Deep brain stimulation therapy for Parkinson’s disease using frameless stereotaxy: comparison with frame‐based surgery
Identifieur interne : 000844 ( Main/Corpus ); précédent : 000843; suivant : 000845Deep brain stimulation therapy for Parkinson’s disease using frameless stereotaxy: comparison with frame‐based surgery
Auteurs : C. Tai ; R. Wu ; C. Lin ; M. Pan ; Y. Chen ; H. Liu ; H. Lu ; C. Tsai ; S. TsengSource :
- European Journal of Neurology [ 1351-5101 ] ; 2010-11.
English descriptors
Abstract
Background and purpose: Deep brain stimulation (DBS) surgery has been performed using frame‐based stereotaxy traditionally; however, in recent years, it has also been performed using frameless stereotaxy. The purpose of this study was to compare the experience at our centre in performing DBS surgery using frameless surgery for patients with Parkinson’s disease with that of using frame‐based surgery. Methods: Twenty‐four patients with advanced Parkinson’s disease underwent DBS surgery, 12 with frameless and 12 with frame‐based stereotaxy. After identifying the subthalamus by microelectrode recording (MER), the DBS electrodes were implanted and connected to an implanted programmable generator in all patients. Programming was started 1 month after the operation and the outcome of the patients was followed up regularly for at least 12 months. Results: After 1 year of follow‐up, the patients who received frameless surgery showed no difference in the degree of improvement in clinical motor function compared with the patients who received frame‐based surgery (P = 0.819); the average improvement was 60.9% and 56.9%, respectively, in the stimulation alone/medication‐off state, as evaluated by the Unified Parkinson’s Disease Rating Scale‐III motor subscore. However, the frameless group had significantly shorter total MER time (P = 0.0127) and a smaller number of trajectories (P = 0.0096) than the frame‐based group. Conclusions: Our data indicate that frameless DBS surgery has a similar outcome when compared with frame‐based surgery; however, frameless surgery can decrease the operation time, MER time, and MER trajectory number.
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DOI: 10.1111/j.1468-1331.2010.03035.x
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ISTEX:7A76717AF8A21127B9F2CE7CD5BE9C72C79E129ALe document en format XML
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Lin</name><affiliation><mods:affiliation>Department of Neurology</mods:affiliation></affiliation><affiliation><mods:affiliation>Centre for Parkinson and Movement Disorders</mods:affiliation></affiliation></author><author><name sortKey="Pan, M" sort="Pan, M" uniqKey="Pan M" first="M." last="Pan">M. Pan</name><affiliation><mods:affiliation>Department of Neurology</mods:affiliation></affiliation><affiliation><mods:affiliation>Centre for Parkinson and Movement Disorders</mods:affiliation></affiliation></author><author><name sortKey="Chen, Y" sort="Chen, Y" uniqKey="Chen Y" first="Y." last="Chen">Y. Chen</name><affiliation><mods:affiliation>Department of Medical Imaging</mods:affiliation></affiliation></author><author><name sortKey="Liu, H" sort="Liu, H" uniqKey="Liu H" first="H." last="Liu">H. Liu</name><affiliation><mods:affiliation>Department of Medical Imaging</mods:affiliation></affiliation></author><author><name sortKey="Lu, H" sort="Lu, H" uniqKey="Lu H" first="H." last="Lu">H. Lu</name><affiliation><mods:affiliation>Department of Neurology</mods:affiliation></affiliation><affiliation><mods:affiliation>Centre for Parkinson and Movement Disorders</mods:affiliation></affiliation></author><author><name sortKey="Tsai, C" sort="Tsai, C" uniqKey="Tsai C" first="C." last="Tsai">C. Tsai</name><affiliation><mods:affiliation>Department of Neurology</mods:affiliation></affiliation><affiliation><mods:affiliation>Centre for Parkinson and Movement Disorders</mods:affiliation></affiliation></author><author><name sortKey="Tseng, S" sort="Tseng, S" uniqKey="Tseng S" first="S." last="Tseng">S. 