Microsubthalamotomy: an immediate predictor of long-term subthalamic stimulation efficacy in Parkinson disease.
A microsubthalamotomy (mSTN) effect is commonly described after implantation that improves Parkinson's motor disability and is considered to be an obvious sign of good placement of the definitive electrode within the subthalamic nucleus (STN). There has been no formal study, however, demonstrating whether this mSTN effect can predict the long-term efficacy of STN stimulation in Parkinson Disease. The mSTN effect was defined by the percentage improvement of unified parkinson's disease rating scale (UPDRS III) baseline score assessed the third day morning following STN implantation, after at least a 12 hour withdrawal of dopaminergic treatment and before the programmable pulse generator was switched on. It was assessed in 30 consecutive patients with PD submitted for STN stimulation. Multiple stepwise regression analysis showed that mSTN effect (P = 0.005) and global mean intensity of stimulation (P = 0.004) were accurate independent predictors of the 6-month postoperative UPDRS III motor score improvement in the off-drug/on-stimulation condition.
Maltête
David
D
Department of Neurology, Rouen University Hospital, Rouen, France.|INSERM U614, Rouen Faculty of Medicine Rouen, France.
Derrey
Stéphane
S
Department of Neurosurgery, Rouen University Hospital, Rouen, France.
Chastan
Nathalie
N
Laboratory of Neurophysiology, Rouen University Hospital, Rouen, France.
Debono
Bertrand
B
Department of Neurosurgery, Rouen University Hospital, Rouen, France.
Gérardin
Emmanuel
E
Department of Radiology, Rouen University Hospital, Rouen, France.
Fréger
Pierre
P
Department of Neurosurgery, Rouen University Hospital, Rouen, France.
Mihout
Bruno
B
Department of Neurology, Rouen University Hospital, Rouen, France.
Menard
Jean François
JF
Department of Biostatistics, Rouen University Hospital, Rouen, France.
Hannequin
Didier
D
Department of Neurology, Rouen University Hospital, Rouen, France.|INSERM U614, Rouen Faculty of Medicine Rouen, France.
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D046690:Deep Brain Stimulation / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008866:Microsurgery / Q000379:methods*; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000379:methods*; D010300:Parkinson Disease / Q000601:surgery* / Q000628:therapy; D011182:Postoperative Care; D011237:Predictive Value of Tests; D020531:Subthalamic Nucleus / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome