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70. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
Joint Meeting mit der Skandinavischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

12.05. - 15.05.2019, Würzburg

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Different connectivity patterns of electrode contacts for rigidity, bradykinesia and tremor in deep brain stimulation for Parkinson’s disease

Tiefe Hirnstimulation – Rigor, Tremor und Bradykinese werden von Elektrodenkontakten mit unterschiedlichen Konnektionsmustern beeinflusst

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  • presenting/speaker Juergen Schlaier - Universitätsklinikum Regensburg, Klinik und Poliklinik für Neurochirurgie, Regensburg, Deutschland
  • Quirin Strotzer - Universitätsklinikum Regensburg, Klinik und Poliklinik für Neurochirurgie, Regensburg, Deutschland
  • Judith Anthofer - Universitätsklinikum Regensburg, Klinik und Poliklinik für Neurochirurgie, Regensburg, Deutschland
  • Rupert Faltermeier - Universitätsklinikum Regensburg, Klinik und Poliklinik für Neurochirurgie, Regensburg, Deutschland
  • Alexander Brawanski - Universitätsklinikum Regensburg, Klinik und Poliklinik für Neurochirurgie, Regensburg, Deutschland
  • Anton Beer - Institut für Psychologie, Experimentelle Psychologie, Regensburg, Deutschland

Deutsche Gesellschaft für Neurochirurgie. 70. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Skandinavischen Gesellschaft für Neurochirurgie. Würzburg, 12.-15.05.2019. Düsseldorf: German Medical Science GMS Publishing House; 2019. DocV085

doi: 10.3205/19dgnc100, urn:nbn:de:0183-19dgnc1007

Published: May 8, 2019

© 2019 Schlaier et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

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Objective: The aim of our study was to investigate whether rigidity, bradykinesia and tremor are effected equally by the same electrode contacts and to look at the connectivity pattern of effective contacts.

Methods: We retrospectively analyzed diffusion tensor data of 21 patients with Parkinson’s disease, who had received STN DBS. Probabilistic tractography was performed based on seeds on each individual electrode contact (n=168). In addition, we evaluated each contact concerning the proportional effect on the alleviation of rigidity, tremor and bradykinesia. Based on this data, effective and ineffective contacts were compared regarding their structural connections and fiber tracts affected by stimulation.

Results: 72% of the contacts were effective to alleviate bradykinesia of at least 50%. Effective contacts for bradykinesia were mainly connected to the pedunculo-pontine nucleus, the ipsilateral dentate-rubro-thalamic tract, the antero-lateral fascicle, the medial part of the anterior limb of the internal capsule und the superior parietal lobule. 81% of the effective contacts for rigidity and 82.4% of effective contacts for tremor were effective for bradykinesia as well as. However, we found significantly different connectivity patterns between all effective contacts for bradykinesia and those for rigidity (p=0.004). The differences between bradykinesia and tremor connectivity patterns were not statistically significant.

Conclusion: We found different connectivity patterns between contacts alleviating bradykinesia, rigidity and tremor. Therefore connections to certain cortical and subcortical structures might be used in the future to adapt targeting in patients with Parkinson’s disease according to their individual symptoms.