title: Fusion image-based programming after subthalamic nucleus deep brain stimulation.
abstract: OBJECTIVE
  To propose fusion image-based 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.
authors: Department of Neurosurgery, Seoul National University Hospital, Seoul, Korea.
authors: Sun Ha
authors: SH
authors: Paek
authors: Hee Jin
authors: HJ
authors: Kim
authors: Ji Young
authors: JY
authors: Yoon
authors: Jae Heok
authors: JH
authors: Heo
authors: Cheolyoung
authors: C
authors: Kim
authors: Mi Ryoung
authors: MR
authors: Kim
authors: Yong Hoon
authors: YH
authors: Lim
authors: Keyong Ran
authors: KR
authors: Kim
authors: Jin Wook
authors: JW
authors: Kim
authors: Jung Ho
authors: JH
authors: Han
authors: Dong Gyu
authors: DG
authors: Kim
authors: Beom S
authors: BS
authors: Jeon