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[Subthalamic deep brain stimulation for severe idiopathic Parkinson's disease. Location study of the effective contacts].
- Source :
-
Neuro-Chirurgie [Neurochirurgie] 2006 Feb; Vol. 52 (1), pp. 15-25. - Publication Year :
- 2006
-
Abstract
- The subthalamic nucleus (STN) is the main target of deep brain stimulation (DBS) treatment for severe idiopathic Parkinson's disease. But there is still no clear information on the location of the effective contacts (used during the chronic phase of stimulation). Our aim was to assess the anatomical structures of the subthalamic area (STA) involved during chronic DBS. Ten patients successfully treated were included. The surgical procedure was based on direct STN targeting (stereotactic MRI based) pondered by the acute effects of intraoperative stimulation. We used a formaldehyde-fixed human specimen to compare by matching MRI images obtained at 1.5 Tesla (performed in clinical stereotactic conditions) and at very high field at 4.7 Tesla. This allowed accurate analysis of the anatomy of the STA and retrospective precision of the location of the center of effective contacts which were located within the STN in 4 patients, at the interface between the STN and the ZI and/or FF in 13, at the interface between ZI and FF in 2 and between the STN and the substantia nigra in one. These results were consistent with the literature, revealing the implication of neighboring structures, especially the zona incerta and Forel's Field, in the clinical benefit.
- Subjects :
- Aged
Female
Humans
Male
Middle Aged
Neurologic Examination
Parkinson Disease pathology
Parkinson Disease physiopathology
Substantia Nigra pathology
Substantia Nigra physiopathology
Subthalamic Nucleus physiopathology
Subthalamus pathology
Subthalamus physiopathology
Treatment Outcome
Deep Brain Stimulation
Electrodes, Implanted
Magnetic Resonance Imaging
Parkinson Disease therapy
Stereotaxic Techniques
Subthalamic Nucleus pathology
Subjects
Details
- Language :
- French
- ISSN :
- 0028-3770
- Volume :
- 52
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Neuro-Chirurgie
- Publication Type :
- Academic Journal
- Accession number :
- 16609656
- Full Text :
- https://doi.org/10.1016/s0028-3770(06)71166-3