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Tai</name><affiliation><mods:affiliation>Department of Neurology</mods:affiliation></affiliation><affiliation><mods:affiliation>Centre for Parkinson and Movement Disorders</mods:affiliation></affiliation></author><author><name sortKey="Wu, R" sort="Wu, R" uniqKey="Wu R" first="R." last="Wu">R. Wu</name><affiliation><mods:affiliation>Department of Neurology</mods:affiliation></affiliation><affiliation><mods:affiliation>Centre for Parkinson and Movement Disorders</mods:affiliation></affiliation></author><author><name sortKey="Lin, C" sort="Lin, C" uniqKey="Lin C" first="C." last="Lin">C. Lin</name><affiliation><mods:affiliation>Department of Neurology</mods:affiliation></affiliation><affiliation><mods:affiliation>Centre for Parkinson and Movement Disorders</mods:affiliation></affiliation></author><author><name sortKey="Pan, M" sort="Pan, M" uniqKey="Pan M" first="M." last="Pan">M. Pan</name><affiliation><mods:affiliation>Department of Neurology</mods:affiliation></affiliation><affiliation><mods:affiliation>Centre for Parkinson and Movement Disorders</mods:affiliation></affiliation></author><author><name sortKey="Chen, Y" sort="Chen, Y" uniqKey="Chen Y" first="Y." last="Chen">Y. Chen</name><affiliation><mods:affiliation>Department of Medical Imaging</mods:affiliation></affiliation></author><author><name sortKey="Liu, H" sort="Liu, H" uniqKey="Liu H" first="H." last="Liu">H. Liu</name><affiliation><mods:affiliation>Department of Medical Imaging</mods:affiliation></affiliation></author><author><name sortKey="Lu, H" sort="Lu, H" uniqKey="Lu H" first="H." last="Lu">H. Lu</name><affiliation><mods:affiliation>Department of Neurology</mods:affiliation></affiliation><affiliation><mods:affiliation>Centre for Parkinson and Movement Disorders</mods:affiliation></affiliation></author><author><name sortKey="Tsai, C" sort="Tsai, C" uniqKey="Tsai C" first="C." last="Tsai">C. Tsai</name><affiliation><mods:affiliation>Department of Neurology</mods:affiliation></affiliation><affiliation><mods:affiliation>Centre for Parkinson and Movement Disorders</mods:affiliation></affiliation></author><author><name sortKey="Tseng, S" sort="Tseng, S" uniqKey="Tseng S" first="S." last="Tseng">S. Tseng</name><affiliation><mods:affiliation>Department of Surgery, University Hospital and College of Medicine, National Taiwan University, Taipei, Taiwan</mods:affiliation></affiliation></author></analytic><monogr></monogr><series><title level="j">European Journal of Neurology</title><idno type="ISSN">1351-5101</idno><idno type="eISSN">1468-1331</idno><imprint><publisher>Blackwell Publishing Ltd</publisher><pubPlace>Oxford, UK</pubPlace><date type="published" when="2010-11">2010-11</date><biblScope unit="volume">17</biblScope><biblScope unit="issue">11</biblScope><biblScope unit="page" from="1377">1377</biblScope><biblScope unit="page" to="1385">1385</biblScope></imprint><idno type="ISSN">1351-5101</idno></series><idno type="istex">7A76717AF8A21127B9F2CE7CD5BE9C72C79E129A</idno><idno type="DOI">10.1111/j.1468-1331.2010.03035.x</idno><idno type="ArticleID">ENE3035</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">1351-5101</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Parkinson’s disease</term><term>deep brain stimulation</term><term>microelectrode recording</term><term>stereotactic surgery</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Background and purpose: Deep brain stimulation (DBS) surgery has been performed using frame‐based stereotaxy traditionally; however, in recent years, it has also been performed using frameless stereotaxy. The purpose of this study was to compare the experience at our centre in performing DBS surgery using frameless surgery for patients with Parkinson’s disease with that of using frame‐based surgery. Methods: Twenty‐four patients with advanced Parkinson’s disease underwent DBS surgery, 12 with frameless and 12 with frame‐based stereotaxy. After identifying the subthalamus by microelectrode recording (MER), the DBS electrodes were implanted and connected to an implanted programmable generator in all patients. Programming was started 1 month after the operation and the outcome of the patients was followed up regularly for at least 12 months. Results: After 1 year of follow‐up, the patients who received frameless surgery showed no difference in the degree of improvement in clinical motor function compared with the patients who received frame‐based surgery (P = 0.819); the average improvement was 60.9% and 56.9%, respectively, in the stimulation alone/medication‐off state, as evaluated by the Unified Parkinson’s Disease Rating Scale‐III motor subscore. However, the frameless group had significantly shorter total MER time (P = 0.0127) and a smaller number of trajectories (P = 0.0096) than the frame‐based group. Conclusions: Our data indicate that frameless DBS surgery has a similar outcome when compared with frame‐based surgery; however, frameless surgery can decrease the operation time, MER time, and MER trajectory number.