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Predictive potential of pre-operative functional neuroimaging in patients treated with subthalamic stimulation

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Abstract

Purpose

The aim of this study was to investigate the predictive potential of pre-operative regional cerebral blood flow (rCBF) in the pre-supplementary motor area (pre-SMA) and clinical factors in Parkinson’s disease (PD) patients treated with subthalamic nucleus (STN) stimulation.

Methods

Ten patients underwent rCBF SPECT and motor Unified Parkinson’s Disease Rating Scale (UPDRS) pre- and post-operatively during stimulation at 5 and 42 months. Statistical parametric mapping (SPM) was used to extract rCBF values in the pre-SMA because it is related with motor improvement. Post-operative outcomes included motor response to stimulation and percent improvement in UPDRS. Pre-operative predictors were explored by correlation test, linear regression and multivariate analyses.

Results

Higher pre-operative rCBF in the pre-SMA and younger age were associated with favourable outcomes at 5 and 42 months. Pre-operative rCBF results were significantly associated with baseline clinical factors.

Conclusion

This study shows that PD patients with younger age have higher rCBF values in the pre-SMA and better outcome, thus giving the rationale to the hypothesis that STN stimulation could be considered early in the course of disease.

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Authors and Affiliations

  1. Department of Diagnostic Imaging, Nuclear Medicine Unit, Ospedale Misericordia e Dolce, Piazza Ospedale 5, 59100, Prato, Italy

    Stelvio Sestini & Antonio Castagnoli

  2. Department of Clinical Physiopathology, Nuclear Medicine Unit, University of Florence, Florence, Italy

    Alberto Pupi & Roberto Sciagrà

  3. Department of Neurological and Psychiatric Sciences, University of Florence, Florence, Italy

    Franco Ammannati, Silvia Ramat & Sandro Sorbi

  4. Department of Diagnostic Imaging, Nuclear Medicine Unit, University II Naples, Naples, Italy

    Luigi Mansi

Authors
  1. Stelvio Sestini
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  2. Alberto Pupi
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  3. Franco Ammannati
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  4. Silvia Ramat
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  5. Sandro Sorbi
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  6. Roberto Sciagrà
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  8. Antonio Castagnoli
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Correspondence to Stelvio Sestini.

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Sestini, S., Pupi, A., Ammannati, F. et al. Predictive potential of pre-operative functional neuroimaging in patients treated with subthalamic stimulation. Eur J Nucl Med Mol Imaging 37, 12–22 (2010). https://doi.org/10.1007/s00259-009-1198-6

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  • DOI: https://doi.org/10.1007/s00259-009-1198-6

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