Operative techniques and morbidity with subthalamic nucleus deep brain stimulation in 100 consecutive patients with advanced Parkinson’s disease
Identifieur interne : 000090 ( Main/Corpus ); précédent : 000089; suivant : 000091Operative techniques and morbidity with subthalamic nucleus deep brain stimulation in 100 consecutive patients with advanced Parkinson’s disease
Auteurs : R R Goodman ; B. Kim ; S. Mcclelland ; P B Senatus ; L M Winfield ; S L Pullman ; Q. Yu ; B. Ford ; G M MckhannSource :
- Journal of Neurology, Neurosurgery & Psychiatry [ 0022-3050 ] ; 2006-01.
English descriptors
- KwdEn :
- AC, anterior commissure, DBS, deep brain stimulation, ICM, intercommisural midpoint, MER, microelectrode recording, MRI, magnetic resonance imaging, NYPH/CUMC, New York Presbyterian Hospital/Columbia University Medical Center, PC, posterior commissure, PD, Parkinson’s disease, Parkinson disease, STN, subthalamic nucleus, deep brain stimulation, morbidity, subthalamic nucleus, techniques.
Abstract
Objective: Subthalamic nucleus (STN) stimulation for patients with medically refractory Parkinson disease (PD) is expanding. Reported experience has provided some indication of techniques, efficacy, and morbidity, but few centres have reported more than 50 patients. To expand this knowledge, we reviewed our experience with a large series of consecutive patients. Methods: From March 1999 to September 2003, 191 subthalamic stimulator devices (19 unilateral) were implanted in 100 patients with PD at New York Presbyterian Hospital/Columbia University Medical Center. Sixteen patients had undergone a prior surgery for PD (pallidotomy, thalamotomy, or fetal transplant). Microelectrode guided implantations were performed using techniques similar to those described previously. Electrode implantation occurred 1–2 weeks before outpatient pulse generator implantation. Results: Reductions of dyskinesias and off severity/duration were similar to prior published reports. Morbidity included: 7 device infections (3.7%), 1 cerebral infarct, 1 intracerebral haematoma, 1 subdural haematoma, 1 air embolism, 2 wound haematomas requiring drainage (1.0%), 2 skin erosions over implanted hardware (1.0%), 3 periprocedural seizures (1.6%), 6 brain electrode revisions (3.1%), postoperative confusion in 13 patients (6.8%), and 16 battery failures (8.4%). Of the 100 patients, there were no surgical deaths or permanent new neurological deficits. The average hospital stay for all 100 patients was 3.1 days. Conclusion: Subthalamic stimulator implantation in a large consecutive series of patients with PD produced significant clinical improvement without mortality or major neurological morbidity. Morbidity primarily involved device infections and hardware/wound revisions.
Url:
DOI: 10.1136/jnnp.2005.069161
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Mcclelland</name><affiliation><mods:affiliation>Departments of Neurological Surgery and Neurology, Columbia College of Physicians and Surgeons, New York, NY, USA</mods:affiliation></affiliation></author><author><name sortKey="Senatus, P B" sort="Senatus, P B" uniqKey="Senatus P" first="P B" last="Senatus">P B Senatus</name><affiliation><mods:affiliation>Departments of Neurological Surgery and Neurology, Columbia College of Physicians and Surgeons, New York, NY, USA</mods:affiliation></affiliation></author><author><name sortKey="Winfield, L M" sort="Winfield, L M" uniqKey="Winfield L" first="L M" last="Winfield">L M Winfield</name><affiliation><mods:affiliation>Departments of Neurological Surgery and Neurology, Columbia College of Physicians and Surgeons, New York, NY, USA</mods:affiliation></affiliation></author><author><name sortKey="Pullman, S L" sort="Pullman, S L" uniqKey="Pullman S" first="S L" last="Pullman">S L Pullman</name><affiliation><mods:affiliation>Departments of Neurological Surgery and Neurology, Columbia College of Physicians and Surgeons, New York, NY, USA</mods:affiliation></affiliation></author><author><name sortKey="Yu, Q" sort="Yu, Q" uniqKey="Yu Q" first="Q" last="Yu">Q. 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Ford</name><affiliation><mods:affiliation>Departments of Neurological Surgery and Neurology, Columbia College of Physicians and Surgeons, New York, NY, USA</mods:affiliation></affiliation></author><author><name sortKey="Mckhann, G M" sort="Mckhann, G M" uniqKey="Mckhann G" first="G M" last="Mckhann">G M Mckhann</name><affiliation><mods:affiliation>Departments of Neurological Surgery and Neurology, Columbia College of Physicians and Surgeons, New York, NY, USA</mods:affiliation></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">ISTEX</idno><idno type="RBID">ISTEX:6B604D2CEE01F5254DD42B6CFE695E9FBF5B4B7C</idno><date when="2006" year="2006">2006</date><idno type="doi">10.1136/jnnp.2005.069161</idno><idno type="url">https://api.istex.fr/document/6B604D2CEE01F5254DD42B6CFE695E9FBF5B4B7C/fulltext/pdf</idno><idno type="wicri:Area/Main/Corpus">000090</idno></publicationStmt><sourceDesc><biblStruct><analytic><title level="a" type="main" xml:lang="en">Operative techniques and morbidity with subthalamic nucleus deep brain stimulation in 100 consecutive patients with advanced Parkinson’s disease</title><author><name sortKey="Goodman, R R" sort="Goodman, R R" uniqKey="Goodman R" first="R