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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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Fibre tracts involved in the occurrence of dysarthria in deep brain stimulation for Parkinson’s disease

Welche Faserbahnen sind für das Auftreten einer Stimulations-bedingten Dysarthrie bei der tiefen Hirnstimulation beim Morbus Parkinson verantwortlich?

Meeting Abstract

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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. DocV236

doi: 10.3205/19dgnc255, urn:nbn:de:0183-19dgnc2558

Veröffentlicht: 8. Mai 2019

© 2019 Schlaier et al.
Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). Lizenz-Angaben siehe http://creativecommons.org/licenses/by/4.0/.

Gliederung

Text

Objective: The aim of our study was to investigate which cerebral fiber tracts are involved in the occurrence of dysarthria in deep brain stimulation for Parkinson’s disease.

Methods: 21 patients with Parkinson’s disease and bilaterally implanted electrodes in the subthalamic nucleus were investigated. Diffusion weighted images (DWI) with 64 gradient directions were included in the routine preoperative imaging procedure for deep brain stimulation. Post-operative CT scans were fused to the DWI data set and the position of the individual contacts of the electrodes were determined. Probabilistic fibre-tracking was performed with seed regions based on each individual contact of the electrodes and the resulting anatomical fibre tracts were determined. We compared the connectivity pattern of contacts, which induced dysarthria with the connectivity pattern of contacts that did not.

Results: 39 out of 168 electrode contacts induced stimulation-associated dysarthria. In all of those 39 contacts dysarthria was already induced at a voltage of 2V or even less. The dentate-rubro-thalamic-tract (p=0.023), the lenticular fascicle (p=0.005) and the pyramidal tract (p=0.001) were significantly more often connected to contacts, which induced dysarthria compared to contacts without that side effect.

Conclusion: There is an ongoing debate in the literature, which fibre-tracts might be responsible for stimulation induced dysarthria in deep brain stimulation. In our study the internal capsule and fibers from the cerebellum and the pallidum seem to play a major role.