</div></front></TEI><istex><corpusName>wiley</corpusName><author><json:item><name>C.‐H. Tai</name><affiliations><json:string>Department of Neurology</json:string><json:string>Centre for Parkinson and Movement Disorders</json:string></affiliations></json:item><json:item><name>R.‐M. Wu</name><affiliations><json:string>Department of Neurology</json:string><json:string>Centre for Parkinson and Movement Disorders</json:string></affiliations></json:item><json:item><name>C.‐H. Lin</name><affiliations><json:string>Department of Neurology</json:string><json:string>Centre for Parkinson and Movement Disorders</json:string></affiliations></json:item><json:item><name>M.‐K. Pan</name><affiliations><json:string>Department of Neurology</json:string><json:string>Centre for Parkinson and Movement Disorders</json:string></affiliations></json:item><json:item><name>Y.‐F. Chen</name><affiliations><json:string>Department of Medical Imaging</json:string></affiliations></json:item><json:item><name>H.‐M. Liu</name><affiliations><json:string>Department of Medical Imaging</json:string></affiliations></json:item><json:item><name>H.‐H. Lu</name><affiliations><json:string>Department of Neurology</json:string><json:string>Centre for Parkinson and Movement Disorders</json:string></affiliations></json:item><json:item><name>C.‐W. Tsai</name><affiliations><json:string>Department of Neurology</json:string><json:string>Centre for Parkinson and Movement Disorders</json:string></affiliations></json:item><json:item><name>S.‐H. Tseng</name><affiliations><json:string>Department of Surgery, University Hospital and College of Medicine, National Taiwan University, Taipei, Taiwan</json:string></affiliations></json:item></author><subject><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>microelectrode recording</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>stereotactic surgery</value></json:item></subject><articleId><json:string>ENE3035</json:string></articleId><language><json:string>eng</json:string></language><abstract>Background and purpose: Deep brain stimulation (DBS) surgery has been performed using frame‐based stereotaxy traditionally; however, in recent years, it has also been performed using frameless stereotaxy. The purpose of this study was to compare the experience at our centre in performing DBS surgery using frameless surgery for patients with Parkinson’s disease with that of using frame‐based surgery. Methods: Twenty‐four patients with advanced Parkinson’s disease underwent DBS surgery, 12 with frameless and 12 with frame‐based stereotaxy. After identifying the subthalamus by microelectrode recording (MER), the DBS electrodes were implanted and connected to an implanted programmable generator in all patients. Programming was started 1 month after the operation and the outcome of the patients was followed up regularly for at least 12 months. Results: After 1 year of follow‐up, the patients who received frameless surgery showed no difference in the degree of improvement in clinical motor function compared with the patients who received frame‐based surgery (P = 0.819); the average improvement was 60.9% and 56.9%, respectively, in the stimulation alone/medication‐off state, as evaluated by the Unified Parkinson’s Disease Rating Scale‐III motor subscore. However, the frameless group had significantly shorter total MER time (P = 0.0127) and a smaller number of trajectories (P = 0.0096) than the frame‐based group. 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Neurology</affiliation><affiliation>Centre for Parkinson and Movement Disorders</affiliation></author><author><persName><forename type="first">M.‐K.</forename><surname>Pan</surname></persName><affiliation>Department of Neurology</affiliation><affiliation>Centre for Parkinson and Movement Disorders</affiliation></author><author><persName><forename type="first">Y.