Subthalamus stimulation in Parkinson disease: Accounting for the bilaterality of contacts - Université Clermont Auvergne
Journal Articles Surgical Neurology International Year : 2016

Subthalamus stimulation in Parkinson disease: Accounting for the bilaterality of contacts

Abstract

Background: Deep brain stimulation (DBS) in Parkinson's disease uses bi‑hemispheric high‑frequency stimulation within the subthalamus, however, the specific impacts of bilaterality of DBS are still not clear. Thus, we aimed to study the individual‑level clinical impact of locations of right‑left contact pair‑up accounting for each subthalamic nucleus (STN) anatomy. Methods: Contact locations and effects at 1 year were studied retrospectively in an unselected series of 53 patients operated between 2004 and 2010. Location of contacts was defined relatively to the main axis of STN used to map longitudinal and transversal positions, and STN membership (out meaning out‑of‑STN). Contact pairings were described via three methods: (i) Unified contact location (UCL) collapsing DBS into an all‑in‑one contact; (ii) balance of contact pair‑up (BCPU), defined as symmetric or asymmetric regardless of laterality; (iii) hemisphere‑wise most frequent contact pair‑up (MFCP) regardless of BCPU. Clinical data were: mean levodopa equivalent dose, Unified Parkinson's Disease Rating Scale (UPDRS) motor score III without medication, UPDRS II and III speech sub‑scores, UPDRS II freezing sub‑score, 1 year versus preoperative values, with and without levodopa. Ad‑hoc two‑sided tests were used for statistical analysis. Results: Worsening speech, was more frequent for UCL_out patients and when the left MFCP contact was rear and/or superolateral, however, it less frequent for BCPU‑asymmetric patients. Worsening freezing was more frequent when the right MFCP contact was rear and superolateral.
Fichier principal
Vignette du fichier
SNI-7-837.pdf (2.41 Mo) Télécharger le fichier
Origin Publisher files allowed on an open archive
Loading...

Dates and versions

hal-01558126 , version 1 (07-07-2017)

Licence

Identifiers

Cite

Jean-Jacques Lemaire, Bruno Pereira, Philippe Derost, François Vassal, Miguel Ulla, et al.. Subthalamus stimulation in Parkinson disease: Accounting for the bilaterality of contacts. Surgical Neurology International, 2016, 7, pp.S837-S847. ⟨10.4103/2152-7806.194066⟩. ⟨hal-01558126⟩

Collections

PRES_CLERMONT
170 View
372 Download

Altmetric

Share

More