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Single electrode and multiple electrode guided electrical stimulation of the subthalamic nucleus in advanced Parkinson's Disease

Yasin Temel, Poldi Wilbrink, Annelien Duits, Paul Boon UGent, Selma Tromp, Linda Ackermans, Vivianne Van Kranen-Mastenbroek, Wim Weber and Veerle Visser-Vandewalle (2007) NEUROSURGERY. 61(5). p.346-355
abstract
OBJECTIVE: It is still debated to what extent intraoperative electrophysiological techniques contribute to the outcome of subthalamic nucleus (STN) deep brain stimulation QBS). Intraoperative electrophysiological recordings for identification of the STN can be made with one electrode or with multiple, simultaneously implanted electrodes. The latter provide more detailed information about the electrophysiological boundaries of the STN; however, implantation of several electrodes at one time might increase the risk of bleeding. Here we report the results of a study of patients with advanced Parkinson's disease, in which one group of patients underwent bilateral STN DBS with electrophysiological recordings from a single electrode, and the other group received STN DBS with multiple (five or fewer) simultaneously implanted electrodes. PATIENTS AND METHODS: Fifty-five patients suffering from advanced Parkinson's disease who underwent bilateral STN stimulation were included in this study. Thirty-two patients underwent STN DBS guided by a single semi-microelectrode, and 23 patients underwent STN DBS guided with simultaneously implanted multiple microelectrodes. All patients were examined preoperatively and 3 and 12 months postoperatively with regard to activities of daily living, motor functions, and neuropsychological functions. RESULTS: We found that the simultaneous implantation of multiple electrodes does not increase the risk of bleeding or any other major intracranial complication. The use of multiple electrodes resulted in better motor results when compared with patients who underwent STN DBS guided with a single recording electrode. There were significantly more improvements in patients' tremor and rigidity, and as a consequence, a better total Unified Parkinson Disease Rating Scale, Part III score was identified during the medication-off phase. Despite better motor effects, patients treated with multiple electrodes showed subtle deterioration in neuropsychological functions, particularly in memory function. CONCLUSION: STN DBS performed with multiple electrophysiological recording electrodes resulted in better motor outcome but induced specific mild declines in neuropsychological functions.
Please use this url to cite or link to this publication:
author
organization
year
type
journalArticle (original)
publication status
published
journal title
NEUROSURGERY
volume
61
issue
5
pages
346 - 355
publisher
LIPPINCOTT WILLIAMS & WILKINS
place of publication
530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA
Web of Science type
Article
Web of Science id
000251793800046
JCR category
SURGERY
JCR impact factor
3.007 (2007)
JCR rank
15/139 (2007)
JCR quartile
1 (2007)
ISSN
0148-396X
DOI
10.1227/01.neu.0000303993.82149.98
language
English
UGent publication?
no
classification
A1
id
667982
handle
http://hdl.handle.net/1854/LU-667982
date created
2009-05-27 10:33:37
date last changed
2009-05-28 12:16:50
@article{667982,
  abstract     = {OBJECTIVE: It is still debated to what extent intraoperative electrophysiological techniques contribute to the outcome of subthalamic nucleus (STN) deep brain stimulation QBS). Intraoperative electrophysiological recordings for identification of the STN can be made with one electrode or with multiple, simultaneously implanted electrodes. The latter provide more detailed information about the electrophysiological boundaries of the STN; however, implantation of several electrodes at one time might increase the risk of bleeding. Here we report the results of a study of patients with advanced Parkinson's disease, in which one group of patients underwent bilateral STN DBS with electrophysiological recordings from a single electrode, and the other group received STN DBS with multiple (five or fewer) simultaneously implanted electrodes.
PATIENTS AND METHODS: Fifty-five patients suffering from advanced Parkinson's disease who underwent bilateral STN stimulation were included in this study. Thirty-two patients underwent STN DBS guided by a single semi-microelectrode, and 23 patients underwent STN DBS guided with simultaneously implanted multiple microelectrodes. All patients were examined preoperatively and 3 and 12 months postoperatively with regard to activities of daily living, motor functions, and neuropsychological functions.

RESULTS: We found that the simultaneous implantation of multiple electrodes does not increase the risk of bleeding or any other major intracranial complication. The use of multiple electrodes resulted in better motor results when compared with patients who underwent STN DBS guided with a single recording electrode. There were significantly more improvements in patients' tremor and rigidity, and as a consequence, a better total Unified Parkinson Disease Rating Scale, Part III score was identified during the medication-off phase. Despite better motor effects, patients treated with multiple electrodes showed subtle deterioration in neuropsychological functions, particularly in memory function.

CONCLUSION: STN DBS performed with multiple electrophysiological recording electrodes resulted in better motor outcome but induced specific mild declines in neuropsychological functions.},
  author       = {Temel, Yasin and Wilbrink, Poldi and Duits, Annelien and Boon, Paul and Tromp, Selma and Ackermans, Linda and Van Kranen-Mastenbroek, Vivianne and Weber, Wim and Visser-Vandewalle, Veerle},
  issn         = {0148-396X},
  journal      = {NEUROSURGERY},
  language     = {eng},
  number       = {5},
  pages        = {346--355},
  publisher    = {LIPPINCOTT WILLIAMS \& WILKINS},
  title        = {Single electrode and multiple electrode guided electrical stimulation of the subthalamic nucleus in advanced Parkinson's Disease},
  url          = {http://dx.doi.org/10.1227/01.neu.0000303993.82149.98},
  volume       = {61},
  year         = {2007},
}

Chicago
Temel, Yasin, Poldi Wilbrink, Annelien Duits, Paul Boon, Selma Tromp, Linda Ackermans, Vivianne Van Kranen-Mastenbroek, Wim Weber, and Veerle Visser-Vandewalle. 2007. “Single Electrode and Multiple Electrode Guided Electrical Stimulation of the Subthalamic Nucleus in Advanced Parkinson’s Disease.” Neurosurgery 61 (5): 346–355.
APA
Temel, Yasin, Wilbrink, P., Duits, A., Boon, P., Tromp, S., Ackermans, L., Van Kranen-Mastenbroek, V., et al. (2007). Single electrode and multiple electrode guided electrical stimulation of the subthalamic nucleus in advanced Parkinson’s Disease. NEUROSURGERY, 61(5), 346–355.
Vancouver
1.
Temel Y, Wilbrink P, Duits A, Boon P, Tromp S, Ackermans L, et al. Single electrode and multiple electrode guided electrical stimulation of the subthalamic nucleus in advanced Parkinson’s Disease. NEUROSURGERY. 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA: LIPPINCOTT WILLIAMS & WILKINS; 2007;61(5):346–55.
MLA
Temel, Yasin, Poldi Wilbrink, Annelien Duits, et al. “Single Electrode and Multiple Electrode Guided Electrical Stimulation of the Subthalamic Nucleus in Advanced Parkinson’s Disease.” NEUROSURGERY 61.5 (2007): 346–355. Print.