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Statistical determination of the optimal subthalamic nucleus stimulation site in patients with Parkinson disease.

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Statistical determination of the optimal subthalamic nucleus stimulation site in patients with Parkinson disease.

Auteurs : Dominique Guehl [France] ; Roderick Edwards ; Emmanuel Cuny ; Pierre Burbaud ; Alain Rougier ; Julien Modolo ; Anne Beuter

Source :

Journal of neurosurgery [ 0022-3085 ] ; 2007.

RBID : pubmed:17236495

English descriptors

KwdEn :
- Aged, Algorithms, Cohort Studies, Deep Brain Stimulation (adverse effects), Electrodes, Implanted, Female, Humans, Male, Models, Statistical, Parkinson Disease (therapy), Retrospective Studies, Subthalamic Nucleus, Treatment Outcome.
MESH :
- adverse effects : Deep Brain Stimulation.
- therapy : Parkinson Disease.
- Aged, Algorithms, Cohort Studies, Electrodes, Implanted, Female, Humans, Male, Models, Statistical, Retrospective Studies, Subthalamic Nucleus, Treatment Outcome.

Abstract

The subthalamic nucleus (STN) is currently recognized as the preferred target for deep brain stimulation (DBS) in patients with Parkinson disease (PD). If there is agreement in the literature that DBS improves motor symptoms significantly, the situation is less clear with respect to the side effects of this procedure. The goal of this study was to correlate the coordinate values of active electrode contacts with the amplitude of residual clinical symptoms and side effects using a mathematical approach.

