gms | German Medical Science

63rd Annual Meeting of the German Society of Neurosurgery (DGNC)
Joint Meeting with the Japanese Neurosurgical Society (JNS)

German Society of Neurosurgery (DGNC)

13 - 16 June 2012, Leipzig

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Improvements of cardinal motor symptoms in Parkinson's disease depending on the stimulation site relative to a standardized, reconstructed, 3-dimensional MRI-defined subthalamic nucleus

Meeting Abstract

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  • J. Schlaier - Klinik und Poliklinik für Neurochirurgie, Universitätsklinikum Regensburg
  • C. Habermeyer - Klinik und Poliklinik für Neurochirurgie, Universitätsklinikum Regensburg
  • A. Hochreiter - Klinik und Poliklinik für Neurochirurgie, Universitätsklinikum Regensburg
  • M. Proescholdt - Klinik und Poliklinik für Neurochirurgie, Universitätsklinikum Regensburg
  • A. Brawanski - Klinik und Poliklinik für Neurochirurgie, Universitätsklinikum Regensburg
  • M. Lange - Klinik und Poliklinik für Neurochirurgie, Universitätsklinikum Regensburg

Deutsche Gesellschaft für Neurochirurgie. Japanische Gesellschaft für Neurochirurgie. 63. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie (JNS). Leipzig, 13.-16.06.2012. Düsseldorf: German Medical Science GMS Publishing House; 2012. DocDO.04.07

doi: 10.3205/12dgnc052, urn:nbn:de:0183-12dgnc0527

Published: June 4, 2012

© 2012 Schlaier 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

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Objective: To our knowledge this is the first study, which evaluates the improvements of cardinal motor symptoms depending on the stimulation site relative to a standardized, reconstructed, 3-dimensional, MRI-defined Subthalamic Nucleus (STN).

Methods: This retrospective, clinical study includes 22 patients with idiopathic Parkinson's disease, who consecutively underwent bilateral subthalamic nucleus stimulation. Microelectrode recording and clinical testing was performed intraoperatively. The localisation of the best stimulation site found during operation and the position of the active electrode contacts were related to a standardized, reconstructed 3-dimensional MRI-defined STN. Statistical tests for the evaluation of correlations between the stimulation site and the percentile improvements of rigidity, tremor and akinesia included Student-t-tests, Kruskal-Wallis One Way Analysis of Variance on Ranks and ANOVA on ranks.

Results: The more lateral and superior the intraoperative stimulation site was located in the MRI-STN, the more pronounced was the improvement of the contralateral akinesia. Postoperative active electrode contacts located superior to or in the dorsal part of the MRI-STN reduced the tremor of the contralateral hand significantly (p <0.05). No other significant correlations were found between the site of the active contact along the x, y and z-axis and the percentile reduction of rigidity, tremor and akinesia.

Conclusions: We found a positive correlation of certain UPDRS subscores with the anatomical stimulation site related to a standardized, MRI-defined STN. However, there was no equal improvement of all cardinal motor symptoms using one distinct stimulation site.