Improvement in Parkinson disease by subthalamic nucleus stimulation based on electrode placement: effects of reimplantation.
Identifieur interne : 000859 ( Ncbi/Merge ); précédent : 000858; suivant : 000860Improvement in Parkinson disease by subthalamic nucleus stimulation based on electrode placement: effects of reimplantation.
Auteurs : Mathieu Anheim [France] ; Alina Batir ; Valérie Fraix ; Madjid Silem ; Stéphan Chabardès ; Eric Seigneuret ; Paul Krack ; Alim-Louis Benabid ; Pierre PollakSource :
- Archives of neurology [ 1538-3687 ] ; 2008.
English descriptors
- KwdEn :
- Aged, Basal Ganglia (physiopathology), Deep Brain Stimulation (instrumentation), Deep Brain Stimulation (methods), Electrodes, Implanted, Female, Follow-Up Studies, Humans, Male, Microelectrodes (standards), Middle Aged, Neural Pathways (physiopathology), Neuronavigation (methods), Neuronavigation (standards), Parkinson Disease (therapy), Postoperative Complications (etiology), Postoperative Complications (physiopathology), Postoperative Complications (prevention & control), Prospective Studies, Recovery of Function (physiology), Reoperation, Stereotaxic Techniques (instrumentation), Stereotaxic Techniques (standards), Subthalamic Nucleus (physiology), Subthalamic Nucleus (surgery), Treatment Outcome.
- MESH :
- etiology : Postoperative Complications.
- instrumentation : Deep Brain Stimulation, Stereotaxic Techniques.
- methods : Deep Brain Stimulation, Neuronavigation.
- physiology : Recovery of Function, Subthalamic Nucleus.
- physiopathology : Basal Ganglia, Neural Pathways, Postoperative Complications.
- prevention & control : Postoperative Complications.
- standards : Microelectrodes, Neuronavigation, Stereotaxic Techniques.
- surgery : Subthalamic Nucleus.
- therapy : Parkinson Disease.
- Aged, Electrodes, Implanted, Female, Follow-Up Studies, Humans, Male, Middle Aged, Prospective Studies, Reoperation, Treatment Outcome.
Abstract
The misplacement of electrodes is a possible explanation for suboptimal response to bilateral subthalamic nucleus (STN) stimulation in patients with Parkinson disease.
DOI: 10.1001/archneur.65.5.612
PubMed: 18474736
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Michallon, Grenoble, France. anheim@titus.u-strasbg.fr</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Department of Neurology, University Hospital A. Michallon, Grenoble</wicri:regionArea><placeName><region type="region">Auvergne-Rhône-Alpes</region><region type="old region">Rhône-Alpes</region><settlement type="city">Grenoble</settlement></placeName></affiliation></author><author><name sortKey="Batir, Alina" sort="Batir, Alina" uniqKey="Batir A" first="Alina" last="Batir">Alina Batir</name></author><author><name sortKey="Fraix, Valerie" sort="Fraix, Valerie" uniqKey="Fraix V" first="Valérie" last="Fraix">Valérie Fraix</name></author><author><name sortKey="Silem, Madjid" sort="Silem, Madjid" uniqKey="Silem M" first="Madjid" last="Silem">Madjid Silem</name></author><author><name sortKey="Chabardes, Stephan" sort="Chabardes, Stephan" uniqKey="Chabardes S" first="Stéphan" last="Chabardès">Stéphan Chabardès</name></author><author><name sortKey="Seigneuret, Eric" sort="Seigneuret, Eric" uniqKey="Seigneuret E" first="Eric" last="Seigneuret">Eric Seigneuret</name></author><author><name sortKey="Krack, Paul" sort="Krack, Paul" uniqKey="Krack P" first="Paul" last="Krack">Paul Krack</name></author><author><name sortKey="Benabid, Alim Louis" sort="Benabid, Alim Louis" uniqKey="Benabid A" first="Alim-Louis" last="Benabid">Alim-Louis Benabid</name></author><author><name sortKey="Pollak, Pierre" sort="Pollak, Pierre" uniqKey="Pollak P" first="Pierre" last="Pollak">Pierre Pollak</name></author></analytic><series><title level="j">Archives of neurology</title><idno type="eISSN">1538-3687</idno><imprint><date when="2008" type="published">2008</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Aged</term><term>Basal Ganglia (physiopathology)</term><term>Deep Brain Stimulation (instrumentation)</term><term>Deep Brain Stimulation (methods)</term><term>Electrodes, Implanted</term><term>Female</term><term>Follow-Up