‐F.</forename><surname>Chen</surname></persName><affiliation>Department of Medical Imaging</affiliation></author><author><persName><forename type="first">H.‐M.</forename><surname>Liu</surname></persName><affiliation>Department of Medical Imaging</affiliation></author><author><persName><forename type="first">H.‐H.</forename><surname>Lu</surname></persName><affiliation>Department of Neurology</affiliation><affiliation>Centre for Parkinson and Movement Disorders</affiliation></author><author><persName><forename type="first">C.‐W.</forename><surname>Tsai</surname></persName><affiliation>Department of Neurology</affiliation><affiliation>Centre for Parkinson and Movement Disorders</affiliation></author><author><persName><forename type="first">S.‐H.</forename><surname>Tseng</surname></persName><affiliation>Department of Surgery, University Hospital and College of Medicine, National Taiwan University, Taipei, Taiwan</affiliation></author></analytic><monogr><title level="j">European Journal of Neurology</title><idno type="pISSN">1351-5101</idno><idno type="eISSN">1468-1331</idno><idno type="DOI">10.1111/(ISSN)1468-1331</idno><imprint><publisher>Blackwell Publishing Ltd</publisher><pubPlace>Oxford, UK</pubPlace><date type="published" when="2010-11"></date><biblScope unit="volume">17</biblScope><biblScope unit="issue">11</biblScope><biblScope unit="page" from="1377">1377</biblScope><biblScope unit="page" to="1385">1385</biblScope></imprint></monogr><idno type="istex">7A76717AF8A21127B9F2CE7CD5BE9C72C79E129A</idno><idno type="DOI">10.1111/j.1468-1331.2010.03035.x</idno><idno type="ArticleID">ENE3035</idno></biblStruct></sourceDesc></fileDesc><profileDesc><creation><date>2010</date></creation><langUsage><language ident="en">en</language></langUsage><abstract xml:lang="en"><p>Background and purpose: Deep brain stimulation (DBS) surgery has been performed using frame‐based stereotaxy traditionally; however, in recent years, it has also been performed using frameless stereotaxy. The purpose of this study was to compare the experience at our centre in performing DBS surgery using frameless surgery for patients with Parkinson’s disease with that of using frame‐based surgery. Methods: Twenty‐four patients with advanced Parkinson’s disease underwent DBS surgery, 12 with frameless and 12 with frame‐based stereotaxy. After identifying the subthalamus by microelectrode recording (MER), the DBS electrodes were implanted and connected to an implanted programmable generator in all patients. Programming was started 1 month after the operation and the outcome of the patients was followed up regularly for at least 12 months. Results: After 1 year of follow‐up, the patients who received frameless surgery showed no difference in the degree of improvement in clinical motor function compared with the patients who received frame‐based surgery (P = 0.819); the average improvement was 60.9% and 56.9%, respectively, in the stimulation alone/medication‐off state, as evaluated by the Unified Parkinson’s Disease Rating Scale‐III motor subscore. However, the frameless group had significantly shorter total MER time (P = 0.0127) and a smaller number of trajectories (P = 0.0096) than the frame‐based group. Conclusions: Our data indicate that frameless DBS surgery has a similar outcome when compared with frame‐based surgery; however, frameless surgery can decrease the operation time, MER time, and MER trajectory number.</p></abstract><textClass xml:lang="en"><keywords scheme="keyword"><list><head>Keywords</head><item><term>deep brain stimulation</term></item><item><term>microelectrode recording</term></item><item><term>Parkinson’s disease</term></item><item><term>stereotactic surgery</term></item></list></keywords></textClass></profileDesc><revisionDesc><change when="2010-11">Published</change></revisionDesc></teiHeader></istex:fulltextTEI><json:item><original>false</original><mimetype>text/plain</mimetype><extension>txt</extension><uri>https://api.istex.fr/document/7A76717AF8A21127B9F2CE7CD5BE9C72C79E129A/fulltext/txt</uri></json:item></fulltext><metadata><istex:metadataXml wicri:clean="Wiley, elements deleted: body"><istex:xmlDeclaration>version="1.0" encoding="UTF-8" standalone="yes"</istex:xmlDeclaration><istex:document><component