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

  • Stelvio Sestini
  • Alberto Pupi
  • Franco Ammannati
  • Silvia Ramat
  • Sandro Sorbi
  • Roberto Sciagrà
  • Luigi Mansi
  • Antonio Castagnoli
Original Article

DOI: 10.1007/s00259-009-1198-6

Cite this article as:
Sestini, S., Pupi, A., Ammannati, F. et al. Eur J Nucl Med Mol Imaging (2010) 37: 12. doi:10.1007/s00259-009-1198-6

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.

Keywords

Parkinson’s disease Subthalamic stimulation Predictive potential rCBF Pre-SMA 

Copyright information

© Springer-Verlag 2009

Authors and Affiliations

  • Stelvio Sestini
    • 1
  • Alberto Pupi
    • 2
  • Franco Ammannati
    • 3
  • Silvia Ramat
    • 3
  • Sandro Sorbi
    • 3
  • Roberto Sciagrà
    • 2
  • Luigi Mansi
    • 4
  • Antonio Castagnoli
    • 1
  1. 1.Department of Diagnostic Imaging, Nuclear Medicine UnitOspedale Misericordia e DolcePratoItaly
  2. 2.Department of Clinical Physiopathology, Nuclear Medicine UnitUniversity of FlorenceFlorenceItaly
  3. 3.Department of Neurological and Psychiatric SciencesUniversity of FlorenceFlorenceItaly
  4. 4.Department of Diagnostic Imaging, Nuclear Medicine UnitUniversity II NaplesNaplesItaly

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