Deep brain stimulation of the subthalamic nucleus in severe Parkinson’s disease: relationships between dual-contact topographic setting and 1-year worsening of speech and gait - Université Clermont Auvergne Access content directly
Journal Articles Acta Neurochirurgica Year : 2023

Deep brain stimulation of the subthalamic nucleus in severe Parkinson’s disease: relationships between dual-contact topographic setting and 1-year worsening of speech and gait

Maxime Luisoni
  • Function : Author

Abstract

Background : Subthalamic nucleus (STN) deep brain stimulation (DBS) alleviates severe motor fluctuations and dyskinesia in Parkinson’s disease, but may result in speech and gait disorders. Among the suspected or demonstrated causes of these adverse effects, we focused on the topography of contact balance (CB; individual, right and left relative dual positions), a scantly studied topic, analyzing the relationships between symmetric or non-symmetric settings, and the worsening of these signs. Method : An observational monocentric study was conducted on a series of 92 patients after ethical approval. CB was specified by longitudinal and transversal positions and relation to the STN (CB sub-aspects) and totalized at the patient level (patient CB). CB was deemed symmetric when the two contacts were at the same locations relative to the STN. CB was deemed asymmetric when at least one sub-aspect differed in the patient CB. Baseline and 1-year characteristics were routinely collected: (i) general, namely, Unified Parkinson’s Disease Rating Scores (UPDRS), II, III motor and IV, daily levodopa equivalent doses and Parkinson’s Disease Questionnaire of Quality of Life (PDQ39) scores; (ii) specific, namely scores for speech (II-5 and III-18) and axial signs (II-14, III-28, III-29, and III-30). Only significant correlations were considered (p < 0.05). Results : Baseline characteristics were comparable (symmetric versus asymmetric). CB settings were related to deteriorations of speech and axial signs: communication PDQ39 and UPDRS speech and gait scores worsened exclusively with symmetric settings; the most influential CB sub-aspect was sym-metric longitudinal position. Conclusion : Our findings suggest that avoiding symmetric CB settings, whether by electrode posi-tioning or shaping of electric fields, could reduce worsening of speech and gait.
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Sunday, August 11, 2024
Embargoed file
0 3 21
Year Month Jours
Avant la publication
Sunday, August 11, 2024
Embargoed file
0 3 21
Year Month Jours
Avant la publication
Sunday, August 11, 2024
Embargoed file
Sunday, August 11, 2024
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hal-04180293 , version 1 (11-08-2023)

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  • HAL Id : hal-04180293 , version 1

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Youssef El Ouadih, Ana Marques, Bruno Pereira, Maxime Luisoni, Béatrice Claise, et al.. Deep brain stimulation of the subthalamic nucleus in severe Parkinson’s disease: relationships between dual-contact topographic setting and 1-year worsening of speech and gait. Acta Neurochirurgica, 2023. ⟨hal-04180293⟩
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