Deep brain stimulation for Parkinson's disease: defining the optimal location within the subthalamic nucleus
Deep brain stimulation for Parkinson's disease: defining the optimal location within the subthalamic nucleus
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DOI：
10.1136/jnnp-2017-316907
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发表时间：
2018-05-01
影响因子：
11
通讯作者：
van den Munckhof, Pepijn
中科院分区：
文献类型：
--
作者：
Bot, Maarten;Schuurman, P. Richard;van den Munckhof, Pepijn
背景：丘脑底核（DBS）脑深部电刺激（DBS）治疗帕金森病（PD）后，个体运动功能的改善差异很大。立体定向靶向背外侧感觉运动部分的脑电刺激被认为是最重要的最大化的有效性，但研究采用中连合点（MCP）作为解剖参考未能显示DBS位置和运动改善之间的相关性。内侧边界的参考可能会提供更好的洞察DBS的位置和临床outcome.Methods电机改善后12个月的65个DBS电极的关系分为无反应，反应和最佳反应的身体两侧。结果以脑内侧缘为参照，脑深部电刺激的最佳电极接触点相对于脑内侧缘和MCP的立体定向坐标与脑深部电刺激的最佳电极接触点相对于脑内侧缘和MCP的立体定向坐标呈显著负相关（Pearson相关系数为-0.52，P
Background Individual motor improvement after deep brain stimulation (DBS) of the subthalamic nucleus (STN) for Parkinson's disease (PD) varies considerably. Stereotactic targeting of the dorsolateral sensorimotor part of the STN is considered paramount for maximising effectiveness, but studies employing the midcommissural point (MCP) as anatomical reference failed to show correlation between DBS location and motor improvement. The medial border of the STN as reference may provide better insight in the relationship between DBS location and clinical outcome.Methods Motor improvement after 12 months of 65 STN DBS electrodes was categorised into non-responding, responding and optimally responding body-sides. Stereotactic coordinates of optimal electrode contacts relative to both medial STN border and MCP served to define theoretic DBS 'hotspots'.Results Using the medial STN border as reference, significant negative correlation (Pearson's correlation -0.52, P