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Vol. 87, No. 5, 2009
Issue release date: September 2009
Section title: Clinical Study
Stereotact Funct Neurosurg 2009;87:297–303
(DOI:10.1159/000230692)

Surgical Repositioning of Misplaced Subthalamic Electrodes in Parkinson’s Disease: Location of Effective and Ineffective Leads

Richardson R.M. · Ostrem J.L. · Starr P.A.
Departments of aNeurological Surgery and bNeurology, University of California, San Francisco, Calif., USA

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Article / Publication Details

First-Page Preview
Abstract of Clinical Study

Received: 3/4/2009
Accepted: 6/5/2009
Published online: 7/29/2009

Number of Print Pages: 7
Number of Figures: 2
Number of Tables: 3

ISSN: 1011-6125 (Print)
eISSN: 1423-0372 (Online)

For additional information: http://www.karger.com/SFN

Abstract

There is no clear consensus regarding the optimal location for placing deep brain stimulation (DBS) electrodes within the subthalamic nucleus (STN) target region in Parkinson’s disease. In cases of poor symptom control or adverse effects following lead placement, leads presumed to be inadequately positioned may be corrected by surgical revision. We retrospectively analyzed a series of 8 patients who underwent surgical lead revision, to study the anatomic boundaries of effective lead placement. Reoperation to achieve changes of 2–5 mm in DBS lead position targeting the dorsolateral part of the STN produced significant clinical improvement in these patients. Improvements were due to better symptom control, reduction of stimulation-induced adverse effects or both. In many cases, leads in a peripheral zone of the STN were repositioned to a more central location within the sensorimotor territory of the nucleus. These results are contrasted with findings in other studies demonstrating optimal lead placement in STN border zones or neighboring white-matter tracts.


Article / Publication Details

First-Page Preview
Abstract of Clinical Study

Received: 3/4/2009
Accepted: 6/5/2009
Published online: 7/29/2009

Number of Print Pages: 7
Number of Figures: 2
Number of Tables: 3

ISSN: 1011-6125 (Print)
eISSN: 1423-0372 (Online)

For additional information: http://www.karger.com/SFN


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