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Impact of localisation of deep brain stimulation electrodes on motor and neurobehavioural outcomes in Parkinson's disease.
- Source :
-
Journal of neurology, neurosurgery, and psychiatry [J Neurol Neurosurg Psychiatry] 2016 Jul; Vol. 87 (7), pp. 758-66. Date of Electronic Publication: 2015 Aug 21. - Publication Year :
- 2016
-
Abstract
- Background: Deep brain stimulation (DBS) of the subthalamic nucleus (STN) represents a well-established treatment in advanced Parkinson's disease (PD) for motor signs, but it is still debated concerning psychiatric effects.<br />Objective: Exploration of relation between position of active electrode contacts and neuropsychological and motor change after STN DBS procedure for PD.<br />Methods: A cohort of 34 patients who underwent STN DBS was followed for 6 months. Preoperative and postoperative assessments included mood evaluation (depression and mania) and motor status. Active contact localisation was identified regarding position into the STN (4 groups: IN meant contacts were IN-IN IN-BORDER; OUT: OUT-OUT or OUT-BORDER; BORDER: BORDER-BORDER; IN-OUT: IN-OUT) and compared with clinical outcomes.<br />Results: STN DBS significantly improved motor scores and reduced dopaminergic medication when compared with baseline and active lead groups: the best result was seen with the IN group. At 3 and 6 months postsurgery, depression and manic scores do not significantly differ compared with baseline and between leads groups. Focusing on symptom domains and compared with baseline, a significant loss of appetite was observed for the IN group at M3 and a significant increase in appetite from baseline was observed at M3 for the OUT group. Graphic representations illustrate that postsurgery evolution parameters at M3 or M6 are very good discriminant variables and well differentiate all leading groups.<br />Conclusions: Stimulation of zona incerta may influence appetite and weight gain. Our clinical results seem to support a personalised DBS-targeted Parkinson therapy including individual motor and non-motor parameters.<br /> (Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/)
- Subjects :
- Aged
Appetite physiology
Brain Mapping
Cohort Studies
Depressive Disorder physiopathology
Female
Follow-Up Studies
Humans
Male
Middle Aged
Postoperative Complications physiopathology
Prospective Studies
Weight Gain physiology
Bipolar Disorder physiopathology
Bipolar Disorder therapy
Deep Brain Stimulation
Depressive Disorder therapy
Electrodes, Implanted
Mental Disorders physiopathology
Mental Disorders therapy
Motor Skills physiology
Parkinson Disease physiopathology
Parkinson Disease therapy
Subthalamic Nucleus physiopathology
Subjects
Details
- Language :
- English
- ISSN :
- 1468-330X
- Volume :
- 87
- Issue :
- 7
- Database :
- MEDLINE
- Journal :
- Journal of neurology, neurosurgery, and psychiatry
- Publication Type :
- Academic Journal
- Accession number :
- 26296870
- Full Text :
- https://doi.org/10.1136/jnnp-2015-310953