Subthalamus stimulation in Parkinson disease: Accounting for the bilaterality of contacts
Identifieur interne : 000153 ( Main/Exploration ); précédent : 000152; suivant : 000154Subthalamus stimulation in Parkinson disease: Accounting for the bilaterality of contacts
Auteurs : Jean-Jacques Lemaire [France] ; Bruno Pereira [France] ; Philippe Derost [France] ; François Vassal [France] ; Miguel Ulla [France] ; Dominique Morand [France] ; Guillaume Coll [France] ; Jean Gabrillargues [France] ; Ana Marques [France] ; Bérangère Debilly [France] ; Jérôme Coste [France] ; Franck Durif [France]Source :
- Surgical Neurology International [ 2229-5097 ] ; 2016.
Abstract
Deep brain stimulation (DBS) in Parkinson's disease uses bi-hemispheric high-frequency stimulation within the subthalamus, however, the specific impacts of bilaterality of DBS are still not clear. Thus, we aimed to study the individual-level clinical impact of locations of right-left contact pair-up accounting for each subthalamic nucleus (STN) anatomy.
Contact locations and effects at 1 year were studied retrospectively in an unselected series of 53 patients operated between 2004 and 2010. Location of contacts was defined relatively to the main axis of STN used to map longitudinal and transversal positions, and STN membership (out meaning out-of-STN). Contact pairings were described via three methods: (i) Unified contact location (UCL) collapsing DBS into an all-in-one contact; (ii) balance of contact pair-up (BCPU), defined as symmetric or asymmetric regardless of laterality; (iii) hemisphere-wise most frequent contact pair-up (MFCP) regardless of BCPU. Clinical data were: mean levodopa equivalent dose, Unified Parkinson's Disease Rating Scale (UPDRS) motor score III without medication, UPDRS II and III speech sub-scores, UPDRS II freezing sub-score, 1 year versus preoperative values, with and without levodopa. Ad-hoc two-sided tests were used for statistical analysis.
Worsening speech, was more frequent for UCL_out patients and when the left MFCP contact was rear and/or superolateral, however, it less frequent for BCPU-asymmetric patients. Worsening freezing was more frequent when the right MFCP contact was rear and superolateral.
These results point to strategies for minimizing dysarthria and freezing as adverse effects of DBS.
Url:
DOI: 10.4103/2152-7806.194066
PubMed: 27990316
PubMed Central: 5134117
Affiliations:
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<affiliation wicri:level="3"><nlm:aff id="aff4">Service of Neurology, Gabriel Montpied Hospital, University Hospital of Clermont-Ferrand, Clermont-Ferrand, France</nlm:aff>
<country xml:lang="fr">France</country>
<wicri:regionArea>Service of Neurology, Gabriel Montpied Hospital, University Hospital of Clermont-Ferrand, Clermont-Ferrand</wicri:regionArea>
<placeName><region type="region">Auvergne-Rhône-Alpes</region>
<region type="old region">Auvergne (région administrative)</region>
<settlement type="city">Clermont-Ferrand</settlement>
</placeName>
</affiliation>
</author>
<author><name sortKey="Debilly, Berangere" sort="Debilly, Berangere" uniqKey="Debilly B" first="Bérangère" last="Debilly">Bérangère Debilly</name>
<affiliation wicri:level="3"><nlm:aff id="aff4">Service of Neurology, Gabriel Montpied Hospital, University Hospital of Clermont-Ferrand, Clermont-Ferrand, France</nlm:aff>
<country xml:lang="fr">France</country>
<wicri:regionArea>Service of Neurology, Gabriel Montpied Hospital, University Hospital of Clermont-Ferrand, Clermont-Ferrand</wicri:regionArea>
<placeName><region type="region">Auvergne-Rhône-Alpes</region>
<region type="old region">Auvergne (région administrative)</region>
<settlement type="city">Clermont-Ferrand</settlement>
</placeName>
</affiliation>
</author>
<author><name sortKey="Coste, Jerome" sort="Coste, Jerome" uniqKey="Coste J" first="Jérôme" last="Coste">Jérôme Coste</name>
