Volume 1, Issue 3 (12-2015)                   Iran J Neurosurg 2015, 1(3): 6-10 | Back to browse issues page

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Parvaresh M, Azar M, Alijani B. Relationship of the P Angle with Stereotactic Arc in Intraoperative Outcome of Patients with Parkinson’s Disease Undergoing Deep Brain Stimulation. Iran J Neurosurg. 2015; 1 (3) :6-10
URL: http://irjns.org/article-1-17-en.html
Abstract:   (2010 Views)

Background & Aim: DBS (deep brain stimulation) is a new and successful technique in treatment of symptoms of Parkinsonism especially after drug resistance. Research in this field is mostly designed for evolution of this technique. The present study aimed at evaluating the relationship between the angle formed in midsagittal and STN (sub-thalamic nucleus) axis line and recording length in the final electrode p lacement.

Methods & Materials/Patients: 46 patient candidates for DBS operation were studied in terms of demographic variables, STN nucleus length, the angle between midsagittal line and STN axis (p angle), the number of tested electrodes, force and length of final electrode registration and final coordinates of the placed electrode. The primary information was obtained from patients records and other technical information based on MRI imaging using Stereonata software and during surgery. The information were analyzed using SPSS (version 16) and descriptive analysis and linear relationship.

Results: The mean force of the recording from trial microelectrodes implanted in the right side ranged from 1.49 ± 1.45 to 2.65 ± 1.42 and in the left side from 1.53 ± 1.35 to 2.65 ± 2.30. In comparative analysis, no significant statistical relationship was found between P angle of the right side and degree registered in the final electrode of the right side (Pearson correlation: 0.314, P value= 0.049).

Conclusion: Not only accurate electrodes positioning in the STN can lead to improved outcome within bilateral STN DBS, but also optimizing defined P angle can have beneficial effects on intraoperative outcome after STN DBS.

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Type of Study: Research | Subject: Gamma Knife Radiosurgery
* Corresponding Author Address: Corresponding Author Address: Poursina Hospital, Guilan University of Medical Sciences, Rasht, Guilan, Iran. Tel: +981333368773, Fax: +981333339842. E-mail: babakalij@gmail.com

