Fusion image-based programming after subthalamic nucleus deep brain stimulation

Sun Ha Paek, Hee Jin Kim, Ji Young Yoon, Jae Heok Heo, Cheolyoung Kim, Mi Ryoung Kim, Yong Hoon Lim, Keyong Ran Kim, Jin Wook Kim, Jung Ho Han, Dong Gyu Kim, Beom S. Jeon

Research output: Contribution to journalReview articlepeer-review

13 Scopus citations

Abstract

Objective: To propose fusion imagebased programming to adjust patients with advanced Parkinson disease (PD) effectively after subthalamic nucleus (STN) deep brain stimulation (DBS). Methods: Between January 2007 and July 2008, 38 patients with advanced PD were consecutively treated with STN DBS. The electrode positions and information regarding their contacts with STN were determined via fusion of the images of preoperative magnetic resonance imaging (MRI) and of postoperative computed tomography (CT) obtained 1 month after STN DBS. Postoperative programming was performed using the information of electrode positions based on the fused images. All patients were evaluated with a prospective protocol of the Unified Parkinson Disease Rating Scale (UPDRS), Hoehn and Yahr Staging, Schwab and England Activities of Daily Living (SEADL), levodopa equivalent daily dose (LEDD), short-form-36 health survey (SF-36), and neuropsychological tests before and at 3 months and 6 months after surgery. Results: There was a rapid and significant improvement of motor symptoms, especially tremor and rigidity, after STN stimulation, with low morbidity. Stimulation led to an improvement in the off-medication UPDSR III scores of the patients of approximately 55% at 3 months and 6 months after STN DBS. Dyskinesia was significantly improved (74% at 3 months and 95% at 6 months) after STN DBS. In addition, LEDD values decreased to 50% of the level observed before surgery within 1 month after STN DBS. Conclusions: Programming based on fused images of preoperative MRI and postoperative CT after STN DBS was performed quickly, easily, and efficiently.

Original languageEnglish
Pages (from-to)517-524
Number of pages8
JournalWorld Neurosurgery
Volume75
Issue number3-4
DOIs
StatePublished - Mar 2011

Keywords

  • Advanced Parkinson disease
  • Electrode positions
  • Fused imagebased programming
  • Postoperative CT
  • Preoperative MRI

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