Studies</term><term>Humans</term><term>Male</term><term>Microelectrodes (standards)</term><term>Middle Aged</term><term>Neural Pathways (physiopathology)</term><term>Neuronavigation (methods)</term><term>Neuronavigation (standards)</term><term>Parkinson Disease (therapy)</term><term>Postoperative Complications (etiology)</term><term>Postoperative Complications (physiopathology)</term><term>Postoperative Complications (prevention & control)</term><term>Prospective Studies</term><term>Recovery of Function (physiology)</term><term>Reoperation</term><term>Stereotaxic Techniques (instrumentation)</term><term>Stereotaxic Techniques (standards)</term><term>Subthalamic Nucleus (physiology)</term><term>Subthalamic Nucleus (surgery)</term><term>Treatment Outcome</term></keywords><keywords scheme="MESH" qualifier="etiology" xml:lang="en"><term>Postoperative Complications</term></keywords><keywords scheme="MESH" qualifier="instrumentation" xml:lang="en"><term>Deep Brain Stimulation</term><term>Stereotaxic Techniques</term></keywords><keywords scheme="MESH" qualifier="methods" xml:lang="en"><term>Deep Brain Stimulation</term><term>Neuronavigation</term></keywords><keywords scheme="MESH" qualifier="physiology" xml:lang="en"><term>Recovery of Function</term><term>Subthalamic Nucleus</term></keywords><keywords scheme="MESH" qualifier="physiopathology" xml:lang="en"><term>Basal Ganglia</term><term>Neural Pathways</term><term>Postoperative Complications</term></keywords><keywords scheme="MESH" qualifier="prevention & control" xml:lang="en"><term>Postoperative Complications</term></keywords><keywords scheme="MESH" qualifier="standards" xml:lang="en"><term>Microelectrodes</term><term>Neuronavigation</term><term>Stereotaxic Techniques</term></keywords><keywords scheme="MESH" qualifier="surgery" xml:lang="en"><term>Subthalamic Nucleus</term></keywords><keywords scheme="MESH" qualifier="therapy" xml:lang="en"><term>Parkinson Disease</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Aged</term><term>Electrodes, Implanted</term><term>Female</term><term>Follow-Up Studies</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>Prospective Studies</term><term>Reoperation</term><term>Treatment Outcome</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">The misplacement of electrodes is a possible explanation for suboptimal response to bilateral subthalamic nucleus (STN) stimulation in patients with Parkinson disease.</div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">18474736</PMID><DateCreated><Year>2008</Year><Month>05</Month><Day>13</Day></DateCreated><DateCompleted><Year>2008</Year><Month>07</Month><Day>15</Day></DateCompleted><DateRevised><Year>2008</Year><Month>05</Month><Day>13</Day></DateRevised><Article PubModel="Print"><Journal><ISSN IssnType="Electronic">1538-3687</ISSN><JournalIssue CitedMedium="Internet"><Volume>65</Volume><Issue>5</Issue><PubDate><Year>2008</Year><Month>May</Month></PubDate></JournalIssue><Title>Archives of neurology</Title><ISOAbbreviation>Arch. Neurol.</ISOAbbreviation></Journal><ArticleTitle>Improvement in Parkinson disease by subthalamic nucleus stimulation based on electrode placement: effects of reimplantation.</ArticleTitle><Pagination><MedlinePgn>612-6</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1001/archneur.65.5.612</ELocationID><Abstract><AbstractText Label="BACKGROUND" NlmCategory="BACKGROUND">The misplacement of electrodes is a possible explanation for suboptimal response to bilateral subthalamic nucleus (STN) stimulation in patients with Parkinson disease.</AbstractText><AbstractText Label="OBJECTIVE" NlmCategory="OBJECTIVE">To evaluate whether reimplantation of electrodes in the STN can produce improvement in patients with poor results from surgery and with suspected electrode misplacement based on imaging findings.</AbstractText><AbstractText Label="DESIGN" NlmCategory="METHODS">Prospective follow-up study.</AbstractText><AbstractText Label="SETTING" NlmCategory="METHODS">Academic research.