version="2.0" type="serialArticle" xml:lang="en"><header><publicationMeta level="product"><publisherInfo><publisherName>Blackwell Publishing Ltd</publisherName><publisherLoc>Oxford, UK</publisherLoc></publisherInfo><doi origin="wiley" registered="yes">10.1111/(ISSN)1468-1331</doi><issn type="print">1351-5101</issn><issn type="electronic">1468-1331</issn><idGroup><id type="product" value="ENE"></id><id type="publisherDivision" value="ST"></id></idGroup><titleGroup><title type="main" sort="EUROPEAN JOURNAL OF NEUROLOGY">European Journal of Neurology</title></titleGroup></publicationMeta><publicationMeta level="part" position="11111"><doi origin="wiley">10.1111/ene.2010.17.issue-11</doi><numberingGroup><numbering type="journalVolume" number="17">17</numbering><numbering type="journalIssue" number="11">11</numbering></numberingGroup><coverDate startDate="2010-11">November 2010</coverDate></publicationMeta><publicationMeta level="unit" type="article" position="11" status="forIssue"><doi origin="wiley">10.1111/j.1468-1331.2010.03035.x</doi><idGroup><id type="unit" value="ENE3035"></id></idGroup><countGroup><count type="pageTotal" number="9"></count></countGroup><titleGroup><title type="tocHeading1">Original Articles</title></titleGroup><copyright>© 2010 The Author(s). Journal compilation © 2010 EFNS</copyright><eventGroup><event type="firstOnline" date="2010-04-23"></event><event type="publishedOnlineAcceptedOrEarlyUnpaginated" date="2010-04-23"></event><event type="xmlConverted" agent="Converter:BPG_TO_WML3G version:2.3.25 mode:FullText source:FullText result:FullText" date="2010-11-05"></event><event type="publishedOnlineFinalForm" date="2010-04-23"></event><event type="xmlConverted" agent="Converter:WILEY_ML3G_TO_WILEY_ML3GV2 version:3.8.8" date="2014-01-24"></event><event type="xmlConverted" agent="Converter:WML3G_To_WML3G version:4.1.7 mode:FullText,remove_FC" date="2014-10-17"></event></eventGroup><numberingGroup><numbering type="pageFirst" number="1377">1377</numbering><numbering type="pageLast" number="1385">1385</numbering></numberingGroup><correspondenceTo>S.‐H. Tseng, Department of Surgery, University Hospital and College of Medicine, National Taiwan University, No 7, Chong‐Shang South Road, Taipei 100, Taiwan (tel.: +886 2 23 56 21 44; fax: +886 2 23 41 83 95, e‐mail: <email>tsh5110@ntu.edu.tw</email>)</correspondenceTo><linkGroup><link type="toTypesetVersion" href="file:ENE.ENE3035.pdf"></link></linkGroup></publicationMeta><contentMeta><unparsedEditorialHistory>Received 1 December 2009 Accepted 10 March 2010</unparsedEditorialHistory><countGroup><count type="figureTotal" number="3"></count><count type="tableTotal" number="2"></count></countGroup><titleGroup><title type="main">Deep brain stimulation therapy for Parkinson’s disease using frameless stereotaxy: comparison with frame‐based surgery</title><title type="shortAuthors">C.‐H. Tai <i>et al.</i></title><title type="short">PD DBS by frameless stereotaxy</title></titleGroup><creators><creator creatorRole="author" xml:id="cr1" affiliationRef="#a1 #a2"><personName><givenNames>C.‐H.</givenNames><familyName>Tai</familyName></personName></creator><creator creatorRole="author" xml:id="cr2" affiliationRef="#a1 #a2"><personName><givenNames>R.‐M.</givenNames><familyName>Wu</familyName></personName></creator><creator creatorRole="author" xml:id="cr3" affiliationRef="#a1 #a2"><personName><givenNames>C.‐H.</givenNames><familyName>Lin</familyName></personName></creator><creator creatorRole="author" xml:id="cr4" affiliationRef="#a1 #a2"><personName><givenNames>M.‐K.</givenNames><familyName>Pan</familyName></personName></creator><creator creatorRole="author" xml:id="cr5" affiliationRef="#a3"><personName><givenNames>Y.‐F.</givenNames><familyName>Chen</familyName></personName></creator><creator creatorRole="author" xml:id="cr6" affiliationRef="#a3"><personName><givenNames>H.‐M.</givenNames><familyName>Liu</familyName></personName></creator><creator creatorRole="author" xml:id="cr7" affiliationRef="#a1 #a2"><personName><givenNames>H.‐H.</givenNames><familyName>Lu</familyName></personName></creator><creator creatorRole="author" xml:id="cr8" affiliationRef="#a1 #a2"><personName><givenNames>C.‐W.</givenNames><familyName>Tsai</familyName></personName></creator><creator creatorRole="author" xml:id="cr9" affiliationRef="#a4"><personName><givenNames>S.