Surgical Repositioning of Misplaced Subthalamic Electrodes in Parkinson’s Disease: Location of Effective and Ineffective LeadsRichardson R.M.a · Ostrem J.L.b · Starr P.A.a
Departments of aNeurological Surgery and bNeurology, University of California, San Francisco, Calif., USA
Do you have an account?
- Rent for 48h to view
- Buy Cloud Access for unlimited viewing via different devices
- Synchronizing in the ReadCube Cloud
- Printing and saving restrictions apply
Rental: USD 8.50
Cloud: USD 20.00
Article / Publication Details
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.
© 2009 S. Karger AG, Basel
Article / Publication Details
Copyright / Drug Dosage / DisclaimerCopyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.