<affiliation wicri:level="3"><nlm:aff id="aff1">Service of Neurosurgery, Gabriel Montpied Hospital, University Hospital of Clermont-Ferrand, Clermont-Ferrand, France</nlm:aff>
<country xml:lang="fr">France</country>
<wicri:regionArea>Service of Neurosurgery, Gabriel Montpied Hospital, University Hospital of Clermont-Ferrand, Clermont-Ferrand</wicri:regionArea>
<placeName><region type="region">Auvergne-Rhône-Alpes</region>
<region type="old region">Auvergne (région administrative)</region>
<settlement type="city">Clermont-Ferrand</settlement>
</placeName>
</affiliation>
<affiliation wicri:level="1"><nlm:aff id="aff2">Image-Guided Clinical Neuroscience and Connectomics, Research Team, Auvergne University, Auvergne, France</nlm:aff>
<country xml:lang="fr">France</country>
<wicri:regionArea>Image-Guided Clinical Neuroscience and Connectomics, Research Team, Auvergne University, Auvergne</wicri:regionArea>
<wicri:noRegion>Auvergne</wicri:noRegion>
<wicri:noRegion>Auvergne</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Durif, Franck" sort="Durif, Franck" uniqKey="Durif F" first="Franck" last="Durif">Franck Durif</name>
<affiliation wicri:level="3"><nlm:aff id="aff4">Service of Neurology, Gabriel Montpied Hospital, University Hospital of Clermont-Ferrand, Clermont-Ferrand, France</nlm:aff>
<country xml:lang="fr">France</country>
<wicri:regionArea>Service of Neurology, Gabriel Montpied Hospital, University Hospital of Clermont-Ferrand, Clermont-Ferrand</wicri:regionArea>
<placeName><region type="region">Auvergne-Rhône-Alpes</region>
<region type="old region">Auvergne (région administrative)</region>
<settlement type="city">Clermont-Ferrand</settlement>
</placeName>
</affiliation>
</author>
</analytic>
<series><title level="j">Surgical Neurology International</title>
<idno type="ISSN">2229-5097</idno>
<idno type="eISSN">2152-7806</idno>
<imprint><date when="2016">2016</date>
</imprint>
</series>
</biblStruct>
</sourceDesc>
</fileDesc>
<profileDesc><textClass></textClass>
</profileDesc>
</teiHeader>
<front><div type="abstract" xml:lang="en"><sec id="st1"><title>Background:</title>
<p>Deep brain stimulation (DBS) in Parkinson's disease uses bi-hemispheric high-frequency stimulation within the subthalamus, however, the specific impacts of bilaterality of DBS are still not clear. Thus, we aimed to study the individual-level clinical impact of locations of right-left contact pair-up accounting for each subthalamic nucleus (STN) anatomy.</p>
</sec>
<sec id="st2"><title>Methods:</title>
<p>Contact locations and effects at 1 year were studied retrospectively in an unselected series of 53 patients operated between 2004 and 2010. Location of contacts was defined relatively to the main axis of STN used to map longitudinal and transversal positions, and STN membership (out meaning out-of-STN). Contact pairings were described via three methods: (i) Unified contact location (UCL) collapsing DBS into an all-in-one contact; (ii) balance of contact pair-up (BCPU), defined as symmetric or asymmetric regardless of laterality; (iii) hemisphere-wise most frequent contact pair-up (MFCP) regardless of BCPU. Clinical data were: mean levodopa equivalent dose, Unified Parkinson's Disease Rating Scale (UPDRS) motor score III without medication, UPDRS II and III speech sub-scores, UPDRS II freezing sub-score, 1 year versus preoperative values, with and without levodopa. Ad-hoc two-sided tests were used for statistical analysis.</p>
</sec>
<sec id="st3"><title>Results:</title>
<p>Worsening speech, was more frequent for UCL_out patients and when the left MFCP contact was rear and/or superolateral, however, it less frequent for BCPU-asymmetric patients. Worsening freezing was more frequent when the right MFCP contact was rear and superolateral.</p>
</sec>
<sec id="st4"><title>Conclusions:</title>
<p>These results point to strategies for minimizing dysarthria and freezing as adverse effects of DBS.</p>
