title: Implications for programming strategy of the location of the active contact in subthalamic nucleus deep brain stimulation.
abstract: We aimed to determine whether our targeting method for the subthalamic nucleus (STN) in Parkinson's disease informs the initial programming sequence. We evaluated 100 STN-lead pairs from 50 patients who underwent bilateral STN-deep brain stimulation operations. All patients had at least one year of follow-up. In each patient, we measured coordinates of the STN borders and determined the center from special T2-weighted MRI. We then measured the postoperative location of the lead tip by MRI registered to preoperative images. Finally, we determined the mode and active contact(s). Programming was monopolar 71% of the time. A total of 52% of left and 72% of right STN active contacts were located posterolateral to the STN center. In z, only 14% of the active contact(s) were >1mm below the STN center. Contacts 1 or 2 were active 90% of the time. The consistent location of active contacts suggests that initial programming began with contact 1 or 2.
authors.affiliation: Department of Neurosurgery, Temple University, Philadelphia, PA 19140, USA. patrick.connolly@tuhs.temple.edu
authors.forename: Patrick J
authors.initials: PJ
authors.lastname: Connolly
authors.forename: Casey H
authors.initials: CH
authors.lastname: Halpern
authors.forename: Gordon H
authors.initials: GH
authors.lastname: Baltuch
authors.forename: Shabbar F
authors.initials: SF
authors.lastname: Danish
authors.forename: Jurg L
authors.initials: JL
authors.lastname: Jaggi
mesh_terms: D016009:Chi-Square Distribution; D046690:Deep Brain Stimulation / Q000379:methods*; D004566:Electrodes / Q000009:adverse effects; D007839:Functional Laterality; D006801:Humans; D008279:Magnetic Resonance Imaging; D010300:Parkinson Disease / Q000628:therapy; D020531:Subthalamic Nucleus / Q000033:anatomy & histology / Q000502:physiology*