DOI: 10.3171/jns.2007.106.1.101
PubMed: 17236495

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Le document en format XML

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<author><name sortKey="Guehl, Dominique" sort="Guehl, Dominique" uniqKey="Guehl D" first="Dominique" last="Guehl">Dominique Guehl</name>
<affiliation wicri:level="1"><nlm:affiliation>Service de Neurophysiologie Clinique, Hôpital Pellegrin, Université de Bordeaux, France.</nlm:affiliation>
<country xml:lang="fr">France</country>
<wicri:regionArea>Service de Neurophysiologie Clinique, Hôpital Pellegrin, Université de Bordeaux</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Edwards, Roderick" sort="Edwards, Roderick" uniqKey="Edwards R" first="Roderick" last="Edwards">Roderick Edwards</name>
</author>
<author><name sortKey="Cuny, Emmanuel" sort="Cuny, Emmanuel" uniqKey="Cuny E" first="Emmanuel" last="Cuny">Emmanuel Cuny</name>
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<author><name sortKey="Burbaud, Pierre" sort="Burbaud, Pierre" uniqKey="Burbaud P" first="Pierre" last="Burbaud">Pierre Burbaud</name>
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<author><name sortKey="Rougier, Alain" sort="Rougier, Alain" uniqKey="Rougier A" first="Alain" last="Rougier">Alain Rougier</name>
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<author><name sortKey="Modolo, Julien" sort="Modolo, Julien" uniqKey="Modolo J" first="Julien" last="Modolo">Julien Modolo</name>
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<author><name sortKey="Beuter, Anne" sort="Beuter, Anne" uniqKey="Beuter A" first="Anne" last="Beuter">Anne Beuter</name>
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<affiliation wicri:level="1"><nlm:affiliation>Service de Neurophysiologie Clinique, Hôpital Pellegrin, Université de Bordeaux, France.</nlm:affiliation>
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<author><name sortKey="Edwards, Roderick" sort="Edwards, Roderick" uniqKey="Edwards R" first="Roderick" last="Edwards">Roderick Edwards</name>
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<author><name sortKey="Cuny, Emmanuel" sort="Cuny, Emmanuel" uniqKey="Cuny E" first="Emmanuel" last="Cuny">Emmanuel Cuny</name>
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<author><name sortKey="Burbaud, Pierre" sort="Burbaud, Pierre" uniqKey="Burbaud P" first="Pierre" last="Burbaud">Pierre Burbaud</name>
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<author><name sortKey="Rougier, Alain" sort="Rougier, Alain" uniqKey="Rougier A" first="Alain" last="Rougier">Alain Rougier</name>
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<author><name sortKey="Modolo, Julien" sort="Modolo, Julien" uniqKey="Modolo J" first="Julien" last="Modolo">Julien Modolo</name>
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<author><name sortKey="Beuter, Anne" sort="Beuter, Anne" uniqKey="Beuter A" first="Anne" last="Beuter">Anne Beuter</name>
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<series><title level="j">Journal of neurosurgery</title>
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<term>Algorithms</term>
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<term>Electrodes, Implanted</term>
<term>Female</term>
<term>Humans</term>
<term>Male</term>
<term>Models, Statistical</term>
<term>Parkinson Disease (therapy)</term>
<term>Retrospective Studies</term>
<term>Subthalamic Nucleus</term>
<term>Treatment Outcome</term>
</keywords>
<keywords scheme="MESH" qualifier="adverse effects" xml:lang="en"><term>Deep Brain Stimulation</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>Algorithms</term>
<term>Cohort Studies</term>
<term>Electrodes, Implanted</term>
<term>Female</term>
<term>Humans</term>
<term>Male</term>
<term>Models, Statistical</term>
<term>Retrospective Studies</term>
<term>Subthalamic Nucleus</term>
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<front><div type="abstract" xml:lang="en">The subthalamic nucleus (STN) is currently recognized as the preferred target for deep brain stimulation (DBS) in patients with Parkinson disease (PD). If there is agreement in the literature that DBS improves motor symptoms significantly, the situation is less clear with respect to the side effects of this procedure. The goal of this study was to correlate the coordinate values of active electrode contacts with the amplitude of residual clinical symptoms and side effects using a mathematical approach.</div>
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<pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">17236495</PMID>
<DateCreated><Year>2007</Year>
<Month>01</Month>
<Day>22</Day>
</DateCreated>
<DateCompleted><Year>2007</Year>
<Month>02</Month>
<Day>08</Day>
</DateCompleted>
<DateRevised><Year>2008</Year>
<Month>03</Month>
<Day>28</Day>
</DateRevised>
<Article PubModel="Print"><Journal><ISSN IssnType="Print">0022-3085</ISSN>
<JournalIssue CitedMedium="Print"><Volume>106</Volume>
<Issue>1</Issue>
<PubDate><Year>2007</Year>
<Month>Jan</Month>
</PubDate>
</JournalIssue>
<Title>Journal of neurosurgery</Title>
<ISOAbbreviation>J. Neurosurg.</ISOAbbreviation>
</Journal>
<ArticleTitle>Statistical determination of the optimal subthalamic nucleus stimulation site in patients with Parkinson disease.</ArticleTitle>
<Pagination><MedlinePgn>101-10</MedlinePgn>
</Pagination>
<Abstract><AbstractText Label="OBJECT" NlmCategory="OBJECTIVE">The subthalamic nucleus (STN) is currently recognized as the preferred target for deep brain stimulation (DBS) in patients with Parkinson disease (PD). If there is agreement in the literature that DBS improves motor symptoms significantly, the situation is less clear with respect to the side effects of this procedure. The goal of this study was to correlate the coordinate values of active electrode contacts with the amplitude of residual clinical symptoms and side effects using a mathematical approach.</AbstractText>
<AbstractText Label="METHODS" NlmCategory="METHODS">In this study the investigators examined a cohort of 41 patients with PD who received clinical benefits from DBS after stimulating electrodes had been implanted bilaterally into the STN. The combined scores of residual clinical symptoms plus side effects, including speech disturbance, postural instability, and weight gain, were fitted by using either inverted ellipsoidal exponefitials or smooth splines. These analyses showed evidence of lower combined scores for stimulating contacts at an x coordinate approximately 12.0 to 12.3 mm lateral to the anterior commissure-posterior commissure (AC-PC) line and at a z coordinate approximately 3.1 to 3.3 mm under the AC-PC line. There was insufficient evidence for a preferred y coordinate location.</AbstractText>
<AbstractText Label="CONCLUSIONS" NlmCategory="CONCLUSIONS">The authors propose a "best" therapeutic ellipse area that is centered at an x, z location of 12.5 mm, -3.3 mm and characterized by an extension of 1.85 mm in the x direction and 2.22 mm in the z direction. Therapeutic electrode contacts located within this area are well correlated with the lowest occurrence of residual symptoms and the lowest occurrence of side effects independent of STN anatomical considerations. The lack of a significant result in the y direction remains to be explored further.</AbstractText>
</Abstract>
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<ForeName>Dominique</ForeName>
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<AffiliationInfo><Affiliation>Service de Neurophysiologie Clinique, Hôpital Pellegrin, Université de Bordeaux, France.</Affiliation>
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<CommentsCorrectionsList><CommentsCorrections RefType="CommentIn"><RefSource>J Neurosurg. 2008 Feb;108(2):425-8; author reply 428-9</RefSource>
<PMID Version="1">18240947</PMID>
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<CommentsCorrections RefType="CommentIn"><RefSource>J Neurosurg. 2007 Jan;106(1):99-100</RefSource>
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<MeshHeadingList><MeshHeading><DescriptorName UI="D000368" MajorTopicYN="N">Aged</DescriptorName>
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<MeshHeading><DescriptorName UI="D015331" MajorTopicYN="N">Cohort Studies</DescriptorName>
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<MeshHeading><DescriptorName UI="D046690" MajorTopicYN="Y">Deep Brain Stimulation</DescriptorName>
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<MeshHeading><DescriptorName UI="D004567" MajorTopicYN="Y">Electrodes, Implanted</DescriptorName>
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<MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName>
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<MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName>
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<MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D015233" MajorTopicYN="Y">Models, Statistical</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D010300" MajorTopicYN="N">Parkinson Disease</DescriptorName>
<QualifierName UI="Q000628" MajorTopicYN="Y">therapy</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D012189" MajorTopicYN="N">Retrospective Studies</DescriptorName>
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<MeshHeading><DescriptorName UI="D020531" MajorTopicYN="Y">Subthalamic Nucleus</DescriptorName>
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<MeshHeading><DescriptorName UI="D016896" MajorTopicYN="N">Treatment Outcome</DescriptorName>
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Statistical determination of the optimal subthalamic nucleus stimulation site in patients with Parkinson disease.

Statistical determination of the optimal subthalamic nucleus stimulation site in patients with Parkinson disease.

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English descriptors

Abstract

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