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56. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)
3èmes journées françaises de Neurochirurgie (SFNC)

Deutsche Gesellschaft für Neurochirurgie e. V.
Société Française de Neurochirurgie

07. bis 11.05.2005, Strasbourg

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Bilateral stimulation of subthalamic nucleus (STN): steep learning curve on implementation of this method

Bilaterale Nucleus subthalamicus (STN) Stimulation: steile Lernkurve bei der Etablierung des Verfahrens

Meeting Abstract

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  • corresponding author J. Helm - Klinik für Neurochirurgie, Universitätsklinikum Leipzig
  • D. Winkler - Klinik für Neurochirurgie, Universitätsklinikum Leipzig
  • J. Schwarz - Klinik für Neurologie, Universitätsklinikum Leipzig
  • M. Meixensberger-Spiegel - Klinik für Neurologie, Universitätsklinikum Leipzig
  • J. Meixensberger - Klinik für Neurochirurgie, Universitätsklinikum Leipzig

Deutsche Gesellschaft für Neurochirurgie. Société Française de Neurochirurgie. 56. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), 3èmes journées françaises de Neurochirurgie (SFNC). Strasbourg, 07.-11.05.2005. Düsseldorf, Köln: German Medical Science; 2005. DocP022

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/dgnc2005/05dgnc0290.shtml

Published: May 4, 2005

© 2005 Helm et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

Text

Objective

Our aim was the implementation of bilateral STN stimulation in patients with Parkinson's Disease (PD) including all modalities of target point planning and verification in our center as a safe and efficient method. Our main focus was to minimize operation time for electrode implantation without quality loss.

Methods

In the years 2003 and 2004, 20 patients with PD had bilateral STN stimulation electrodes implanted using several MR data sets as well as 3T T2 MRI data for target planning on standard stereotactic planning software. During operation we performed test stimulation with clinical evaluation. Using microelectrode leads of neuronal activity.

Results

Stimulation was succesful in all patients. We achieved a reduction of L-DOPA doses by 71%±36%, mean UPDRS scores were markedly reduced from 26±14,8 (on) and 46,9±18,2 (off) to 14,7±8,7. There were surgical complications in only 2 patients (one electrode malposition due to brainshift and one CSF accumulation in the stimulator area making needling necessary). Process optimization led to a reduction of pure intervention time (for electrode implantantion) from 7 to less than 3.5 hours.

Conclusions

The learning curve of this new method proved to be steep. In our centre with rich experience in stereotactic but not yet in functional neurosurgery, the bilateral STN stimulation was found to be feasible. Complete planning, implantation of electrodes and stimulator can easily be carried out in one day.