Prospective analysis of gross and fine motor manifestations following STN- DBS and their correlation with electrode position

Abstract OBJECTIVE The electrode position is important to the surgical outcome after subthalamic nucleus (STN) deep brain stimulation (DBS). The aim of this study was to compare the surgical outcome of bilateral STN DBS with the electrode position estimated using fused magnetic resonance imaging. METHODS Bilateral STN DBS was performed in 60 patients with advanced Parkinson's disease. Patients were evaluated with the Unified Parkinson's Disease Rating Scale, Hoehn and Yahr staging, Schwab and England Activities of Daily Living, L-dopa equivalent dose, and Short Form-36 Health Survey before and at 3 and 6 months after surgery. Brain magnetic resonance imaging (1.5-T) was performed in 53 patients at 6 months after STN DBS. The electrode position was estimated in the fused pre- and postoperative magnetic resonance images and correlated with the surgical results. RESULTS As a group, the Unified Parkinson's Disease Rating Scale, Hoehn and Yahr staging, Schwab and England Activities of Daily Living, and Short Form-36 Health Survey scores improved at 3 and 6 months after STN DBS. The L-dopa equivalent dose decreased by 60% at 3 and 6 months after STN DBS. The electrode position was divided into 6 types according to its relationship to the STN and the red nucleus. Most off-medication Unified Parkinson's Disease Rating Scale motor subscale scores improved regardless of the type of electrode position. The off-medication speech subscale score improved only in the patients whose electrodes were correctly positioned in the STN bilaterally. CONCLUSION The electrodes accurately positioned in the STN led to improved speech after bilateral STN DBS. An effort should be made in each patient to document the electrode position to monitor surgical performance and to improve the surgical outcome after STN DBS.

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Changes in Vowel Articulation with Subthalamic Nucleus Deep Brain Stimulation in Dysarthric Speakers with Parkinson’s Disease

Parkinson s Disease ◽

10.1155/2014/487035 ◽

2014 ◽

Vol 2014 ◽

pp. 1-9 ◽

Cited By ~ 5

Author(s):

Vincent Martel Sauvageau ◽

Joël Macoir ◽

Mélanie Langlois ◽

Michel Prud’Homme ◽

Léo Cantin ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Deep Brain Stimulation ◽

Subthalamic Nucleus ◽

Brain Stimulation ◽

Speech Intelligibility ◽

Fine Motor ◽

The Impact ◽

Stn Dbs ◽

Deep Brain

Purpose. To investigate changes in vowel articulation with the electrical deep brain stimulation (DBS) of the subthalamic nucleus (STN) in dysarthric speakers with Parkinson’s disease (PD).Methods. Eight Quebec-French speakers diagnosed with idiopathic PD who had undergone STN DBS were evaluated ON-stimulation and OFF-stimulation (1 hour after DBS was turned off). Vowel articulation was compared ON-simulation versus OFF-stimulation using acoustic vowel space and formant centralization ratio, calculated with the first (F1) and second formant (F2) of the vowels /i/, /u/, and /a/. The impact of the preceding consonant context on articulation, which represents a measure of coarticulation, was also analyzed as a function of the stimulation state.Results. Maximum vowel articulation increased during ON-stimulation. Analyses also indicate that vowel articulation was modulated by the consonant context but this relationship did not change with STN DBS.Conclusions. Results suggest that STN DBS may improve articulation in dysarthric speakers with PD, in terms of range of movement. Optimization of the electrical parameters for each patient is important and may lead to improvement in speech fine motor control. However, the impact on overall speech intelligibility may still be small. Clinical considerations are discussed and new research avenues are suggested.Corrigendum to “Changes in Vowel Articulation with Subthalamic Nucleus Deep Brain Stimulation in Dysarthric Speakers with Parkinson’s Disease”

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Relationship between electrode position of deep brain stimulation and motor symptoms of Parkinson’s disease

BMC Neurology ◽

10.1186/s12883-021-02148-1 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Feng Zhang ◽

Feng Wang ◽

Weiguo Li ◽

Ning Wang ◽

Chunlei Han ◽

...

