title: Microsubthalamotomy: an immediate predictor of long-term subthalamic stimulation efficacy in Parkinson disease.
abstract: 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.
authors.affiliation: Department of Neurology, Rouen University Hospital, Rouen, France.|INSERM U614, Rouen Faculty of Medicine Rouen, France.
authors.forename: David
authors.initials: D
authors.lastname: Maltête
authors.affiliation: Department of Neurosurgery, Rouen University Hospital, Rouen, France.
authors.forename: Stéphane
authors.initials: S
authors.lastname: Derrey
authors.affiliation: Laboratory of Neurophysiology, Rouen University Hospital, Rouen, France.
authors.forename: Nathalie
authors.initials: N
authors.lastname: Chastan
authors.affiliation: Department of Neurosurgery, Rouen University Hospital, Rouen, France.
authors.forename: Bertrand
authors.initials: B
authors.lastname: Debono
authors.affiliation: Department of Radiology, Rouen University Hospital, Rouen, France.
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Gérardin
authors.affiliation: Department of Neurosurgery, Rouen University Hospital, Rouen, France.
authors.forename: Pierre
authors.initials: P
authors.lastname: Fréger
authors.affiliation: Department of Neurology, Rouen University Hospital, Rouen, France.
authors.forename: Bruno
authors.initials: B
authors.lastname: Mihout
authors.affiliation: Department of Biostatistics, Rouen University Hospital, Rouen, France.
authors.forename: Jean François
authors.initials: JF
authors.lastname: Menard
authors.affiliation: Department of Neurology, Rouen University Hospital, Rouen, France.|INSERM U614, Rouen Faculty of Medicine Rouen, France.
authors.forename: Didier
authors.initials: D
authors.lastname: Hannequin
mesh_terms: 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