R" last="Goodman">R R Goodman</name><affiliation><mods:affiliation>Departments of Neurological Surgery and Neurology, Columbia College of Physicians and Surgeons, New York, NY, USA</mods:affiliation></affiliation></author><author><name sortKey="Kim, B" sort="Kim, B" uniqKey="Kim B" first="B" last="Kim">B. Kim</name><affiliation><mods:affiliation>Departments of Neurological Surgery and Neurology, Columbia College of Physicians and Surgeons, New York, NY, USA</mods:affiliation></affiliation></author><author><name sortKey="Mcclelland, S" sort="Mcclelland, S" uniqKey="Mcclelland S" first="S" last="Mcclelland">S. Mcclelland</name><affiliation><mods:affiliation>Departments of Neurological Surgery and Neurology, Columbia College of Physicians and Surgeons, New York, NY, USA</mods:affiliation></affiliation></author><author><name sortKey="Senatus, P B" sort="Senatus, P B" uniqKey="Senatus P" first="P B" last="Senatus">P B Senatus</name><affiliation><mods:affiliation>Departments of Neurological Surgery and Neurology, Columbia College of Physicians and Surgeons, New York, NY, USA</mods:affiliation></affiliation></author><author><name sortKey="Winfield, L M" sort="Winfield, L M" uniqKey="Winfield L" first="L M" last="Winfield">L M Winfield</name><affiliation><mods:affiliation>Departments of Neurological Surgery and Neurology, Columbia College of Physicians and Surgeons, New York, NY, USA</mods:affiliation></affiliation></author><author><name sortKey="Pullman, S L" sort="Pullman, S L" uniqKey="Pullman S" first="S L" last="Pullman">S L Pullman</name><affiliation><mods:affiliation>Departments of Neurological Surgery and Neurology, Columbia College of Physicians and Surgeons, New York, NY, USA</mods:affiliation></affiliation></author><author><name sortKey="Yu, Q" sort="Yu, Q" uniqKey="Yu Q" first="Q" last="Yu">Q. Yu</name><affiliation><mods:affiliation>Departments of Neurological Surgery and Neurology, Columbia College of Physicians and Surgeons, New York, NY, USA</mods:affiliation></affiliation></author><author><name sortKey="Ford, B" sort="Ford, B" uniqKey="Ford B" first="B" last="Ford">B. Ford</name><affiliation><mods:affiliation>Departments of Neurological Surgery and Neurology, Columbia College of Physicians and Surgeons, New York, NY, USA</mods:affiliation></affiliation></author><author><name sortKey="Mckhann, G M" sort="Mckhann, G M" uniqKey="Mckhann G" first="G M" last="Mckhann">G M Mckhann</name><affiliation><mods:affiliation>Departments of Neurological Surgery and Neurology, Columbia College of Physicians and Surgeons, New York, NY, USA</mods:affiliation></affiliation></author></analytic><monogr></monogr><series><title level="j">Journal of Neurology, Neurosurgery & Psychiatry</title><title level="j" type="abbrev">J Neurol Neurosurg Psychiatry</title><idno type="ISSN">0022-3050</idno><idno type="eISSN">1468-330X</idno><imprint><publisher>BMJ Publishing Group Ltd</publisher><date type="published" when="2006-01">2006-01</date><biblScope unit="volume">77</biblScope><biblScope unit="issue">1</biblScope><biblScope unit="page" from="12">12</biblScope></imprint><idno type="ISSN">0022-3050</idno></series><idno type="istex">6B604D2CEE01F5254DD42B6CFE695E9FBF5B4B7C</idno><idno type="DOI">10.1136/jnnp.2005.069161</idno><idno type="href">jnnp-77-12.pdf</idno><idno type="PMID">16361585</idno><idno type="local">0770012</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0022-3050</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>AC, anterior commissure</term><term>DBS, deep brain stimulation</term><term>ICM, intercommisural midpoint</term><term>MER, microelectrode recording</term><term>MRI, magnetic resonance imaging</term><term>NYPH/CUMC, New York Presbyterian Hospital/Columbia University Medical Center</term><term>PC, posterior commissure</term><term>PD, Parkinson’s disease</term><term>Parkinson disease</term><term>STN, subthalamic nucleus</term><term>deep brain stimulation</term><term>morbidity</term><term>subthalamic nucleus</term><term>techniques</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Objective: Subthalamic nucleus (STN) stimulation for patients with medically refractory Parkinson disease (PD) is expanding. Reported experience has provided some indication of techniques, efficacy, and morbidity, but few centres have reported more than 50 patients. To expand this knowledge, we reviewed our experience with a large series of consecutive patients. Methods: From March 1999 to September 2003, 191 subthalamic stimulator devices (19 unilateral) were implanted in 100 patients with PD at New York Presbyterian Hospital/Columbia University Medical Center. Sixteen patients had undergone a prior surgery for PD (pallidotomy, thalamotomy, or fetal transplant). Microelectrode guided implantations were performed using techniques similar to those described previously. Electrode implantation occurred 1–2 weeks before outpatient pulse generator implantation. Results: Reductions of dyskinesias and off severity/duration were similar to prior published reports. Morbidity included: 7 device infections (3.7%), 1 cerebral infarct, 1 intracerebral haematoma, 1 subdural haematoma, 1 air embolism, 2 wound haematomas requiring drainage (1.0%), 2 skin erosions over implanted hardware (1.0%), 3 periprocedural seizures (1.6%), 6 brain electrode revisions (3.1%), postoperative confusion in 13 patients (6.8%), and 16 battery failures (8.4%). Of the 100 patients, there were no surgical deaths or permanent new neurological deficits. The average hospital stay for all 100 patients was 3.1 days. Conclusion: Subthalamic stimulator implantation in a large consecutive series of patients with PD produced significant clinical improvement without mortality or major neurological morbidity. Morbidity primarily involved device infections and hardware/wound revisions.