Keyword(s):

Quality Of Life ◽

Parkinson’S Disease ◽

Parkinson's Disease ◽

Electrode Position ◽

Motor Symptoms ◽

Improvement Rate ◽

Significant Difference ◽

Quality Of Life Scale ◽

Stn Dbs

Abstract Background To investigate the relationship between the position of bilateral STN-DBS location of active contacts and the clinical efficacy of STN-DBS on motor symptoms in Parkinson’s disease (PD) patients. Methods Retrospectively analyze the clinical data of 57 patients with PD who underwent bilateral STN-DBS from March 2018 to December 2018. Unified Parkinson’s Disease Rating Scale-Part III (UPDRS-III) score, levodopa equivalent day dose (LEDD), Parkinson’s Disease Quality of Life Scale (PDQ-39) before operation and within 6 months after operation, determine the location of activated contacts and volume of tissue activated (VTA) in the Montreal Neurological Institute (MNI) space, and analyze their correlation with the improvement rate of motor symptoms (UPDRS-III score improvement rate). Results After 6 months of follow up, the UPDRS-III scores of 57 patients (Med-off) were improved by 55.4 ± 18.9% (P<0.001) compared with that before operation. The improvement rate of PDQ-39 scores [(47.4 ± 23.2)%, (P < 0.001)] and the reduction rate of LEDD [(40.1 ± 24.3)%, (P < 0.01)] at 6 months postoperation were positively correlated with the improvement rate of motor symptoms (Med-off)(PDQ-39:r = 0.461, P<0.001; LEDD: r = 0.354, P = 0.007), the improvement rate of UPDRS-III (Med-off) and the Z-axis coordinate of the active contact in the MNI space were positively correlated (left side: r = 0.349,P = 0.008;right side: r = 0.369,P = 0.005). In the MNI space, there was no correlation between the UPDRS-III scores improvement rate (Med-off) at 6 months after operation and bilateral VTA in the STN motor subregion, STN associative subregion and STN limbic subregion of the active electrode contacts of 57 patients (all P > 0.05). At 6 months after surgery, the difference between the Z-axis coordinate in the different improvement rate subgroups(<25, 25 to 50%, and>50%) in the MNI space was statistically significant (left side: P = 0.030; right side: P = 0.024). In the MNI space, there was no statistically significant difference between the groups in the VTA of the electrode active contacts (all P > 0.05). Conclusion STN-DBS can improve the motor symptoms of PD patients and improve the quality of life. The closer the stimulation is to the STN dorsolateral sensorimotor area, the higher the DBS is to improve the motor symptoms of PD patients.

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1024 – Prospective analysis of STN DBS in parkinson's disease: motor and non-motor symptoms evolution link to electrodes localization

European Psychiatry ◽

10.1016/s0924-9338(13)76151-0 ◽

2013 ◽

Vol 28 ◽

pp. 1

Author(s):

I. de Chazeron ◽

B. Pereira ◽

F. Durif ◽

P.-M. Llorca ◽

I. Chéreau-Boudet

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Prospective Analysis ◽

Motor Symptoms ◽

Non Motor Symptoms ◽

Stn Dbs

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Analysis of Contact Position for Subthalamic Nucleus Deep Brain Stimulation-Induced Hyperhidrosis

Parkinson s Disease ◽

10.1155/2019/8180123 ◽

2019 ◽

Vol 2019 ◽

pp. 1-6 ◽

Cited By ~ 1

Author(s):

Chunhui Yang ◽

Yiqing Qiu ◽

Xi Wu ◽

Jiali Wang ◽

Yina Wu ◽

...