‐H.</givenNames><familyName>Tseng</familyName></personName></creator></creators><affiliationGroup><affiliation xml:id="a1"><unparsedAffiliation>Department of Neurology</unparsedAffiliation></affiliation><affiliation xml:id="a2"><unparsedAffiliation>Centre for Parkinson and Movement Disorders</unparsedAffiliation></affiliation><affiliation xml:id="a3"><unparsedAffiliation>Department of Medical Imaging</unparsedAffiliation></affiliation><affiliation xml:id="a4"><unparsedAffiliation>Department of Surgery, University Hospital and College of Medicine, National Taiwan University, Taipei, Taiwan</unparsedAffiliation></affiliation></affiliationGroup><keywordGroup xml:lang="en"><keyword xml:id="k1">deep brain stimulation</keyword><keyword xml:id="k2">microelectrode recording</keyword><keyword xml:id="k3">Parkinson’s disease</keyword><keyword xml:id="k4">stereotactic surgery</keyword></keywordGroup><abstractGroup><abstract type="main" xml:lang="en"><p><b>Background and purpose: </b> Deep brain stimulation (DBS) surgery has been performed using frame‐based stereotaxy traditionally; however, in recent years, it has also been performed using frameless stereotaxy. The purpose of this study was to compare the experience at our centre in performing DBS surgery using frameless surgery for patients with Parkinson’s disease with that of using frame‐based surgery.</p><p><b>Methods: </b> Twenty‐four patients with advanced Parkinson’s disease underwent DBS surgery, 12 with frameless and 12 with frame‐based stereotaxy. After identifying the subthalamus by microelectrode recording (MER), the DBS electrodes were implanted and connected to an implanted programmable generator in all patients. Programming was started 1 month after the operation and the outcome of the patients was followed up regularly for at least 12 months.</p><p><b>Results: </b> After 1 year of follow‐up, the patients who received frameless surgery showed no difference in the degree of improvement in clinical motor function compared with the patients who received frame‐based surgery (<i>P</i> = 0.819); the average improvement was 60.9% and 56.9%, respectively, in the stimulation alone/medication‐off state, as evaluated by the Unified Parkinson’s Disease Rating Scale‐III motor subscore. However, the frameless group had significantly shorter total MER time (<i>P</i> = 0.0127) and a smaller number of trajectories (<i>P</i> = 0.0096) than the frame‐based group.</p><p><b>Conclusions: </b> Our data indicate that frameless DBS surgery has a similar outcome when compared with frame‐based surgery; however, frameless surgery can decrease the operation time, MER time, and MER trajectory number.</p></abstract></abstractGroup></contentMeta></header></component></istex:document></istex:metadataXml><mods version="3.6"><titleInfo lang="en"><title>Deep brain stimulation therapy for Parkinson’s disease using frameless stereotaxy: comparison with frame‐based surgery</title></titleInfo><titleInfo type="abbreviated"><title>PD DBS by frameless stereotaxy</title></titleInfo><titleInfo type="alternative" contentType="CDATA" lang="en"><title>Deep brain stimulation therapy for Parkinson’s disease using frameless stereotaxy: comparison with frame‐based surgery</title></titleInfo><name type="personal"><namePart type="given">C.‐H.</namePart><namePart type="family">Tai</namePart><affiliation>Department of Neurology</affiliation><affiliation>Centre for Parkinson and Movement Disorders</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">R.‐M.</namePart><namePart type="family">Wu</namePart><affiliation>Department of Neurology</affiliation><affiliation>Centre for Parkinson and Movement Disorders</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">C.‐H.</namePart><namePart type="family">Lin</namePart><affiliation>Department of Neurology</affiliation><affiliation>Centre for Parkinson and Movement Disorders</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">M.‐K.</namePart><namePart type="family">Pan</namePart><affiliation>Department of Neurology</affiliation><affiliation>Centre for Parkinson and Movement Disorders</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Y.‐F.</namePart><namePart type="family">Chen</namePart><affiliation>Department of Medical Imaging</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">H.