2. Dostrovsky JO, Lozano AM. Mechanisms of deep brain stimulation. Movement Disorders. 2002;17(S3):S63-S8. [DOI:10.1002/mds.10143] [PMID]
3. Vitek JL. Mechanisms of deep brain stimulation: excitation or inhibition. Movement disorders. 2002;17(S3):S69-S72. [DOI:10.1002/mds.10144] [PMID]
4. Benabid AL, Benazzous A, Pollak P. Mechanisms of deep brain stimulation. Movement Disorders. 2002;17(S3):S73-S4. [DOI:10.1002/mds.10145] [PMID]
5. Okun MS, Foote KD. Parkinson's disease DBS: what, when, who and why? The time has come to tailor DBS targets. 2010.
6. Hamel W, Fietzek U, Morsnowski A, Schrader B, Herzog J, Weinert D, et al. Deep brain stimulation of the subthalamic nucleus in Parkinson's disease: evaluation of active electrode contacts. Journal of Neurology, Neurosurgery & Psychiatry. 2003;74(8):1036-46. [DOI:10.1136/jnnp.74.8.1036] [PMCID]
7. Nunta-Aree S, Sitthinamsuwan B, Boonyapisit K, Pisarnpong A. SW2-year outcomes of subthalamic deep brain stimulation for idiopathic Parkinson's disease. J Med Assoc Thai. 2010;93(5):529-40. [PMID]
8. Ford B, Winfield L, Pullman S, Frucht S, Du Y, Greene P, et al. Subthalamic nucleus stimulation in advanced Parkinson's disease: blinded assessments at one year follow up. Journal of Neurology, Neurosurgery & Psychiatry. 2004;75(9):1255-9. [DOI:10.1136/jnnp.2003.027557] [PMID] [PMCID]
9. Harries AM, Kausar J, Roberts SA, Mocroft AP, Hodson JA, Pall HS, et al. Deep brain stimulation of the subthalamic nucleus for advanced Parkinson disease using general anesthesia: long-term results: Clinical article. Journal of neurosurgery. 2012;116(1):107-13. [DOI:10.3171/2011.7.JNS11319] [PMID]
10. Okun MS, Fernandez HH, Wu SS, Kirsch‐Darrow L, Bowers D, Bova F, et al. Cognition and mood in Parkinson's disease in subthalamic nucleus versus globus pallidus interna deep brain stimulation: the COMPARE trial. Annals of neurology. 2009;65(5):586-95. [DOI:10.1002/ana.21596] [PMID] [PMCID]
11. Follett KA, Weaver FM, Stern M, Hur K, Harris CL, Luo P, et al. Pallidal versus subthalamic deep-brain stimulation for Parkinson's disease. New England Journal of Medicine. 2010;362(22):2077-91. [DOI:10.1056/NEJMoa0907083] [PMID]
12. Cuny E, Guehl D, Burbaud P, Gross C, Dousset V, Rougier A. Lack of agreement between direct magnetic resonance imaging and statistical determination of a subthalamic target: the role of electrophysiological guidance. Journal of neurosurgery. 2002;97(3):591-7. [DOI:10.3171/jns.2002.97.3.0591] [PMID]
13. Hamid N, Mitchell R, Mocroft P, Westby G, Milner J, Pall H. Targeting the subthalamic nucleus for deep brain stimulation: technical approach and fusion of pre-and postoperative MR images to define accuracy of lead placement. Journal of Neurology, Neurosurgery & Psychiatry. 2005;76(3):409-14. [DOI:10.1136/jnnp.2003.032029] [PMID] [PMCID]
14. Yoon MS, Munz M. Placement of deep brain stimulators into the subthalamic nucleus. Stereotactic and functional neurosurgery. 1999;72(2-4):145-9. [DOI:10.1159/000029717] [PMID]
15. Richter EO, Hoque T, Halliday W, Lozano AM, Saint-Cyr JA. Determining the position and size of the subthalamic nucleus based on magnetic resonance imaging results in patients with advanced Parkinson disease. Journal of neurosurgery. 2004;100(3):541-6. [DOI:10.3171/jns.2004.100.3.0541] [PMID]
16. Bejjani B-P, Dormont D, Pidoux B, Yelnik J, Damier P, Arnulf I, et al. Bilateral subthalamic stimulation for Parkinson's disease by using three-dimensional stereotactic magnetic resonance imaging and electrophysiological guidance. Journal of neurosurgery. 2000;92(4):615-25. [DOI:10.3171/jns.2000.92.4.0615] [PMID]
17. Perozzo P, Rizzone M, Bergamasco B, Castelli L, Lanotte M, Tavella A, et al. Deep brain stimulation of the subthalamic nucleus in Parkinson's disease: comparison of pre-and postoperative neuropsychological evaluation. Journal of the neurological sciences. 2001;192(1):9-15. [DOI:10.1016/S0022-510X(01)00575-5]
18. Gelb DJ, Oliver E, Gilman S. Diagnostic criteria for Parkinson disease. Archives of neurology. 1999;56(1):33-9. [DOI:10.1001/archneur.56.1.33] [PMID]
19. Nakano N, Taneda M. [Three-dimensional atlas of subthalamic nucleus and its adjacent structures]. No shinkei geka Neurological surgery. 2005;33(7):683-92. [PMID]
20. Benabid A, Benazzouz A, Hoffmann D, Limousin P, Krack P, Pollak P. Long‐term electrical inhibition of deep brain targets in movement disorders. Movement Disorders. 1998;13(S3):119-25. [DOI:10.1002/mds.870131321] [PMID]
21. Rodriguez-Oroz MC, Rodriguez M, Guridi J, Mewes K, Chockkman V, Vitek J, et al. The subthalamic nucleus in Parkinson's disease: somatotopic organization and physiological characteristics. Brain. 2001;124(9):1777-90. [DOI:10.1093/brain/124.9.1777] [PMID]
22. McClelland III S, Ford B, Senatus PB, Winfield LM, Du YE, Pullman SL, et al. Subthalamic stimulation for Parkinson disease: determination of electrode location necessary for clinical efficacy. Neurosurgical focus. 2005;19(5):1-9. [DOI:10.3171/foc.2005.19.5.13]
23. Paek SH, Han JH, Lee J-Y, Kim C, Jeon BS, Kim DG. Electrode position determined

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