Keyword(s):

Deep Brain Stimulation ◽

Subthalamic Nucleus ◽

Brain Stimulation ◽

Control Group ◽

Electrode Position ◽

Improvement Rate ◽

Number Of Patients ◽

Significant Difference ◽

Stn Dbs ◽

Deep Brain

Objectives. To analyze the hyperhidrosis neural network structure induced by subthalamic nucleus (STN) - deep brain stimulation (DBS). Materials and Methods. Patients with Parkinson’s disease treated with STN-DBS in Changhai Hospital between July 1, 2015, and December 1, 2016, were analyzed retrospectively. Using records of side effects of the intraoperative macrostimulation test, patients with skin sweats were selected as the sweating group. Based on the number of cases in the sweating group, the same number of patients was randomly selected from other STN-DBS patients without sweating to form the control group. The study standardized electrode position with Lead-DBS software to Montreal Neurological Institute (MNI) standard stereotactic space to compare the differences in three-dimensional coordinates of activated contacts between groups. Results. Of 355 patients, 11 patients had sweats during intraoperative macrostimulation tests. There was no significant difference in the preoperative baseline information and the postoperative UPDRS-III improvement rate (Med-off, IPG-on) between groups. Contacts inducing sweat were more medial (X-axis) (11.02 ± 0.69 mm vs 11.98 ± 0.84 mm, P=0.00057) and more upward (Z-axis) (−7.15 ± 1.06 mm VS −7.98 ± 1.21 mm, P=0.032) than those of the control group. The straight-line distance between the center of the sweat contact and the nearest voxel of the red nucleus was closer than that of the control group (2.72 ± 0.65 mm VS 3.76 ± 0.85 mm, P=0.00012). Conclusions. STN-DBS-induced sweat indicated that the contact was at superior medial of STN.

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Relationship Between Electrode Position and Clinical Efficacy of Subthalamic Nucleus Deep Brain Stimulation and Motor Symptoms of Parkinson's Disease

10.21203/rs.3.rs-57719/v1 ◽

2020 ◽

Author(s):

Feng Zhang ◽

Feng Wang ◽

Weiguo Li ◽

Ning Wang ◽

Chunlei Han ◽

...

Keyword(s):

Clinical Efficacy ◽

Electrode Position ◽

Motor Symptoms ◽

Active Electrode ◽

Improvement Rate ◽

Post Surgery ◽

Score Improvement ◽

Significant Difference ◽

Stn Dbs ◽

Rate Of Improvement

Abstract Objectives To investigate the relationship between the position of bilateral STN-DBS location of active contacts and clinical efficacy of STN-DBS in the motor symptoms of Parkinson’ disease (PD) patients. Methods We retrospectively analyzed the clinical data of 57 patients with PD who underwent bilateral STN-DBS from March 2018 to December 2018. UPDRS III scores, LEDD, PDQ-39 scores before operation and within 6 months after operation were determined. The location of activate contacts and volume of tissue activated (VTA) in the Montreal Neurological Institute (MNI) space, and their correlation with the rate of improvement of motor symptoms（UPDRS-Ⅲ score improvement rate）were examined. Results After 6 months of follow up, the UPDRS-Ⅲ scores of 57 patients（Med-off） were improved by 55.4±18.9% (P＜0.001) compared with that before operation. The improvement rate of PDQ-39 score [(47.4±23.2)%, (P<0.001)] and the reduction rate of LEDD [(40.1±24.3)% , (P<0.01)] at 6 months post surgery were positively correlated with the improvement rate of motor symptoms（Med-off）(PDQ-39:r=0.461, P＜0.001; LEDD:r=0.354, P=0.007)，the rate of improvement of UPDRS Ⅲ (Med-off) and the Z-axis coordinate of the active contact in the MNI space were positively correlated (left side:r=0.349,P=0.008;right eide:r=0.369,P=0.005). In the MNI space,there was no correlation between the UPDRS-Ⅲ score improvement rate (Med-off) at 6 months after operation and bilateral VTA in the STN motor subregion,STN associative subregion and STN limbic subregion of the active electrode contacts of 57 patients(all P>0.05).At 6 months after surgery, the difference between the Z-axis coordinate in the different improvement rate subgroups（＜25%, 25% to 50%, and＞50%） in the MNI space was statistically significant (left side: P=0.030; right side: P=0.024). In the MNI space, there was no statistically significant difference between the 3 groups in the VTA of the active electrode contacts (all P>0.05). Conclusions STN-DBS could improve the motor symptoms of PD patients and improved the quality of life. The closer the active stimulation contacts is to the dorsolateral sensorimotor area of STN, the better effect the DBS has on the motor symptoms of PD patients.

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