Microsubthalamotomy effect at day 3: screening for determinants.
Identifieur interne : 000734 ( Hal/Corpus ); précédent : 000733; suivant : 000735Microsubthalamotomy effect at day 3: screening for determinants.
Auteurs : David Maltête ; Nathalie Chastan ; Stéphane Derrey ; Bertrand Debono ; Emmanuel Gérardin ; Romain Lefaucheur ; Bruno Mihout ; Didier HannequinSource :
- Movement Disorders [ 0885-3185 ] ; 2009-01-30.
Abstract
A microsubthalamotomy (mSTN) effect has been frequently reported after implantation that improves Parkinson's motor disability. It is usually believed that mSTN effect reflects the post-traumatic tissue reaction within the STN. However, it has never, to our knowledge, been reported whether pre and intraoperative factors could predict this mSTN effect. Preoperative clinical characteristics, that is, age, disease duration, Mattis Dementia Rating Scale score, levodopa responsiveness, severity of motor fluctuations and dyskinesia, and intraoperative parameters, that is, the number of tracks, distance of typical STN neuronal activity recorded along all microelectrodes, and along the definitive electrodes, were assessed in 40 consecutive PD patients submitted for STN stimulation. Multiple stepwise regression analysis showed that only the number of tracks used for microelectrodes recordings was predictor of the contralateral mSTN effect (F (4,73) = 1.83, P = 0.02). This result suggests that the contralateral mSTN depends on the tissue changes along the entirety of surgical trajectories affecting both STN and its adjacent structures.
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DOI: 10.1002/mds.22380
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Hal:inserm-00472800Le document en format XML
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<front><div type="abstract" xml:lang="en">A microsubthalamotomy (mSTN) effect has been frequently reported after implantation that improves Parkinson's motor disability. It is usually believed that mSTN effect reflects the post-traumatic tissue reaction within the STN. However, it has never, to our knowledge, been reported whether pre and intraoperative factors could predict this mSTN effect. Preoperative clinical characteristics, that is, age, disease duration, Mattis Dementia Rating Scale score, levodopa responsiveness, severity of motor fluctuations and dyskinesia, and intraoperative parameters, that is, the number of tracks, distance of typical STN neuronal activity recorded along all microelectrodes, and along the definitive electrodes, were assessed in 40 consecutive PD patients submitted for STN stimulation. Multiple stepwise regression analysis showed that only the number of tracks used for microelectrodes recordings was predictor of the contralateral mSTN effect (F (4,73) = 1.83, P = 0.02). This result suggests that the contralateral mSTN depends on the tissue changes along the entirety of surgical trajectories affecting both STN and its adjacent structures.</div>
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<classCode scheme="mesh">Radiography, Interventional</classCode>
<classCode scheme="mesh">Severity of Illness Index</classCode>
<classCode scheme="mesh">Aged</classCode>
<classCode scheme="mesh">Stereotaxic Techniques</classCode>
<classCode scheme="mesh">Thalamus</classCode>
<classCode scheme="mesh">Time Factors</classCode>
<classCode scheme="mesh">Tomography, X-Ray Computed</classCode>
<classCode scheme="mesh">Tremor</classCode>
<classCode scheme="mesh">Antiparkinson Agents</classCode>
<classCode scheme="mesh">Brain Edema</classCode>
<classCode scheme="mesh">Combined Modality Therapy</classCode>
<classCode scheme="mesh">Contrast Media</classCode>
<classCode scheme="mesh">Deep Brain Stimulation</classCode>
<classCode scheme="mesh">Dyskinesias</classCode>
<classCode scheme="mesh">Female</classCode>
<classCode scheme="halDomain" n="sdv.bbm">Life Sciences [q-bio]/Biochemistry, Molecular Biology</classCode>
<classCode scheme="halTypology" n="ART">Journal articles</classCode>
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<abstract xml:lang="en">A microsubthalamotomy (mSTN) effect has been frequently reported after implantation that improves Parkinson's motor disability. It is usually believed that mSTN effect reflects the post-traumatic tissue reaction within the STN. However, it has never, to our knowledge, been reported whether pre and intraoperative factors could predict this mSTN effect. Preoperative clinical characteristics, that is, age, disease duration, Mattis Dementia Rating Scale score, levodopa responsiveness, severity of motor fluctuations and dyskinesia, and intraoperative parameters, that is, the number of tracks, distance of typical STN neuronal activity recorded along all microelectrodes, and along the definitive electrodes, were assessed in 40 consecutive PD patients submitted for STN stimulation. Multiple stepwise regression analysis showed that only the number of tracks used for microelectrodes recordings was predictor of the contralateral mSTN effect (F (4,73) = 1.83, P = 0.02). This result suggests that the contralateral mSTN depends on the tissue changes along the entirety of surgical trajectories affecting both STN and its adjacent structures.</abstract>
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