Intraoperative MRI for Deep Brain Stimulation Lead Placement in Parkinson's Disease: 1 year Motor and Neuropsychological Outcomes

Overview

Journal J Neurol

Specialty Neurology

Date 2016 Apr 30

PMID 27126457

Citations 8

Authors

Christos Sidiropoulos

Richard Rammo

Brad Merker

Abhimanyu Mahajan

Peter LeWitt

Patricia Kaminski

Melissa Womble

Adrianna Zec

Danette Taylor

Julia Wall

Jason M Schwalb

Affiliations

Soon will be listed here.

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.

Citing Articles

Brain-implanted conductors amplify radiofrequency fields in rodents: Advantages and risks.

Voroslakos M, Yaghmazadeh O, Alon L, Sodickson D, Buzsaki G Bioelectromagnetics. 2023; 45(3):139-155.

PMID: 37876116 PMC: 10947979. DOI: 10.1002/bem.22489.

Bilateral Subthalamic Nucleus Deep Brain Stimulation under General Anesthesia: Literature Review and Single Center Experience.

Park H, Lim Y, Song E, Lee J, Park K, Park K J Clin Med. 2020; 9(9).

PMID: 32967337 PMC: 7564882. DOI: 10.3390/jcm9093044.

Data-driven evolution of neurosurgical gene therapy delivery in Parkinson's disease.

Richardson R, Bankiewicz K, Christine C, Van Laar A, Gross R, Lonser R J Neurol Neurosurg Psychiatry. 2020; 91(11):1210-1218.

PMID: 32732384 PMC: 7569395. DOI: 10.1136/jnnp-2020-322904.

Asleep Deep Brain Stimulation of the Nucleus Ventralis Intermedius for Essential Tremor Using Indirect Targeting and Interventional Magnetic Resonance Imaging: Single-Institution Case Series.

Gravbrot N, Burket A, Saranathan M, Kasoff W Mov Disord Clin Pract. 2020; 7(5):521-530.

PMID: 32626797 PMC: 7328410. DOI: 10.1002/mdc3.12955.

Gene Therapy for Neurodegenerative Diseases.

Sudhakar V, Richardson R Neurotherapeutics. 2018; 16(1):166-175.

PMID: 30542906 PMC: 6361055. DOI: 10.1007/s13311-018-00694-0.

References

LAITINEN L, Bergenheim A, Hariz M . Leksell's posteroventral pallidotomy in the treatment of Parkinson's disease. J Neurosurg. 1992; 76(1):53-61. DOI: 10.3171/jns.1992.76.1.0053. View

Anderson V, Burchiel K, Hogarth P, Favre J, Hammerstad J . Pallidal vs subthalamic nucleus deep brain stimulation in Parkinson disease. Arch Neurol. 2005; 62(4):554-60. DOI: 10.1001/archneur.62.4.554. View

Follett K, Weaver F, Stern M, Hur K, Harris C, Luo P . Pallidal versus subthalamic deep-brain stimulation for Parkinson's disease. N Engl J Med. 2010; 362(22):2077-91. DOI: 10.1056/NEJMoa0907083. View

Homack S, Lee D, Riccio C . Test review: Delis-Kaplan executive function system. J Clin Exp Neuropsychol. 2005; 27(5):599-609. DOI: 10.1080/13803390490918444. View

Mascott C, Sol J, Bousquet P, Lagarrigue J, Lazorthes Y, Lauwers-Cances V . Quantification of true in vivo (application) accuracy in cranial image-guided surgery: influence of mode of patient registration. Neurosurgery. 2006; 59(1 Suppl 1):ONS146-56. DOI: 10.1227/01.NEU.0000220089.39533.4E. View

Ostrem J, Galifianakis N, Markun L, Grace J, Martin A, Starr P . Clinical outcomes of PD patients having bilateral STN DBS using high-field interventional MR-imaging for lead placement. Clin Neurol Neurosurg. 2012; 115(6):708-12. PMC: 3578021. DOI: 10.1016/j.clineuro.2012.08.019. View

Lang A, Benabid A, Koller W, Lozano A, Obeso J, Olanow C . The core assessment program for intracerebral transplantation. Mov Disord. 1995; 10(4):527-8. DOI: 10.1002/mds.870100426. View

Ostrem J, Ziman N, Galifianakis N, Starr P, San Luciano M, Katz M . Clinical outcomes using ClearPoint interventional MRI for deep brain stimulation lead placement in Parkinson's disease. J Neurosurg. 2015; 124(4):908-16. DOI: 10.3171/2015.4.JNS15173. View

Odekerken V, Boel J, Geurtsen G, Schmand B, Dekker I, de Haan R . Neuropsychological outcome after deep brain stimulation for Parkinson disease. Neurology. 2015; 84(13):1355-61. DOI: 10.1212/WNL.0000000000001419. View

10.

