gms | German Medical Science

57th Annual Meeting of the German Society of Neurosurgery
Joint Meeting with the Japanese Neurosurgical Society

German Society of Neurosurgery (DGNC)

11 - 14 May, Essen

Surgical and clinical data of STN-DBS basing on 3T MRI

Operationstechnische und klinische Daten zur 3T-MRT-basierten STN-DBS

Meeting Abstract

  • corresponding author D. Winkler - Neurochirurgische Klinik der Universität Leipzig
  • J. Helm - Neurochirurgische Klinik der Universität Leipzig
  • K. Strecker - Department of Neurologische Klinik der Universität Leipzig
  • A. Goldammer - Neurochirurgische Klinik der Universität Leipzig
  • J. Schwarz - Department of Neurologische Klinik der Universität Leipzig
  • C. Preul - Max-Planck-Institut für Neuropsychologische Forschung, Leipzig
  • J. Meixensberger - Neurochirurgische Klinik der Universität Leipzig

Deutsche Gesellschaft für Neurochirurgie. Japanische Gesellschaft für Neurochirurgie. 57. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie. Essen, 11.-14.05.2006. Düsseldorf, Köln: German Medical Science; 2006. DocSO.08.02

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/dgnc2006/06dgnc210.shtml

Published: May 8, 2006

© 2006 Winkler et al.
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Outline

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Objective: Deep brain stimulation of the STN is markedly changing the quality of life of patients with advanced Parkinson’s disease. However, the success of the procedure as well as the neurological outcome depend on the quality of electrode placement. A combination of anatomical imaging, microrecording (MER) and macrostimulation is currently considered the most reliable approach for STN targeting.

Methods: We conducted a prospective study on 27 patients in whom STN-DBS surgery was performed. For the targeting procedure, image fusion of preoperatively acquired 3D T1w and T2w 1.5T MR-image series (Siemens, Germany, 13 patients, group I) and 3D T1w 1.5 T and T2w 3T MR-image series (Bruker, Germany, 14 patients, group II) was used and the possible benefit of 3 T MRI was evaluated, by analyzing surgical and clinical data. Placement of test and permanent electrodes were carried out according to standard functional neurosurgical technique including MER and intraoperative testing.

Results: Beside a shortening of the mean operation time from 267 min (group I) to 217 min (group II), the number of microelectrodes which showed typical STN signature during MER (Leadpoint 4, medtronic, USA) increased from 6.7 (group I) to 7.1 (group II). Reduction of the L-Dopa dose one, two, three and twelve months postoperatively as well as improvement of UPDRS score up to one year after operation were comparable.

Conclusions: Acquisition of T2w 3T MRI for following a planning procedure is a useful tool for excellent visualizing the target region as well as the anatomical landmarks. This compensates the missing clinical improvement. Using high-resolution-3T MR image series is one way of increasing the surgeons’ and the patients’ safety and to support an optimal electrode placement.