</AbstractText><AbstractText Label="PATIENTS" NlmCategory="METHODS">A 1-year postoperative study was undertaken in 7 consecutive patients with Parkinson disease who, despite bilateral STN stimulation, experienced persistent motor disability and who were operated on for reimplantation a median of 16.9 months later.</AbstractText><AbstractText Label="MAIN OUTCOME MEASURES" NlmCategory="METHODS">The primary outcome was measured as the change in the Unified Parkinson Disease Rating Scale (UPDRS) motor score 1 year after reimplantation. The secondary outcome was measured as the extent of pharmacologic and electrical treatments required and the threshold at which the first stimulation-induced adverse effect appeared. The distances between the electrode contacts used for chronic stimulation and the STN theoretical effective target, defined as the mean position of the clinically efficient contact from 193 previously implanted electrodes, were compared.</AbstractText><AbstractText Label="RESULTS" NlmCategory="RESULTS">Except for a single patient, all patients displayed improvement following reimplantation. Under off-medication (ie, the patient is taking no medication) condition, STN stimulation improved the basal state UPDRS motor score by 26.7% before reimplantation and by 59.4% at 1 year after reimplantation. The median off-medication Schwab and England score improved from 51% to 76%. The median levodopa equivalent daily dose was reduced from 1202 mg to 534 mg. The stimulation varibles changed from a mean of 2.6 V/73.0 micros/163.0 Hz to 2.8 V/60. 0 micros/ 140.0 Hz. The mean threshold of the first stimulation-induced adverse effect increased from 2.6 to 4.4 V. The mean distance between the contacts used for chronic stimulation and the theoretical effective target decreased from 5.4 to 2.0 mm. This distance correlated inversely with the percentage improvement in theUPDRS motor score.</AbstractText><AbstractText Label="CONCLUSION" NlmCategory="CONCLUSIONS">Patients demonstrating poor response to STN stimulation as a result of electrode misplacement can benefit from reimplantation in the STN closer to the theoretical target.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Anheim</LastName><ForeName>Mathieu</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Department of Neurology, University Hospital A. Michallon, Grenoble, France. anheim@titus.u-strasbg.fr</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Batir</LastName><ForeName>Alina</ForeName><Initials>A</Initials></Author><Author ValidYN="Y"><LastName>Fraix</LastName><ForeName>Valérie</ForeName><Initials>V</Initials></Author><Author ValidYN="Y"><LastName>Silem</LastName><ForeName>Madjid</ForeName><Initials>M</Initials></Author><Author ValidYN="Y"><LastName>Chabardès</LastName><ForeName>Stéphan</ForeName><Initials>S</Initials></Author><Author ValidYN="Y"><LastName>Seigneuret</LastName><ForeName>Eric</ForeName><Initials>E</Initials></Author><Author ValidYN="Y"><LastName>Krack</LastName><ForeName>Paul</ForeName><Initials>P</Initials></Author><Author ValidYN="Y"><LastName>Benabid</LastName><ForeName>Alim-Louis</ForeName><Initials>AL</Initials></Author><Author ValidYN="Y"><LastName>Pollak</LastName><ForeName>Pierre</ForeName><Initials>P</Initials></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList></Article><MedlineJournalInfo><Country>United States</Country><MedlineTA>Arch Neurol</MedlineTA><NlmUniqueID>0372436</NlmUniqueID><ISSNLinking>0003-9942</ISSNLinking></MedlineJournalInfo><CitationSubset>AIM</CitationSubset><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D000368" MajorTopicYN="N">Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D001479" MajorTopicYN="N">Basal Ganglia</DescriptorName><QualifierName UI="Q000503" MajorTopicYN="N">physiopathology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D046690" MajorTopicYN="N">Deep Brain Stimulation</DescriptorName><QualifierName UI="Q000295" MajorTopicYN="Y">instrumentation</QualifierName><QualifierName UI="Q000379" MajorTopicYN="Y">methods</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D004567" MajorTopicYN="N">Electrodes, Implanted</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D005500" MajorTopicYN="N">Follow-Up