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