</div></front></TEI><istex><corpusName>bmj</corpusName><author><json:item><name>R R Goodman</name><affiliations><json:string>Departments of Neurological Surgery and Neurology, Columbia College of Physicians and Surgeons, New York, NY, USA</json:string></affiliations></json:item><json:item><name>B Kim</name><affiliations><json:string>Departments of Neurological Surgery and Neurology, Columbia College of Physicians and Surgeons, New York, NY, USA</json:string></affiliations></json:item><json:item><name>S McClelland III</name><affiliations><json:string>Departments of Neurological Surgery and Neurology, Columbia College of Physicians and Surgeons, New York, NY, USA</json:string></affiliations></json:item><json:item><name>P B Senatus</name><affiliations><json:string>Departments of Neurological Surgery and Neurology, Columbia College of Physicians and Surgeons, New York, NY, USA</json:string></affiliations></json:item><json:item><name>L M Winfield</name><affiliations><json:string>Departments of Neurological Surgery and Neurology, Columbia College of Physicians and Surgeons, New York, NY, USA</json:string></affiliations></json:item><json:item><name>S L Pullman</name><affiliations><json:string>Departments of Neurological Surgery and Neurology, Columbia College of Physicians and Surgeons, New York, NY, USA</json:string></affiliations></json:item><json:item><name>Q Yu</name><affiliations><json:string>Departments of Neurological Surgery and Neurology, Columbia College of Physicians and Surgeons, New York, NY, USA</json:string></affiliations></json:item><json:item><name>B Ford</name><affiliations><json:string>Departments of Neurological Surgery and Neurology, Columbia College of Physicians and Surgeons, New York, NY, USA</json:string></affiliations></json:item><json:item><name>G M McKhann II</name><affiliations><json:string>Departments of Neurological Surgery and Neurology, Columbia College of Physicians and Surgeons, New York, NY, USA</json:string></affiliations></json:item></author><subject><json:item><lang><json:string>eng</json:string></lang><value>Papers</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>Drugs: CNS (not psychiatric)</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>Epilepsy and seizures</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>Neurological injury</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>Parkinson's disease</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>Stroke</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>Trauma CNS / PNS</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>Trauma</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>Injury</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>AC, anterior commissure</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>DBS, deep brain stimulation</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>ICM, intercommisural midpoint</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>MER, microelectrode recording</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>MRI, magnetic resonance imaging</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>NYPH/CUMC, New York Presbyterian Hospital/Columbia University Medical Center</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>PC, posterior commissure</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>PD, Parkinson’s disease</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>STN, subthalamic nucleus</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>deep brain stimulation</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>subthalamic nucleus</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>Parkinson disease</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>morbidity</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>techniques</value></json:item></subject><language><json:string>eng</json:string></language><abstract>Objective: Subthalamic nucleus (STN) stimulation for patients with medically refractory Parkinson disease (PD) is expanding. Reported experience has provided some indication of techniques, efficacy, and morbidity, but few centres have reported more than 50 patients. To expand this knowledge, we reviewed our experience with a large series of consecutive patients. Methods: From March 1999 to September 2003, 191 subthalamic stimulator devices (19 unilateral) were implanted in 100 patients with PD at New York Presbyterian Hospital/Columbia University Medical Center. Sixteen patients had undergone a prior surgery for PD (pallidotomy, thalamotomy, or fetal transplant). Microelectrode guided implantations were performed using techniques similar to those described previously. Electrode implantation occurred 1–2 weeks before outpatient pulse generator implantation. Results: Reductions of dyskinesias and off severity/duration were similar to prior published