rodriguez-Oroz</surname></persName><email></email><idno type="halauthor">409450</idno><affiliation ref="#struct-95820"></affiliation></author><author role="aut"><persName><forename type="first">Ali</forename><forename type="middle">R.</forename><surname>Rezai</surname></persName><email></email><idno type="halauthor">409451</idno><affiliation ref="#struct-95821"></affiliation></author><author role="aut"><persName><forename type="first">Alim-Louis</forename><surname>Benabid</surname></persName><email></email><idno type="halauthor">296407</idno><affiliation ref="#struct-92131"></affiliation></author><editor role="depositor"><persName><forename>Jean-Paul</forename><surname>Issartel</surname></persName><email>jean-paul.issartel@ujf-grenoble.fr</email></editor></titleStmt><editionStmt><edition n="v1" type="current"><date type="whenSubmitted">2009-06-02 15:33:16</date><date type="whenModified">2009-11-27 11:17:11</date><date type="whenReleased">2009-06-12 09:38:48</date><date type="whenProduced">2006-06</date></edition><respStmt><resp>contributor</resp><name key="140381"><persName><forename>Jean-Paul</forename><surname>Issartel</surname></persName><email>jean-paul.issartel@ujf-grenoble.fr</email></name></respStmt></editionStmt><publicationStmt><distributor>CCSD</distributor><idno type="halId">inserm-00390675</idno><idno type="halUri">http://www.hal.inserm.fr/inserm-00390675</idno><idno type="halBibtex">gross:inserm-00390675</idno><idno type="halRefHtml">Movement Disorders, Wiley, 2006, 21 Suppl 14, pp.S259-83. <10.1002/mds.20960></idno><idno type="halRef">Movement Disorders, Wiley, 2006, 21 Suppl 14, pp.S259-83. <10.1002/mds.20960></idno></publicationStmt><seriesStmt><idno type="stamp" n="INSERM">INSERM - Institut national de la santé et de la recherche médicale</idno><idno type="stamp" n="UNIV-GRENOBLE1" p="UGA">Université Joseph Fourier - Grenoble I</idno><idno type="stamp" n="UGA">HAL Grenoble Alpes</idno></seriesStmt><notesStmt><note type="audience" n="2">International</note><note type="popular" n="0">No</note><note type="peer" n="1">Yes</note></notesStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Electrophysiological mapping for the implantation of deep brain stimulators for Parkinson's disease and tremor.</title><author role="aut"><persName><forename type="first">Robert</forename><forename type="middle">E.</forename><surname>Gross</surname></persName><idno type="halAuthorId">409449</idno><affiliation ref="#struct-95818"></affiliation></author><author role="aut"><persName><forename type="first">Paul</forename><surname>Krack</surname></persName><idno type="halAuthorId">296412</idno><affiliation ref="#struct-14242"></affiliation></author><author role="aut"><persName><forename type="first">Maria</forename><forename type="middle">C.</forename><surname>Rodriguez-Oroz</surname></persName><idno type="halAuthorId">409450</idno><affiliation ref="#struct-95820"></affiliation></author><author role="aut"><persName><forename type="first">Ali</forename><forename type="middle">R.</forename><surname>Rezai</surname></persName><idno type="halAuthorId">409451</idno><affiliation ref="#struct-95821"></affiliation></author><author role="aut"><persName><forename type="first">Alim-Louis</forename><surname>Benabid</surname></persName><idno type="halAuthorId">296407</idno><affiliation ref="#struct-92131"></affiliation></author></analytic><monogr><idno type="halJournalId" status="VALID">17211</idno><idno type="issn">0885-3185</idno><idno type="eissn">1531-8257</idno><title level="j">Movement Disorders</title><imprint><publisher>Wiley</publisher><biblScope unit="volume">21 Suppl 14</biblScope><biblScope unit="pp">S259-83</biblScope><date type="datePub">2006-06</date></imprint></monogr><idno type="doi">10.1002/mds.20960</idno><idno type="pubmed">16810720</idno></biblStruct></sourceDesc><profileDesc><langUsage><language ident="en">English</language></langUsage><textClass><classCode scheme="mesh">Brain</classCode><classCode scheme="mesh">Brain Mapping</classCode><classCode scheme="mesh">Ventral Thalamic Nuclei</classCode><classCode scheme="mesh">Deep Brain Stimulation</classCode><classCode scheme="mesh">Electrodes, Implanted</classCode><classCode scheme="mesh">Globus Pallidus</classCode><classCode scheme="mesh">Humans</classCode><classCode scheme="mesh">Microelectrodes</classCode><classCode scheme="mesh">Parkinson Disease</classCode><classCode scheme="mesh">Subthalamic Nucleus</classCode><classCode scheme="mesh">Tremor</classCode><classCode scheme="halTypology" n="ART">Journal articles</classCode></textClass><abstract xml:lang="en">The vast majority of centers use electrophysiological mapping techniques to finalize target selection during the implantation of deep brain stimulation (DBS) leads for the treatment of Parkinson's disease and tremor. This review discusses the techniques used for physiological mapping and addresses the questions of how various mapping strategies modify target selection and outcome following subthalamic nucleus (STN), globus pallidus internus (GPi), and ventralis intermedius (Vim) deep brain stimulation. Mapping strategies vary greatly across centers, but can be broadly categorized into those that use microelectrode or semimicroelectrode techniques to optimize position prior to implantation and macrostimulation through a macroelectrode or the DBS lead, and those that rely solely on macrostimulation and its threshold for clinical effects (benefits and side effects). Microelectrode criteria for implantation into the STN or GPi include length of the nucleus recorded, presence of movement-responsive neurons, and/or distance from the borders with adjacent structures. However, the threshold for the production of clinical benefits relative to side effects is, in most centers, the final, and sometimes only, determinant of DBS electrode position. Macrostimulation techniques for mapping, the utility of microelectrode mapping is reflected in its modification of electrode position in 17% to 87% of patients undergoing STN DBS, with average target adjustments of 1 to 4 mm. Nevertheless, with the absence of class I data, and in consideration of the large number of variables that impact clinical outcome, it is not possible to conclude that one technique is superior to the other in so far as motor Unified Parkinson's Disease Rating Scale outcome is concerned. Moreover, mapping technique is only one out of many variables that determine the outcome. The increase in surgical risk of intracranial hemorrhage correlated to the number of microelectrode trajectories must be considered against the risk of suboptimal benefits related to omission of this technique.</abstract><particDesc><org type="consortium">Collaboration</org></particDesc></profileDesc></hal></record>Pour manipuler ce document sous Unix (Dilib)
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