Bilateral subthalamic stimulation for Parkinson's disease by using three-dimensional stereotactic magnetic resonance imaging and electrophysiological guidance.
Identifieur interne : 000102 ( Ncbi/Merge ); précédent : 000101; suivant : 000103Bilateral subthalamic stimulation for Parkinson's disease by using three-dimensional stereotactic magnetic resonance imaging and electrophysiological guidance.
Auteurs : B P Bejjani [France] ; D. Dormont ; B. Pidoux ; J. Yelnik ; P. Damier ; I. Arnulf ; A M Bonnet ; C. Marsault ; Yves Agid [France] ; J. Philippon ; P. CornuSource :
- Journal of neurosurgery [ 0022-3085 ] ; 2000.
English descriptors
- KwdEn :
- Aged, Antiparkinson Agents (administration & dosage), Antiparkinson Agents (adverse effects), Antiparkinson Agents (therapeutic use), Dyskinesia, Drug-Induced (prevention & control), Electric Stimulation Therapy (instrumentation), Electric Stimulation Therapy (methods), Electrodes, Implanted, Electroencephalography, Female, Follow-Up Studies, Humans, Levodopa (adverse effects), Magnetic Resonance Imaging, Male, Mesencephalon (pathology), Middle Aged, Monitoring, Intraoperative, Movement, Parkinson Disease (drug therapy), Parkinson Disease (therapy), Patient Care Planning, Radiology, Interventional, Red Nucleus (pathology), Safety, Stereotaxic Techniques, Subthalamic Nucleus (pathology), Tremor (physiopathology), Tremor (therapy).
- MESH :
- chemical , administration & dosage : Antiparkinson Agents.
- chemical , adverse effects : Antiparkinson Agents, Levodopa.
- chemical , therapeutic use : Antiparkinson Agents.
- drug therapy : Parkinson Disease.
- instrumentation : Electric Stimulation Therapy.
- methods : Electric Stimulation Therapy.
- pathology : Mesencephalon, Red Nucleus, Subthalamic Nucleus.
- physiopathology : Tremor.
- prevention & control : Dyskinesia, Drug-Induced.
- therapy : Parkinson Disease, Tremor.
- Aged, Electrodes, Implanted, Electroencephalography, Female, Follow-Up Studies, Humans, Magnetic Resonance Imaging, Male, Middle Aged, Monitoring, Intraoperative, Movement, Patient Care Planning, Radiology, Interventional, Safety, Stereotaxic Techniques.
Abstract
Several methods are used for stereotactically guided implantation of electrodes into the subthalamic nucleus (STN) for continuous high-frequency stimulation in the treatment of Parkinson's disease (PD). The authors present a stereotactic magnetic resonance (MR) method relying on three-dimensional (3D) T1-weighted images for surgical planning and multiplanar T2-weighted images for direct visualization of the STN, coupled with electrophysiological recording and stimulation guidance.
DOI: 10.3171/jns.2000.92.4.0615
PubMed: 10761650
Links toward previous steps (curation, corpus...)
- to stream PubMed, to step Corpus: 001334
- to stream PubMed, to step Curation: 001293
- to stream PubMed, to step Checkpoint: 001293
Links to Exploration step
pubmed:10761650Le document en format XML
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<front><div type="abstract" xml:lang="en">Several methods are used for stereotactically guided implantation of electrodes into the subthalamic nucleus (STN) for continuous high-frequency stimulation in the treatment of Parkinson's disease (PD). The authors present a stereotactic magnetic resonance (MR) method relying on three-dimensional (3D) T1-weighted images for surgical planning and multiplanar T2-weighted images for direct visualization of the STN, coupled with electrophysiological recording and stimulation guidance.</div>
</front>
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<DateCreated><Year>2000</Year>
<Month>04</Month>
<Day>25</Day>
</DateCreated>
<DateCompleted><Year>2000</Year>
<Month>04</Month>
<Day>25</Day>
</DateCompleted>
<DateRevised><Year>2013</Year>
<Month>11</Month>
<Day>21</Day>
</DateRevised>
<Article PubModel="Print"><Journal><ISSN IssnType="Print">0022-3085</ISSN>
<JournalIssue CitedMedium="Print"><Volume>92</Volume>
<Issue>4</Issue>
<PubDate><Year>2000</Year>
<Month>Apr</Month>
</PubDate>
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<Title>Journal of neurosurgery</Title>
<ISOAbbreviation>J. Neurosurg.</ISOAbbreviation>
</Journal>
<ArticleTitle>Bilateral subthalamic stimulation for Parkinson's disease by using three-dimensional stereotactic magnetic resonance imaging and electrophysiological guidance.</ArticleTitle>
<Pagination><MedlinePgn>615-25</MedlinePgn>
</Pagination>
<Abstract><AbstractText Label="OBJECT" NlmCategory="OBJECTIVE">Several methods are used for stereotactically guided implantation of electrodes into the subthalamic nucleus (STN) for continuous high-frequency stimulation in the treatment of Parkinson's disease (PD). The authors present a stereotactic magnetic resonance (MR) method relying on three-dimensional (3D) T1-weighted images for surgical planning and multiplanar T2-weighted images for direct visualization of the STN, coupled with electrophysiological recording and stimulation guidance.</AbstractText>
<AbstractText Label="METHODS" NlmCategory="METHODS">Twelve patients with advanced PD were enrolled in this study of bilateral STN implantation. Both STNs were visible as 3D ovoid biconvex hypointense structures located in the upper mesencephalon. The coordinates of the centers of the STNs were determined with reference to the patient's anterior commissure-posterior commissure line by using a new landmark, the anterior border of the red nucleus. Electrophysiological monitoring through five parallel tracks was performed simultaneously to define the functional target accurately. Microelectrode recording identified high-frequency, spontaneous, movement-related activity and tremor-related cells within the STNs. Acute STN macrostimulation improved contralateral rigidity and akinesia, suppressed tremor when present, and could induce dyskinesias. The central track, which was directed at the predetermined target by using MR imaging, was selected for implantation of 19 of 24 electrodes. No surgical complications were noted.</AbstractText>
<AbstractText Label="CONCLUSIONS" NlmCategory="CONCLUSIONS">At evaluation 6 months after surgery, continuous STN stimulation was shown to have improved parkinsonian motor disability by 64% and 78% in the "off' and "on" medication states, respectively. Antiparkinsonian drug treatment was reduced by 70% in 10 patients and withdrawn in two patients. The severity of levodopa-induced dyskinesias was reduced by 83% and motor fluctuations by 88%. Continuous high-frequency stimulation of the STN applied through electrodes implanted with the aid of 3D MR imaging and electrophysiological guidance is a safe and effective therapy for patients suffering from severe, advanced levodopa-responsive PD.</AbstractText>
</Abstract>
<AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Bejjani</LastName>
<ForeName>B P</ForeName>
<Initials>BP</Initials>
<AffiliationInfo><Affiliation>Centre d'Investigation Clinique, Fédération de Neurologie, INSERM U 289, Service de Neuroradiologie, Groupe Hospitalier Pitié-Salpêtrière, Paris, France.</Affiliation>
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<Author ValidYN="Y"><LastName>Dormont</LastName>
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<Author ValidYN="Y"><LastName>Pidoux</LastName>
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<Initials>I</Initials>
</Author>
<Author ValidYN="Y"><LastName>Bonnet</LastName>
<ForeName>A M</ForeName>
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<Author ValidYN="Y"><LastName>Marsault</LastName>
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<Initials>C</Initials>
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<Author ValidYN="Y"><LastName>Cornu</LastName>
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