reports. Morbidity included: 7 device infections (3.7%), 1 cerebral infarct, 1 intracerebral haematoma, 1 subdural haematoma, 1 air embolism, 2 wound haematomas requiring drainage (1.0%), 2 skin erosions over implanted hardware (1.0%), 3 periprocedural seizures (1.6%), 6 brain electrode revisions (3.1%), postoperative confusion in 13 patients (6.8%), and 16 battery failures (8.4%). Of the 100 patients, there were no surgical deaths or permanent new neurological deficits. The average hospital stay for all 100 patients was 3.1 days. Conclusion: Subthalamic stimulator implantation in a large consecutive series of patients with PD produced significant clinical improvement without mortality or major neurological morbidity. Morbidity primarily involved device infections and hardware/wound revisions.</abstract><qualityIndicators><score>7.367</score><pdfVersion>1.3</pdfVersion><pdfPageSize>612 x 792 pts (letter)</pdfPageSize><refBibsNative>false</refBibsNative><keywordCount>23</keywordCount><abstractCharCount>1766</abstractCharCount><pdfWordCount>4559</pdfWordCount><pdfCharCount>30111</pdfCharCount><pdfPageCount>6</pdfPageCount><abstractWordCount>234</abstractWordCount></qualityIndicators><title>Operative techniques and morbidity with subthalamic nucleus deep brain stimulation in 100 consecutive patients with advanced Parkinson’s disease</title><pmid><json:string>16361585</json:string></pmid><genre><json:string>research-article</json:string></genre><host><volume>77</volume><pages><first>12</first></pages><issn><json:string>0022-3050</json:string></issn><issue>1</issue><genre></genre><language><json:string>unknown</json:string></language><eissn><json:string>1468-330X</json:string></eissn><title>Journal of Neurology, Neurosurgery & Psychiatry</title></host><publicationDate>2006</publicationDate><copyrightDate>2006</copyrightDate><doi><json:string>10.1136/jnnp.2005.069161</json:string></doi><id>6B604D2CEE01F5254DD42B6CFE695E9FBF5B4B7C</id><fulltext><json:item><original>true</original><mimetype>application/pdf</mimetype><extension>pdf</extension><uri>https://api.istex.fr/document/6B604D2CEE01F5254DD42B6CFE695E9FBF5B4B7C/fulltext/pdf</uri></json:item><json:item><original>false</original><mimetype>application/zip</mimetype><extension>zip</extension><uri>https://api.istex.fr/document/6B604D2CEE01F5254DD42B6CFE695E9FBF5B4B7C/fulltext/zip</uri></json:item><istex:fulltextTEI uri="https://api.istex.fr/document/6B604D2CEE01F5254DD42B6CFE695E9FBF5B4B7C/fulltext/tei"><teiHeader><fileDesc><titleStmt><title level="a" type="main" xml:lang="en">Operative techniques and morbidity with subthalamic nucleus deep brain stimulation in 100 consecutive patients with advanced Parkinson’s disease</title><respStmt xml:id="ISTEX-API" resp="Références bibliographiques récupérées via GROBID" name="ISTEX-API (INIST-CNRS)"></respStmt></titleStmt><publicationStmt><authority>ISTEX</authority><publisher>BMJ Publishing Group Ltd</publisher><availability><p>BMJ</p></availability><date>2005-12-16</date></publicationStmt><notesStmt><note>Correspondence to:
Dr R R Goodman
Neurological Institute of New York, Department of Neurological Surgery, 710 West 168th Street, Box 99, New York, NY 10032, USA; rrg2@columbia.edu</note></notesStmt><sourceDesc><biblStruct type="inbook"><analytic><title level="a" type="main" xml:lang="en">Operative techniques and morbidity with subthalamic nucleus deep brain stimulation in 100 consecutive patients with advanced Parkinson’s disease</title><author><persName><forename type="first">R R</forename><surname>Goodman</surname></persName><affiliation>Departments of Neurological Surgery and Neurology, Columbia College of Physicians and Surgeons, New York, NY, USA</affiliation></author><author><persName><forename type="first">B</forename><surname>Kim</surname></persName><affiliation>Departments of Neurological Surgery and Neurology, Columbia College of Physicians and Surgeons, New York, NY, USA</affiliation></author><author><persName><forename type="first">S</forename><surname>McClelland</surname></persName><roleName type="degree">III</roleName><affiliation>Departments of Neurological Surgery and Neurology, Columbia College of Physicians and Surgeons, New York, NY, USA</affiliation></author><author><persName><forename type="first">P B</forename><surname>Senatus</surname></persName><affiliation>Departments of Neurological Surgery and Neurology, Columbia College of Physicians and Surgeons, New York, NY, USA</affiliation></author><author><persName><forename type="first">L M</forename><surname>Winfield</surname></persName><affiliation>Departments of Neurological Surgery and Neurology, Columbia College of Physicians and Surgeons, New York, NY, USA</affiliation></author><author><persName><forename type="first">S L</forename><surname>Pullman</surname></persName><affiliation>Departments of Neurological Surgery and Neurology, Columbia College of Physicians and Surgeons, New York, NY, USA</affiliation></author><author><persName><forename type="first">Q</forename><surname>Yu</surname></persName><affiliation>Departments of Neurological Surgery and Neurology, Columbia College of Physicians and Surgeons, New York, NY, USA</affiliation></author><author><persName><forename type="first">B</forename><surname>Ford</surname></persName><affiliation>Departments of Neurological Surgery