</sec>
</div>
</front>
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<author><name sortKey="Karachi, C" uniqKey="Karachi C">C Karachi</name>
</author>
<author><name sortKey="Fernandez Vidal, S" uniqKey="Fernandez Vidal S">S Fernandez-Vidal</name>
</author>
<author><name sortKey="Golmard, Jl" uniqKey="Golmard J">JL Golmard</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Yelnik, J" uniqKey="Yelnik J">J Yelnik</name>
</author>
<author><name sortKey="Bardinet, E" uniqKey="Bardinet E">E Bardinet</name>
</author>
<author><name sortKey="Dormont, D" uniqKey="Dormont D">D Dormont</name>
</author>
<author><name sortKey="Malandain, G" uniqKey="Malandain G">G Malandain</name>
</author>
<author><name sortKey="Ourselin, S" uniqKey="Ourselin S">S Ourselin</name>
</author>
<author><name sortKey="Tande, D" uniqKey="Tande D">D Tandé</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Zonenshayn, M" uniqKey="Zonenshayn M">M Zonenshayn</name>
</author>
<author><name sortKey="Sterio, D" uniqKey="Sterio D">D Sterio</name>
</author>
<author><name sortKey="Kelly, Pj" uniqKey="Kelly P">PJ Kelly</name>
</author>
<author><name sortKey="Rezai, Ar" uniqKey="Rezai A">AR Rezai</name>
</author>
<author><name sortKey="Beric, A" uniqKey="Beric A">A Beric</name>
</author>
</analytic>
</biblStruct>
</listBibl>
</div1>
</back>
</TEI>
<affiliations><list><country><li>France</li>
</country>
<region><li>Auvergne (région administrative)</li>
<li>Auvergne-Rhône-Alpes</li>
</region>
<settlement><li>Clermont-Ferrand</li>
</settlement>
</list>
<tree><country name="France"><region name="Auvergne-Rhône-Alpes"><name sortKey="Lemaire, Jean Jacques" sort="Lemaire, Jean Jacques" uniqKey="Lemaire J" first="Jean-Jacques" last="Lemaire">Jean-Jacques Lemaire</name>
</region>
<name sortKey="Coll, Guillaume" sort="Coll, Guillaume" uniqKey="Coll G" first="Guillaume" last="Coll">Guillaume Coll</name>
<name sortKey="Coll, Guillaume" sort="Coll, Guillaume" uniqKey="Coll G" first="Guillaume" last="Coll">Guillaume Coll</name>
<name sortKey="Coste, Jerome" sort="Coste, Jerome" uniqKey="Coste J" first="Jérôme" last="Coste">Jérôme Coste</name>
<name sortKey="Coste, Jerome" sort="Coste, Jerome" uniqKey="Coste J" first="Jérôme" last="Coste">Jérôme Coste</name>
<name sortKey="Debilly, Berangere" sort="Debilly, Berangere" uniqKey="Debilly B" first="Bérangère" last="Debilly">Bérangère Debilly</name>
<name sortKey="Derost, Philippe" sort="Derost, Philippe" uniqKey="Derost P" first="Philippe" last="Derost">Philippe Derost</name>
<name sortKey="Durif, Franck" sort="Durif, Franck" uniqKey="Durif F" first="Franck" last="Durif">Franck Durif</name>
<name sortKey="Gabrillargues, Jean" sort="Gabrillargues, Jean" uniqKey="Gabrillargues J" first="Jean" last="Gabrillargues">Jean Gabrillargues</name>
<name sortKey="Gabrillargues, Jean" sort="Gabrillargues, Jean" uniqKey="Gabrillargues J" first="Jean" last="Gabrillargues">Jean Gabrillargues</name>
<name sortKey="Lemaire, Jean Jacques" sort="Lemaire, Jean Jacques" uniqKey="Lemaire J" first="Jean-Jacques" last="Lemaire">Jean-Jacques Lemaire</name>
<name sortKey="Marques, Ana" sort="Marques, Ana" uniqKey="Marques A" first="Ana" last="Marques">Ana Marques</name>
<name sortKey="Morand, Dominique" sort="Morand, Dominique" uniqKey="Morand D" first="Dominique" last="Morand">Dominique Morand</name>
<name sortKey="Pereira, Bruno" sort="Pereira, Bruno" uniqKey="Pereira B" first="Bruno" last="Pereira">Bruno Pereira</name>
<name sortKey="Pereira, Bruno" sort="Pereira, Bruno" uniqKey="Pereira B" first="Bruno" last="Pereira">Bruno Pereira</name>
<name sortKey="Ulla, Miguel" sort="Ulla, Miguel" uniqKey="Ulla M" first="Miguel" last="Ulla">Miguel Ulla</name>
<name sortKey="Vassal, Francois" sort="Vassal, Francois" uniqKey="Vassal F" first="François" last="Vassal">François Vassal</name>
</country>
</tree>
</affiliations>
</record>
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