PMID- 30568585
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20200929
IS  - 1662-5161 (Print)
IS  - 1662-5161 (Electronic)
IS  - 1662-5161 (Linking)
VI  - 12
DP  - 2018
TI  - Indirect Targeting of Subthalamic Deep Brain Stimulation Guided by Stereotactic 
      Computed Tomography and Microelectrode Recordings in Patients With Parkinson's 
      Disease.
PG  - 470
LID - 10.3389/fnhum.2018.00470 [doi]
LID - 470
AB  - Objective: Magnetic resonance imaging fusion techniques guided by frame-based 
      stereotactic computed tomography and microelectrode recordings are widely used to 
      target the subthalamic nucleus. However, MRI is not always available. The aim of 
      this study was to determine whether the indirect targeting of the subthalamic 
      nucleus for deep brain stimulation using frame-based stereotactic computed 
      tomography and microelectrode recording guidance in patients with advanced 
      idiopathic Parkinson's disease was an effective and safe treatment and to 
      determine the factors that contributed to outcome. Methods: Thirty-four 
      consecutive patients with Parkinson's disease who were treated from 2010 to 2012 
      were enrolled in this retrospective cohort study. The patients were assessed with 
      the Unified Parkinson's Disease Rating Scale-part III (UPDRS-III) and other 
      clinical profiles peri- and post-operatively. The horizontal and vertical 
      distances between the midpoint of the head frame and the brain midline at the 
      septum pellucidum level and the upper edge of the bilateral lens, respectively, 
      on a thin-section brain computed tomography scan were defined as the horizontal 
      and vertical deviations, respectively. Results: After the deep brain stimulation 
      surgery, the patients' UPDRS-III scores improved 48 +/- 2.8% (range, 20-81%) 
      compared to the patients' baseline off-levodopa scores. No surgery-associated 
      complications were found. The mean recorded length difference of the subthalamic 
      nucleus between the initial and final single microelectrode recording 
      trajectories was 5.37 +/- 0.16 mm (range, 3.99-7.50). Multiple linear regression 
      analyses revealed that the increased lengths of the vertical (regression 
      coefficient [B]: -0.0626; 95% confidence interval [CI]: -0.113 to -0.013) and 
      horizontal deviations (B: -0.0497; 95% CI: -0.083 to -0.017) were associated with 
      less improvement in the patients' UPDRS scores. Conclusion: These results showed 
      that the indirect targeting of the subthalamic nucleus for deep brain stimulation 
      using frame-based stereotactic computed tomography and microelectrode recording 
      guidance in patients with advanced idiopathic Parkinson's disease was effective 
      and safe. Greater symmetry of the head frame fixation resulted in better outcomes 
      of the deep brain stimulation of the subthalamic nucleus in patients with 
      Parkinson's disease, especially when the horizontal deviation was 2 mm or less 
      and the vertical deviation was 1 mm or less.
FAU - Tu, Po-Hsun
AU  - Tu PH
AD  - Department of Neurosurgery, Chang Gung Memorial Hospital at Linkou, Chang Gung 
      Medical College and University, Linkou, Taiwan.
FAU - Liu, Zhuo-Hao
AU  - Liu ZH
AD  - Department of Neurosurgery, Chang Gung Memorial Hospital at Linkou, Chang Gung 
      Medical College and University, Linkou, Taiwan.
FAU - Chen, Chiung Chu
AU  - Chen CC
AD  - Department of Neurology, Chang Gung Memorial Hospital at Linkou, Chang Gung 
      Medical College and University, Linkou, Taiwan.
AD  - Neuroscience Research Center, Chang Gung Memorial Hospital, Taipei, Taiwan.
FAU - Lin, Wey Yil
AU  - Lin WY
AD  - Department of Neurology, Chang Gung Memorial Hospital at Linkou, Chang Gung 
      Medical College and University, Linkou, Taiwan.
AD  - Neuroscience Research Center, Chang Gung Memorial Hospital, Taipei, Taiwan.
AD  - Department of Neurology, Landseed Hospital, Taoyuan, Taiwan.
FAU - Bowes, Amy L
AU  - Bowes AL
AD  - Royal Free London NHS Foundation Trust, Royal Free Hospital, London, United 
      Kingdom.
FAU - Lu, Chin Song
AU  - Lu CS
AD  - Department of Neurology, Chang Gung Memorial Hospital at Linkou, Chang Gung 
      Medical College and University, Linkou, Taiwan.
AD  - Neuroscience Research Center, Chang Gung Memorial Hospital, Taipei, Taiwan.
FAU - Lee, Shih-Tseng
AU  - Lee ST
AD  - Department of Neurosurgery, Chang Gung Memorial Hospital at Linkou, Chang Gung 
      Medical College and University, Linkou, Taiwan.
LA  - eng
PT  - Journal Article
DEP - 20181204
PL  - Switzerland
TA  - Front Hum Neurosci
JT  - Frontiers in human neuroscience
JID - 101477954
PMC - PMC6290336
OTO - NOTNLM
OT  - Parkinson's disease
OT  - deep brain stimulation
OT  - effect factor
OT  - head frame fixation
OT  - outcome
OT  - subthalamic nucleus
EDAT- 2018/12/21 06:00
MHDA- 2018/12/21 06:01
PMCR- 2018/01/01
CRDT- 2018/12/21 06:00
PHST- 2018/03/07 00:00 [received]
PHST- 2018/11/08 00:00 [accepted]
PHST- 2018/12/21 06:00 [entrez]
PHST- 2018/12/21 06:00 [pubmed]
PHST- 2018/12/21 06:01 [medline]
PHST- 2018/01/01 00:00 [pmc-release]
AID - 10.3389/fnhum.2018.00470 [doi]
PST - epublish
SO  - Front Hum Neurosci. 2018 Dec 4;12:470. doi: 10.3389/fnhum.2018.00470. eCollection 
      2018.