and Neurology, Columbia College of Physicians and Surgeons, New York, NY, USA</affiliation></author><author><persName><forename type="first">G M</forename><surname>McKhann</surname></persName><roleName type="degree">II</roleName><affiliation>Departments of Neurological Surgery and Neurology, Columbia College of Physicians and Surgeons, New York, NY, USA</affiliation></author></analytic><monogr><title level="j">Journal of Neurology, Neurosurgery & Psychiatry</title><title level="j" type="abbrev">J Neurol Neurosurg Psychiatry</title><idno type="pISSN">0022-3050</idno><idno type="eISSN">1468-330X</idno><imprint><publisher>BMJ Publishing Group Ltd</publisher><date type="published" when="2006-01"></date><biblScope unit="volume">77</biblScope><biblScope unit="issue">1</biblScope><biblScope unit="page" from="12">12</biblScope></imprint></monogr><idno type="istex">6B604D2CEE01F5254DD42B6CFE695E9FBF5B4B7C</idno><idno type="DOI">10.1136/jnnp.2005.069161</idno><idno type="href">jnnp-77-12.pdf</idno><idno type="PMID">16361585</idno><idno type="local">0770012</idno></biblStruct></sourceDesc></fileDesc><profileDesc><creation><date>2005-12-16</date></creation><langUsage><language ident="en">en</language></langUsage><abstract xml:lang="en"><p>Objective: Subthalamic nucleus (STN) stimulation for patients with medically refractory Parkinson disease (PD) is expanding. Reported experience has provided some indication of techniques, efficacy, and morbidity, but few centres have reported more than 50 patients. To expand this knowledge, we reviewed our experience with a large series of consecutive patients. Methods: From March 1999 to September 2003, 191 subthalamic stimulator devices (19 unilateral) were implanted in 100 patients with PD at New York Presbyterian Hospital/Columbia University Medical Center. Sixteen patients had undergone a prior surgery for PD (pallidotomy, thalamotomy, or fetal transplant). Microelectrode guided implantations were performed using techniques similar to those described previously. Electrode implantation occurred 1–2 weeks before outpatient pulse generator implantation. Results: Reductions of dyskinesias and off severity/duration were similar to prior published reports. Morbidity included: 7 device infections (3.7%), 1 cerebral infarct, 1 intracerebral haematoma, 1 subdural haematoma, 1 air embolism, 2 wound haematomas requiring drainage (1.0%), 2 skin erosions over implanted hardware (1.0%), 3 periprocedural seizures (1.6%), 6 brain electrode revisions (3.1%), postoperative confusion in 13 patients (6.8%), and 16 battery failures (8.4%). Of the 100 patients, there were no surgical deaths or permanent new neurological deficits. The average hospital stay for all 100 patients was 3.1 days. Conclusion: Subthalamic stimulator implantation in a large consecutive series of patients with PD produced significant clinical improvement without mortality or major neurological morbidity. Morbidity primarily involved device infections and hardware/wound revisions.</p></abstract><textClass><keywords scheme="keyword"><list><head>hwp-journal-coll</head><item><term>Drugs: CNS (not psychiatric)</term></item></list></keywords></textClass><textClass><keywords scheme="keyword"><list><head>hwp-journal-coll</head><item><term>Epilepsy and seizures</term></item></list></keywords></textClass><textClass><keywords scheme="keyword"><list><head>hwp-journal-coll</head><item><term>Neurological injury</term></item></list></keywords></textClass><textClass><keywords scheme="keyword"><list><head>hwp-journal-coll</head><item><term>Parkinson's disease</term></item></list></keywords></textClass><textClass><keywords scheme="keyword"><list><head>hwp-journal-coll</head><item><term>Stroke</term></item></list></keywords></textClass><textClass><keywords scheme="keyword"><list><head>hwp-journal-coll</head><item><term>Trauma CNS / PNS</term></item></list></keywords></textClass><textClass><keywords scheme="keyword"><list><head>hwp-journal-coll</head><item><term>Trauma</term></item></list></keywords></textClass><textClass><keywords scheme="keyword"><list><head>hwp-journal-coll</head><item><term>Injury</term></item></list></keywords></textClass><textClass xml:lang="en"><keywords scheme="keyword"><list><head>ABR</head><item><term>AC, anterior commissure</term></item><item><term>DBS, deep brain stimulation</term></item><item><term>ICM, intercommisural midpoint</term></item><item><term>MER, microelectrode recording</term></item><item><term>MRI, magnetic resonance imaging</term></item><item><term>NYPH/CUMC, New York Presbyterian Hospital/Columbia University Medical Center</term></item><item><term>PC, posterior commissure</term></item><item><term>PD, Parkinson’s disease</term></item><item><term>STN, subthalamic nucleus</term></item></list></keywords></textClass><textClass xml:lang="en"><keywords scheme="keyword"><list><head>KWD</head><item><term>deep brain stimulation</term></item><item><term>subthalamic nucleus</term></item><item><term>Parkinson disease</term></item><item><term>morbidity</term></item><item><term>techniques</term></item></list></keywords></textClass></profileDesc><revisionDesc><change when="2005-12-16">Created</change><change when="2006-01">Published</change><change xml:id="refBibs-istex" who="#ISTEX-API" when="2016-3-14">References