Randolph C, Tierney M, Mohr E, Chase T . The Repeatable Battery for the Assessment of Neuropsychological Status (RBANS): preliminary clinical validity. J Clin Exp Neuropsychol. 1998; 20(3):310-9. DOI: 10.1076/jcen.20.3.310.823. View

11.

Williams A, Gill S, Varma T, Jenkinson C, Quinn N, Mitchell R . Deep brain stimulation plus best medical therapy versus best medical therapy alone for advanced Parkinson's disease (PD SURG trial): a randomised, open-label trial. Lancet Neurol. 2010; 9(6):581-91. PMC: 2874872. DOI: 10.1016/S1474-4422(10)70093-4. View

12.

Chabardes S, Isnard S, Castrioto A, Oddoux M, Fraix V, Carlucci L . Surgical implantation of STN-DBS leads using intraoperative MRI guidance: technique, accuracy, and clinical benefit at 1-year follow-up. Acta Neurochir (Wien). 2015; 157(4):729-37. DOI: 10.1007/s00701-015-2361-4. View

13.

Mirzadeh Z, Chapple K, Lambert M, Dhall R, Ponce F . Validation of CT-MRI fusion for intraoperative assessment of stereotactic accuracy in DBS surgery. Mov Disord. 2014; 29(14):1788-95. DOI: 10.1002/mds.26056. View

14.

Larson P, Starr P, Bates G, Tansey L, Richardson R, Martin A . An optimized system for interventional magnetic resonance imaging-guided stereotactic surgery: preliminary evaluation of targeting accuracy. Neurosurgery. 2011; 70(1 Suppl Operative):95-103. PMC: 3249469. DOI: 10.1227/NEU.0b013e31822f4a91. View

15.

Odekerken V, van Laar T, Staal M, Mosch A, Hoffmann C, Nijssen P . Subthalamic nucleus versus globus pallidus bilateral deep brain stimulation for advanced Parkinson's disease (NSTAPS study): a randomised controlled trial. Lancet Neurol. 2012; 12(1):37-44. DOI: 10.1016/S1474-4422(12)70264-8. View

16.

Starr P, Markun L, Larson P, Volz M, Martin A, Ostrem J . Interventional MRI-guided deep brain stimulation in pediatric dystonia: first experience with the ClearPoint system. J Neurosurg Pediatr. 2014; 14(4):400-8. DOI: 10.3171/2014.6.PEDS13605. View

17.

Foltynie T, Zrinzo L, Martinez-Torres I, Tripoliti E, Petersen E, Holl E . MRI-guided STN DBS in Parkinson's disease without microelectrode recording: efficacy and safety. J Neurol Neurosurg Psychiatry. 2010; 82(4):358-63. DOI: 10.1136/jnnp.2010.205542. View

18.

Ellis T, Foote K, Fernandez H, Sudhyadhom A, Rodriguez R, Zeilman P . Reoperation for suboptimal outcomes after deep brain stimulation surgery. Neurosurgery. 2008; 63(4):754-60. DOI: 10.1227/01.NEU.0000325492.58799.35. View

19.

Weaver F, Follett K, Stern M, Luo P, Harris C, Hur K . Randomized trial of deep brain stimulation for Parkinson disease: thirty-six-month outcomes. Neurology. 2012; 79(1):55-65. PMC: 3385495. DOI: 10.1212/WNL.0b013e31825dcdc1. View

20.

Patel N, Plaha P, Gill S . Magnetic resonance imaging-directed method for functional neurosurgery using implantable guide tubes. Neurosurgery. 2008; 61(5 Suppl 2):358-65. DOI: 10.1227/01.neu.0000303994.89773.01. View