‐M.</namePart><namePart type="family">Liu</namePart><affiliation>Department of Medical Imaging</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">H.‐H.</namePart><namePart type="family">Lu</namePart><affiliation>Department of Neurology</affiliation><affiliation>Centre for Parkinson and Movement Disorders</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">C.‐W.</namePart><namePart type="family">Tsai</namePart><affiliation>Department of Neurology</affiliation><affiliation>Centre for Parkinson and Movement Disorders</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">S.‐H.</namePart><namePart type="family">Tseng</namePart><affiliation>Department of Surgery, University Hospital and College of Medicine, National Taiwan University, Taipei, Taiwan</affiliation><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre type="article" displayLabel="article"></genre><originInfo><publisher>Blackwell Publishing Ltd</publisher><place><placeTerm type="text">Oxford, UK</placeTerm></place><dateIssued encoding="w3cdtf">2010-11</dateIssued><edition>Received 1 December 2009 Accepted 10 March 2010</edition><copyrightDate encoding="w3cdtf">2010</copyrightDate></originInfo><language><languageTerm type="code" authority="rfc3066">en</languageTerm><languageTerm type="code" authority="iso639-2b">eng</languageTerm></language><physicalDescription><internetMediaType>text/html</internetMediaType><extent unit="figures">3</extent><extent unit="tables">2</extent></physicalDescription><abstract lang="en">Background and purpose: Deep brain stimulation (DBS) surgery has been performed using frame‐based stereotaxy traditionally; however, in recent years, it has also been performed using frameless stereotaxy. The purpose of this study was to compare the experience at our centre in performing DBS surgery using frameless surgery for patients with Parkinson’s disease with that of using frame‐based surgery. Methods: Twenty‐four patients with advanced Parkinson’s disease underwent DBS surgery, 12 with frameless and 12 with frame‐based stereotaxy. After identifying the subthalamus by microelectrode recording (MER), the DBS electrodes were implanted and connected to an implanted programmable generator in all patients. Programming was started 1 month after the operation and the outcome of the patients was followed up regularly for at least 12 months. Results: After 1 year of follow‐up, the patients who received frameless surgery showed no difference in the degree of improvement in clinical motor function compared with the patients who received frame‐based surgery (P = 0.819); the average improvement was 60.9% and 56.9%, respectively, in the stimulation alone/medication‐off state, as evaluated by the Unified Parkinson’s Disease Rating Scale‐III motor subscore. However, the frameless group had significantly shorter total MER time (P = 0.0127) and a smaller number of trajectories (P = 0.0096) than the frame‐based group. Conclusions: Our data indicate that frameless DBS surgery has a similar outcome when compared with frame‐based surgery; however, frameless surgery can decrease the operation time, MER time, and MER trajectory number.</abstract><subject lang="en"><genre>Keywords</genre><topic>deep brain stimulation</topic><topic>microelectrode recording</topic><topic>Parkinson’s disease</topic><topic>stereotactic surgery</topic></subject><relatedItem type="host"><titleInfo><title>European Journal of Neurology</title></titleInfo><genre type="Journal">journal</genre><identifier type="ISSN">1351-5101</identifier><identifier type="eISSN">1468-1331</identifier><identifier type="DOI">10.1111/(ISSN)1468-1331</identifier><identifier type="PublisherID">ENE</identifier><part><date>2010</date><detail type="volume"><caption>vol.</caption><number>17</number></detail><detail type="issue"><caption>no.</caption><number>11</number></detail><extent unit="pages"><start>1377</start><end>1385</end><total>9</total></extent></part></relatedItem><identifier type="istex">7A76717AF8A21127B9F2CE7CD5BE9C72C79E129A</identifier><identifier type="DOI">10.1111/j.1468-1331.2010.03035.x</identifier><identifier type="ArticleID">ENE3035</identifier><accessCondition type="use and reproduction" contentType="copyright">© 2010 The Author(s). 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