added</change></revisionDesc></teiHeader></istex:fulltextTEI><json:item><original>false</original><mimetype>text/plain</mimetype><extension>txt</extension><uri>https://api.istex.fr/document/6B604D2CEE01F5254DD42B6CFE695E9FBF5B4B7C/fulltext/txt</uri></json:item></fulltext><metadata><istex:metadataXml wicri:clean="corpus bmj" wicri:toSee="no header"><istex:xmlDeclaration>version="1.0" encoding="UTF-8" standalone="no"</istex:xmlDeclaration><istex:docType PUBLIC="-//NLM//DTD Journal Archiving and Interchange DTD v2.3 20070202//EN" URI="archivearticle.dtd" name="istex:docType"></istex:docType><istex:document><article xml:lang="en" article-type="research-article"><front><journal-meta><journal-id journal-id-type="hwp">jnnp</journal-id><journal-id journal-id-type="nlm-ta">J Neurol Neurosurg Psychiatry</journal-id><journal-title>Journal of Neurology, Neurosurgery & Psychiatry</journal-title><abbrev-journal-title abbrev-type="publisher">J Neurol Neurosurg Psychiatry</abbrev-journal-title><issn pub-type="ppub">0022-3050</issn><issn pub-type="epub">1468-330X</issn><publisher><publisher-name>BMJ Publishing Group Ltd</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="other">0770012</article-id><article-id pub-id-type="doi">10.1136/jnnp.2005.069161</article-id><article-id pub-id-type="other">jnnp;77/1/12</article-id><article-id pub-id-type="pmid">16361585</article-id><article-id pub-id-type="other">12</article-id><article-id pub-id-type="other">jnnp.2005.069161</article-id><article-categories><subj-group subj-group-type="heading"><subject content-type="original">Papers</subject></subj-group><subj-group subj-group-type="hwp-journal-coll"><subject>Drugs: CNS (not psychiatric)</subject></subj-group><subj-group subj-group-type="hwp-journal-coll"><subject>Epilepsy and seizures</subject></subj-group><subj-group subj-group-type="hwp-journal-coll"><subject>Neurological injury</subject></subj-group><subj-group subj-group-type="hwp-journal-coll"><subject>Parkinson's disease</subject></subj-group><subj-group subj-group-type="hwp-journal-coll"><subject>Stroke</subject></subj-group><subj-group subj-group-type="hwp-journal-coll"><subject>Trauma CNS / PNS</subject></subj-group><subj-group subj-group-type="hwp-journal-coll"><subject>Trauma</subject></subj-group><subj-group subj-group-type="hwp-journal-coll"><subject>Injury</subject></subj-group></article-categories><title-group><article-title>Operative techniques and morbidity with subthalamic nucleus deep brain stimulation in 100 consecutive patients with advanced Parkinson’s disease</article-title></title-group><contrib-group><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Goodman</surname><given-names>R R</given-names></name><xref rid="AFF1"></xref></contrib><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Kim</surname><given-names>B</given-names></name><xref rid="AFF1"></xref></contrib><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>McClelland</surname><given-names>S</given-names><suffix>III</suffix></name><xref rid="AFF1"></xref></contrib><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Senatus</surname><given-names>P B</given-names></name><xref rid="AFF1"></xref></contrib><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Winfield</surname><given-names>L M</given-names></name><xref rid="AFF1"></xref></contrib><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Pullman</surname><given-names>S L</given-names></name><xref rid="AFF1"></xref></contrib><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Yu</surname><given-names>Q</given-names></name><xref rid="AFF1"></xref></contrib><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Ford</surname><given-names>B</given-names></name><xref rid="AFF1"></xref></contrib><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>McKhann</surname><given-names>G M</given-names><suffix>II</suffix></name><xref rid="AFF1"></xref></contrib><aff id="AFF1">Departments of Neurological Surgery and Neurology, Columbia College of Physicians and Surgeons, New York, NY, USA</aff></contrib-group><author-notes><corresp>Correspondence to:
Dr R R Goodman
Neurological Institute of New York, Department of Neurological Surgery, 710 West 168th Street, Box 99, New York, NY 10032, USA; <ext-link xlink:href="rrg2@columbia.edu" ext-link-type="email" xlink:type="simple">rrg2@columbia.edu</ext-link></corresp></author-notes><pub-date pub-type="ppub"><month>1</month><year>2006</year></pub-date><pub-date pub-type="epub"><day>16</day><month>12</month><year>2005</year></pub-date><volume>77</volume><volume-id pub-id-type="other">77</volume-id><volume-id pub-id-type="other">77</volume-id><issue>1</issue><issue-id pub-id-type="other">jnnp;77/1</issue-id><issue-id pub-id-type="other">1</issue-id><issue-id pub-id-type="other">77/1</issue-id><fpage>12</fpage><history><date date-type="accepted"><day>27</day><month>06</month><year>2005</year></date><date date-type="received"><day>06</day><month>04</month><year>2005</year></date><date date-type="rev-recd"><day>20</day><month>06</month><year>2005</year></date></history><permissions><copyright-statement>Copyright 2006 Journal of Neurology Neurosurgery and Psychiatry</copyright-statement><copyright-year>2006</copyright-year></permissions><self-uri content-type="pdf" xlink:role="full-text" xlink:href="jnnp-77-12.pdf"></self-uri><abstract xml:lang="en"><p><bold>Objective:</bold> Subthalamic nucleus (STN) stimulation for patients with medically refractory Parkinson disease (PD) is expanding. Reported experience has provided some indication of techniques, efficacy, and morbidity, but few centres have reported more than 50 patients. To expand this knowledge, we reviewed our experience with a large series of consecutive patients.