Deep brain stimulation of the subthalamic nucleus in Parkinson's disease: usefulness of intraoperative radiological guidance. The Stereoplan.
Identifieur interne : 000266 ( Hal/Corpus ); précédent : 000265; suivant : 000267Deep brain stimulation of the subthalamic nucleus in Parkinson's disease: usefulness of intraoperative radiological guidance. The Stereoplan.
Auteurs : Stéphane Derrey ; David Maltête ; Nathalie Chastan ; Bertrand Debono ; François Proust ; Emmanuel Gérardin ; Jacques Weber ; Bruno Mihout ; Pierre FrégerSource :
- Stereotactic and Functional Neurosurgery [ 1011-6125 ] ; 2008.
Abstract
BACKGROUND: In our stereotactic procedure, intraoperative radiological documentation of electrode localization is performed using the Stereoplan. The aim of the study was to evaluate its accuracy. PATIENTS AND METHODS: Data of 20 consecutive patients, treated for Parkinson's disease by implantation of deep brain stimulators into the subthalamic nucleus, were collected prospectively. During surgery, Stereoplan coordinates of the tip of the central macroelectrodes were compared with intended coordinates along the central trajectory at 4 levels: (1) 10 mm above the anatomical target, (2) in the target, (3) in the substantia nigra pars reticulata, and (4) at the depth of contact 1. Before the frame's removal, Stereoplan coordinates of the contacts of the definitive electrode were compared with postoperative MRI coordinates. The mean of the differences was calculated in the x-, y-, and z-axis. Clinical results at 6 months were recorded. RESULTS: The mean of the differences between Stereoplan coordinates and intended coordinates for the macroelectrodes was lower than 1 mm. A submillimeter difference was also found for the definitive contacts. At 6 months, the Unified Parkinson's Disease Rating Scale III score improved by 70.6% compared with the baseline score. Dyskinesia and motor fluctuations decreased by 85.7 and 87%, respectively (p < 0.0001). CONCLUSION: Stereoplan could be considered an accurate intraoperative radiological system which assures the correct position of the electrode in the anatomical target.
Url:
DOI: 10.1159/000163556
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Hal:inserm-00472950Le document en format XML
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<front><div type="abstract" xml:lang="en">BACKGROUND: In our stereotactic procedure, intraoperative radiological documentation of electrode localization is performed using the Stereoplan. The aim of the study was to evaluate its accuracy. PATIENTS AND METHODS: Data of 20 consecutive patients, treated for Parkinson's disease by implantation of deep brain stimulators into the subthalamic nucleus, were collected prospectively. During surgery, Stereoplan coordinates of the tip of the central macroelectrodes were compared with intended coordinates along the central trajectory at 4 levels: (1) 10 mm above the anatomical target, (2) in the target, (3) in the substantia nigra pars reticulata, and (4) at the depth of contact 1. Before the frame's removal, Stereoplan coordinates of the contacts of the definitive electrode were compared with postoperative MRI coordinates. The mean of the differences was calculated in the x-, y-, and z-axis. Clinical results at 6 months were recorded. RESULTS: The mean of the differences between Stereoplan coordinates and intended coordinates for the macroelectrodes was lower than 1 mm. A submillimeter difference was also found for the definitive contacts. At 6 months, the Unified Parkinson's Disease Rating Scale III score improved by 70.6% compared with the baseline score. Dyskinesia and motor fluctuations decreased by 85.7 and 87%, respectively (p < 0.0001). CONCLUSION: Stereoplan could be considered an accurate intraoperative radiological system which assures the correct position of the electrode in the anatomical target.</div>
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<author role="aut"> <persName> <forename type="first">François</forename>
<surname>Proust</surname>
</persName>
<idno type="halauthorid">478795</idno>