Studies</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008839" MajorTopicYN="N">Microelectrodes</DescriptorName><QualifierName UI="Q000592" MajorTopicYN="N">standards</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D008875" MajorTopicYN="N">Middle Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D009434" MajorTopicYN="N">Neural Pathways</DescriptorName><QualifierName UI="Q000503" MajorTopicYN="N">physiopathology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D038361" MajorTopicYN="N">Neuronavigation</DescriptorName><QualifierName UI="Q000379" MajorTopicYN="N">methods</QualifierName><QualifierName UI="Q000592" MajorTopicYN="N">standards</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D010300" MajorTopicYN="N">Parkinson Disease</DescriptorName><QualifierName UI="Q000628" MajorTopicYN="Y">therapy</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D011183" MajorTopicYN="N">Postoperative Complications</DescriptorName><QualifierName UI="Q000209" MajorTopicYN="N">etiology</QualifierName><QualifierName UI="Q000503" MajorTopicYN="N">physiopathology</QualifierName><QualifierName UI="Q000517" MajorTopicYN="N">prevention & control</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D011446" MajorTopicYN="N">Prospective Studies</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D020127" MajorTopicYN="N">Recovery of Function</DescriptorName><QualifierName UI="Q000502" MajorTopicYN="N">physiology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D012086" MajorTopicYN="N">Reoperation</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D013238" MajorTopicYN="N">Stereotaxic Techniques</DescriptorName><QualifierName UI="Q000295" MajorTopicYN="N">instrumentation</QualifierName><QualifierName UI="Q000592" MajorTopicYN="N">standards</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D020531" MajorTopicYN="N">Subthalamic Nucleus</DescriptorName><QualifierName UI="Q000502" MajorTopicYN="Y">physiology</QualifierName><QualifierName UI="Q000601" MajorTopicYN="Y">surgery</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D016896" MajorTopicYN="N">Treatment Outcome</DescriptorName></MeshHeading></MeshHeadingList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="pubmed"><Year>2008</Year><Month>5</Month><Day>14</Day><Hour>9</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2008</Year><Month>7</Month><Day>17</Day><Hour>9</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2008</Year><Month>5</Month><Day>14</Day><Hour>9</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">18474736</ArticleId><ArticleId IdType="pii">65/5/612</ArticleId><ArticleId IdType="doi">10.1001/archneur.65.5.612</ArticleId></ArticleIdList></PubmedData></pubmed><affiliations><list><country><li>France</li></country><region><li>Auvergne-Rhône-Alpes</li><li>Rhône-Alpes</li></region><settlement><li>Grenoble</li></settlement></list><tree><noCountry><name sortKey="Batir, Alina" sort="Batir, Alina" uniqKey="Batir A" first="Alina" last="Batir">Alina Batir</name><name sortKey="Benabid, Alim Louis" sort="Benabid, Alim Louis" uniqKey="Benabid A" first="Alim-Louis" last="Benabid">Alim-Louis Benabid</name><name sortKey="Chabardes, Stephan" sort="Chabardes, Stephan" uniqKey="Chabardes S" first="Stéphan" last="Chabardès">Stéphan Chabardès</name><name sortKey="Fraix, Valerie" sort="Fraix, Valerie" uniqKey="Fraix V" first="Valérie" last="Fraix">Valérie Fraix</name><name sortKey="Krack, Paul" sort="Krack, Paul" uniqKey="Krack P" first="Paul" last="Krack">Paul Krack</name><name sortKey="Pollak, Pierre" sort="Pollak, Pierre" uniqKey="Pollak P" first="Pierre" last="Pollak">Pierre Pollak</name><name sortKey="Seigneuret, Eric" sort="Seigneuret, Eric" uniqKey="Seigneuret E" first="Eric" last="Seigneuret">Eric Seigneuret</name><name sortKey="Silem, Madjid" sort="Silem, Madjid" uniqKey="Silem M" first="Madjid" last="Silem">Madjid Silem</name></noCountry><country name="France"><region name="Auvergne-Rhône-Alpes"><name sortKey="Anheim, Mathieu" sort="Anheim, Mathieu" uniqKey="Anheim M" first="Mathieu" last="Anheim">Mathieu 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