</p><p><bold>Methods:</bold> From March 1999 to September 2003, 191 subthalamic stimulator devices (19 unilateral) were implanted in 100 patients with PD at New York Presbyterian Hospital/Columbia University Medical Center. Sixteen patients had undergone a prior surgery for PD (pallidotomy, thalamotomy, or fetal transplant). Microelectrode guided implantations were performed using techniques similar to those described previously. Electrode implantation occurred 1–2 weeks before outpatient pulse generator implantation.</p><p><bold>Results:</bold> Reductions of dyskinesias and off severity/duration were similar to prior published reports. Morbidity included: 7 device infections (3.7%), 1 cerebral infarct, 1 intracerebral haematoma, 1 subdural haematoma, 1 air embolism, 2 wound haematomas requiring drainage (1.0%), 2 skin erosions over implanted hardware (1.0%), 3 periprocedural seizures (1.6%), 6 brain electrode revisions (3.1%), postoperative confusion in 13 patients (6.8%), and 16 battery failures (8.4%). Of the 100 patients, there were no surgical deaths or permanent new neurological deficits. The average hospital stay for all 100 patients was 3.1 days.</p><p><bold>Conclusion:</bold> Subthalamic stimulator implantation in a large consecutive series of patients with PD produced significant clinical improvement without mortality or major neurological morbidity. Morbidity primarily involved device infections and hardware/wound revisions.</p></abstract><kwd-group kwd-group-type="ABR" xml:lang="en"><kwd>AC, anterior commissure</kwd><kwd>DBS, deep brain stimulation</kwd><kwd>ICM, intercommisural midpoint</kwd><kwd>MER, microelectrode recording</kwd><kwd>MRI, magnetic resonance imaging</kwd><kwd>NYPH/CUMC, New York Presbyterian Hospital/Columbia University Medical Center</kwd><kwd>PC, posterior commissure</kwd><kwd>PD, Parkinson’s disease</kwd><kwd>STN, subthalamic nucleus</kwd></kwd-group><kwd-group kwd-group-type="KWD" xml:lang="en"><kwd>deep brain stimulation</kwd><kwd>subthalamic nucleus</kwd><kwd>Parkinson disease</kwd><kwd>morbidity</kwd><kwd>techniques</kwd></kwd-group></article-meta></front></article></istex:document></istex:metadataXml><mods version="3.6"><titleInfo lang="en"><title>Operative techniques and morbidity with subthalamic nucleus deep brain stimulation in 100 consecutive patients with advanced Parkinson’s disease</title></titleInfo><titleInfo type="alternative" lang="en" contentType="CDATA"><title>Operative techniques and morbidity with subthalamic nucleus deep brain stimulation in 100 consecutive patients with advanced Parkinson’s disease</title></titleInfo><name type="personal"><namePart type="given">R R</namePart><namePart type="family">Goodman</namePart><affiliation>Departments of Neurological Surgery and Neurology, Columbia College of Physicians and Surgeons, New York, NY, USA</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">B</namePart><namePart type="family">Kim</namePart><affiliation>Departments of Neurological Surgery and Neurology, Columbia College of Physicians and Surgeons, New York, NY, USA</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">S</namePart><namePart type="family">McClelland</namePart><namePart type="termsOfAddress">III</namePart><affiliation>Departments of Neurological Surgery and Neurology, Columbia College of Physicians and Surgeons, New York, NY, USA</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">P B</namePart><namePart type="family">Senatus</namePart><affiliation>Departments of Neurological Surgery and Neurology, Columbia College of Physicians and Surgeons, New York, NY, USA</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">L M</namePart><namePart type="family">Winfield</namePart><affiliation>Departments of Neurological Surgery and Neurology, Columbia College of Physicians and Surgeons, New York, NY, USA</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">S L</namePart><namePart type="family">Pullman</namePart><affiliation>Departments of Neurological Surgery and Neurology, Columbia College of Physicians and Surgeons, New York, NY, USA</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Q</namePart><namePart type="family">Yu</namePart><affiliation>Departments of Neurological Surgery and Neurology, Columbia College of Physicians and Surgeons, New York, NY, USA</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">B</namePart><namePart type="family">Ford</namePart><affiliation>Departments of Neurological Surgery and Neurology, Columbia College of Physicians and Surgeons, New York, NY, USA</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">G M</namePart><namePart type="family">McKhann</namePart><namePart type="termsOfAddress">II</namePart><affiliation>Departments of Neurological Surgery and Neurology, Columbia College of Physicians and Surgeons, New York, NY, USA</affiliation><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre type="research-article" displayLabel="research-article"></genre><subject><genre>hwp-journal-coll</genre><topic>Drugs: