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Intraoperative MRI for deep brain stimulation lead placement in Parkinson’s disease: 1 year motor and neuropsychological outcomes

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Abstract

Traditional deep brain stimulation requires intraoperative neurophysiological confirmation of electrode placement. Recently, purely image guided methods are being evaluated as to their clinical efficacy in comparison to surgery using microelectrode recordings. We used the ClearPoint® system to place electrodes in both the subthalamic nucleus and globus pallidus internus in patients with advanced Parkinson’s disease. Off medication UPDRS scores were assessed before and 1 year after surgery as well as pre- and 1 year post-operative neuropsychological outcomes. Targeting precision was also assessed. Patients implanted in the subthalamic nucleus improved by 46.2 % in their UPDRS scores post-operatively (p = 0.03) whereas the globus pallidus group improved by 41 % (p = 0.06). There were no significant adverse neuropsychological outcomes in either group of patients. Mean radial error for the STN group was 1.2 ± 0.7 mm and for the GPi group 0.8 mm ± 0.3 mm. Image guided DBS using the ClearPoint®system has high targeting precision with robust clinical outcomes. Our data are in accord with recent studies using the same or similar technologies and provide a rationale for a large comparative study of image-guided versus microelectrode guided DBS.

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Authors and Affiliations

  1. Parkinson’s Disease and Movement Disorders Program, Henry Ford Hospital, 6777 West Maple Road, West Bloomfield, MI, 48322, USA

    Christos Sidiropoulos, Peter LeWitt, Patricia Kaminski, Danette Taylor & Julia Wall

  2. Department of Neurosurgery, Henry Ford Hospital, 2799 West Grand Blvd, Detroit, MI, 48202, USA

    Richard Rammo, Julia Wall & Jason M. Schwalb

  3. Division of Neuropsychology, Henry Ford Health System, 1 Ford Place, Suite 1E, Detroit, MI, 48202, USA

    Brad Merker, Melissa Womble & Adrianna Zec

  4. Department of Neurology, Henry Ford Hospital, 2799 West Grand Blvd, Detroit, MI, 48202, USA

    Abhimanyu Mahajan

  5. William Beaumont Health System, 3601 W 13 Mile Rd, Royal Oak, MI, 48073, USA

    Danette Taylor

Authors
  1. Christos Sidiropoulos
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  2. Richard Rammo
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  3. Brad Merker
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  4. Abhimanyu Mahajan
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  6. Patricia Kaminski
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  8. Adrianna Zec
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  10. Julia Wall
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Correspondence to Christos Sidiropoulos.

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The authors report no pertinent financial disclosures.

This study has been approved by the appropriate ethics committee and has therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.

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Sidiropoulos, C., Rammo, R., Merker, B. et al. Intraoperative MRI for deep brain stimulation lead placement in Parkinson’s disease: 1 year motor and neuropsychological outcomes. J Neurol 263, 1226–1231 (2016). https://doi.org/10.1007/s00415-016-8125-0

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  • DOI: https://doi.org/10.1007/s00415-016-8125-0

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