gms | German Medical Science

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

Gpi and STN electrical stimulation in PD under general anesthesia: initial experience

Meeting Abstract

  • corresponding author S. Gil Robles - Department of Neurosurgery, Centre Hospitalo Universitaire Gui de Chauliac, Montpellier, France
  • M. Charif - Department of Neurology, Centre Hospitalo Universitaire Gui de Chauliac, Montpellier, France
  • L. Cif - Department of URMA, Centre Hospitalo Universitaire Gui de Chauliac, Montpellier, France
  • N. Vayssiere - Department of URMA, Centre Hospitalo Universitaire Gui de Chauliac, Montpellier, France
  • S. Hemm - Department of URMA, Centre Hospitalo Universitaire Gui de Chauliac, Montpellier, France
  • J. Touchon - Department of Neurology, Centre Hospitalo Universitaire Gui de Chauliac, Montpellier, France
  • P. Coubes - Department of Neurosurgery, Centre Hospitalo Universitaire Gui de Chauliac, Montpellier, France

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. Doc10.05.-01.01

Die elektronische Version dieses Artikels ist vollständig und ist verfügbar unter: http://www.egms.de/de/meetings/dgnc2005/05dgnc0096.shtml

Veröffentlicht: 4. Mai 2005

© 2005 Gil Robles et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielf&aauml;ltigt, verbreitet und &oauml;ffentlich zug&aauml;nglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

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Objective

We aim at validating a surgical MRI-based stereotactical method for GPI and STN electrode implantation under general anesthesia without clinical and or electrophysiological guidance.

Methods

We performed a retrospective study in 24 PD patients surgically treated by DBS,14 were bilaterally implanted in the Gpi and 10 in the STN. All patients were operated under general anesthesia with stereotactic MRI planing and direct anatomical targeting with inmediate postoperative stereotactic control MRI.

Patients were assessed by a Neurologist (MC) and data of the Unified Parkinson Desease Rating Scale (UPDRS) for all patients before surgery and at 6 and 12 months postoperatively. Data were analyzed separately for GPi and STN in the medication on and off periods.

Results

For Gpi stimulation, at 6 and12 months stimulation improved the global motor score (UPDRS III) in 35,2% (p<0.001) compared to the preoperative medication off score. Speech and akinesia improved but did not show a statistically significative improvement. The UPDRS IV global motor score showed a marked improvement of 79.5% (p<0.001) in the postoperative medication on period.

For STN stimulation we found at six months a 40,1% improvement of the preoperative « best on » global motor score UPDRS III (medical treatment associated to stimulation) and a 51 % improvement of the preoperative med off global motor score UPDRS III with no medical treatment associated to stimulation. The global UPDRS IV at six months showed a 66% improvement with the association of stimulation and antiparkinsonian treatment in the postoperative period.

Surgically related complications were one electrode misplacement (1.5mm DX). No intracerebral hemorrhage is reported.

Conclusions

Patients with PD treated with bilateral STN or GPI stimulation under general anesthesia and with direct anatomical targetting had marked improvements in both global motor scores of the UPDRS III and IV at 6 and 12 months with no surgical morbidity., these results are comparable to other series using electrophysiological guidance.