CNS (not psychiatric)</topic></subject><subject><genre>hwp-journal-coll</genre><topic>Epilepsy and seizures</topic></subject><subject><genre>hwp-journal-coll</genre><topic>Neurological injury</topic></subject><subject><genre>hwp-journal-coll</genre><topic>Parkinson's disease</topic></subject><subject><genre>hwp-journal-coll</genre><topic>Stroke</topic></subject><subject><genre>hwp-journal-coll</genre><topic>Trauma CNS / PNS</topic></subject><subject><genre>hwp-journal-coll</genre><topic>Trauma</topic></subject><subject><genre>hwp-journal-coll</genre><topic>Injury</topic></subject><originInfo><publisher>BMJ Publishing Group Ltd</publisher><dateIssued encoding="w3cdtf">2006-01</dateIssued><dateCreated encoding="w3cdtf">2005-12-16</dateCreated><copyrightDate encoding="w3cdtf">2006</copyrightDate></originInfo><language><languageTerm type="code" authority="iso639-2b">eng</languageTerm><languageTerm type="code" authority="rfc3066">en</languageTerm></language><physicalDescription><internetMediaType>text/html</internetMediaType></physicalDescription><abstract lang="en">Objective: Subthalamic nucleus (STN) stimulation for patients with medically refractory Parkinson disease (PD) is expanding. Reported experience has provided some indication of techniques, efficacy, and morbidity, but few centres have reported more than 50 patients. To expand this knowledge, we reviewed our experience with a large series of consecutive patients. Methods: From March 1999 to September 2003, 191 subthalamic stimulator devices (19 unilateral) were implanted in 100 patients with PD at New York Presbyterian Hospital/Columbia University Medical Center. Sixteen patients had undergone a prior surgery for PD (pallidotomy, thalamotomy, or fetal transplant). Microelectrode guided implantations were performed using techniques similar to those described previously. Electrode implantation occurred 1–2 weeks before outpatient pulse generator implantation. Results: Reductions of dyskinesias and off severity/duration were similar to prior published reports. Morbidity included: 7 device infections (3.7%), 1 cerebral infarct, 1 intracerebral haematoma, 1 subdural haematoma, 1 air embolism, 2 wound haematomas requiring drainage (1.0%), 2 skin erosions over implanted hardware (1.0%), 3 periprocedural seizures (1.6%), 6 brain electrode revisions (3.1%), postoperative confusion in 13 patients (6.8%), and 16 battery failures (8.4%). Of the 100 patients, there were no surgical deaths or permanent new neurological deficits. The average hospital stay for all 100 patients was 3.1 days. Conclusion: Subthalamic stimulator implantation in a large consecutive series of patients with PD produced significant clinical improvement without mortality or major neurological morbidity. Morbidity primarily involved device infections and hardware/wound revisions.</abstract><note type="author-notes">Correspondence to:
Dr R R Goodman
Neurological Institute of New York, Department of Neurological Surgery, 710 West 168th Street, Box 99, New York, NY 10032, USA; rrg2@columbia.edu</note><subject lang="en"><genre>ABR</genre><topic>AC, anterior commissure</topic><topic>DBS, deep brain stimulation</topic><topic>ICM, intercommisural midpoint</topic><topic>MER, microelectrode recording</topic><topic>MRI, magnetic resonance imaging</topic><topic>NYPH/CUMC, New York Presbyterian Hospital/Columbia University Medical Center</topic><topic>PC, posterior commissure</topic><topic>PD, Parkinson’s disease</topic><topic>STN, subthalamic nucleus</topic></subject><subject lang="en"><genre>KWD</genre><topic>deep brain stimulation</topic><topic>subthalamic nucleus</topic><topic>Parkinson disease</topic><topic>morbidity</topic><topic>techniques</topic></subject><relatedItem type="host"><titleInfo><title>Journal of Neurology, Neurosurgery & Psychiatry</title></titleInfo><titleInfo type="abbreviated"><title>J Neurol Neurosurg Psychiatry</title></titleInfo><genre type="Journal">journal</genre><identifier type="ISSN">0022-3050</identifier><identifier type="eISSN">1468-330X</identifier><identifier type="PublisherID-hwp">jnnp</identifier><identifier type="PublisherID-nlm-ta">J Neurol Neurosurg Psychiatry</identifier><part><date>2006</date><detail type="volume"><caption>vol.</caption><number>77</number></detail><detail type="issue"><caption>no.</caption><number>1</number></detail><extent unit="pages"><start>12</start></extent></part></relatedItem><identifier type="istex">6B604D2CEE01F5254DD42B6CFE695E9FBF5B4B7C</identifier><identifier type="DOI">10.1136/jnnp.2005.069161</identifier><identifier type="href">jnnp-77-12.pdf</identifier><identifier type="PMID">16361585</identifier><identifier type="local">0770012</identifier><accessCondition type="use and reproduction" contentType="copyright">Copyright 2006 Journal of Neurology Neurosurgery and Psychiatry</accessCondition><recordInfo><recordContentSource>BMJ</recordContentSource></recordInfo></mods></metadata><annexes><json:item><original>true</original><mimetype>image/jpeg</mimetype><extension>jpeg</extension><uri>https://api.istex.fr/document/6B604D2CEE01F5254DD42B6CFE695E9FBF5B4B7C/annexes/jpeg</uri></json:item></annexes><serie></serie></istex></record>Pour manipuler ce document sous Unix (Dilib)
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