<affiliation ref="#struct-111551"></affiliation>
</author>
<author role="aut"> <persName> <forename type="first">Emmanuel</forename>
<surname>Gérardin</surname>
</persName>
<idno type="halauthorid">348290</idno>
<affiliation ref="#struct-110330"></affiliation>
</author>
<author role="aut"> <persName> <forename type="first">Jacques</forename>
<surname>Weber</surname>
</persName>
<idno type="halauthorid">161872</idno>
<affiliation ref="#struct-115097"></affiliation>
</author>
<author role="aut"> <persName> <forename type="first">Bruno</forename>
<surname>Mihout</surname>
</persName>
<idno type="halauthorid">475908</idno>
<affiliation ref="#struct-43394"></affiliation>
</author>
<author role="aut"> <persName> <forename type="first">Pierre</forename>
<surname>Fréger</surname>
</persName>
<idno type="halauthorid">479149</idno>
<affiliation ref="#struct-111551"></affiliation>
</author>
</analytic>
<monogr> <idno type="halJournalId" status="VALID">19154</idno>
<idno type="issn">1011-6125</idno>
<idno type="eissn">1423-0372</idno>
<title level="j">Stereotactic and Functional Neurosurgery</title>
<imprint> <publisher>Karger</publisher>
<biblScope unit="volume">86</biblScope>
<biblScope unit="issue">6</biblScope>
<biblScope unit="pp">351-8</biblScope>
<date type="datePub">2008</date>
<date type="dateEpub">2008-10-16</date>
</imprint>
</monogr>
<idno type="doi">10.1159/000163556</idno>
<idno type="pubmed">18854662</idno>
</biblStruct>
</sourceDesc>
<profileDesc> <langUsage> <language ident="en">English</language>
</langUsage>
<textClass> <classCode scheme="mesh">Adult</classCode>
<classCode scheme="mesh">Aged</classCode>
<classCode scheme="mesh">Prospective Studies</classCode>
<classCode scheme="mesh">Stereotaxic Techniques</classCode>
<classCode scheme="mesh">Subthalamic Nucleus</classCode>
<classCode scheme="mesh">Deep Brain Stimulation</classCode>
<classCode scheme="mesh">Female</classCode>
<classCode scheme="mesh">Humans</classCode>
<classCode scheme="mesh">Magnetic Resonance Imaging</classCode>
<classCode scheme="mesh">Male</classCode>
<classCode scheme="mesh">Middle Aged</classCode>
<classCode scheme="mesh">Monitoring, Intraoperative</classCode>
<classCode scheme="mesh">Parkinson Disease</classCode>
<classCode scheme="halDomain" n="sdv.neu">Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC]</classCode>
<classCode scheme="halTypology" n="ART">Journal articles</classCode>
</textClass>
<abstract xml:lang="en">BACKGROUND: In our stereotactic procedure, intraoperative radiological documentation of electrode localization is performed using the Stereoplan. The aim of the study was to evaluate its accuracy. PATIENTS AND METHODS: Data of 20 consecutive patients, treated for Parkinson's disease by implantation of deep brain stimulators into the subthalamic nucleus, were collected prospectively. During surgery, Stereoplan coordinates of the tip of the central macroelectrodes were compared with intended coordinates along the central trajectory at 4 levels: (1) 10 mm above the anatomical target, (2) in the target, (3) in the substantia nigra pars reticulata, and (4) at the depth of contact 1. Before the frame's removal, Stereoplan coordinates of the contacts of the definitive electrode were compared with postoperative MRI coordinates. The mean of the differences was calculated in the x-, y-, and z-axis. Clinical results at 6 months were recorded. RESULTS: The mean of the differences between Stereoplan coordinates and intended coordinates for the macroelectrodes was lower than 1 mm. A submillimeter difference was also found for the definitive contacts. At 6 months, the Unified Parkinson's Disease Rating Scale III score improved by 70.6% compared with the baseline score. Dyskinesia and motor fluctuations decreased by 85.7 and 87%, respectively (p < 0.0001). CONCLUSION: Stereoplan could be considered an accurate intraoperative radiological system which assures the correct position of the electrode in the anatomical target.</abstract>
</profileDesc>
</hal>
</record>
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