title: Intraoperative MRI for deep brain stimulation lead placement in Parkinson's disease: 1 year motor and neuropsychological outcomes.
abstract: Traditional deep brain stimulation requires intraoperative neurophysiological confirmation of electrode placement. Recently, purely image guided methods are being evaluated as to their clinical efficacy in comparison to surgery using microelectrode recordings. We used the ClearPoint(®) system to place electrodes in both the subthalamic nucleus and globus pallidus internus in patients with advanced Parkinson's disease. Off medication UPDRS scores were assessed before and 1 year after surgery as well as pre- and 1 year post-operative neuropsychological outcomes. Targeting precision was also assessed. Patients implanted in the subthalamic nucleus improved by 46.2 % in their UPDRS scores post-operatively (p = 0.03) whereas the globus pallidus group improved by 41 % (p = 0.06). There were no significant adverse neuropsychological outcomes in either group of patients. Mean radial error for the STN group was 1.2 ± 0.7 mm and for the GPi group 0.8 mm ± 0.3 mm. Image guided DBS using the ClearPoint(®)system has high targeting precision with robust clinical outcomes. Our data are in accord with recent studies using the same or similar technologies and provide a rationale for a large comparative study of image-guided versus microelectrode guided DBS.
authors.affiliation: Parkinson's Disease and Movement Disorders Program, Henry Ford Hospital, 6777 West Maple Road, West Bloomfield, MI, 48322, USA. csidiro1@hfhs.org.
authors.forename: Christos
authors.initials: C
authors.lastname: Sidiropoulos
authors.affiliation: Department of Neurosurgery, Henry Ford Hospital, 2799 West Grand Blvd, Detroit, MI, 48202, USA.
authors.forename: Richard
authors.initials: R
authors.lastname: Rammo
authors.affiliation: Division of Neuropsychology, Henry Ford Health System, 1 Ford Place, Suite 1E, Detroit, MI, 48202, USA.
authors.forename: Brad
authors.initials: B
authors.lastname: Merker
authors.affiliation: Department of Neurology, Henry Ford Hospital, 2799 West Grand Blvd, Detroit, MI, 48202, USA.
authors.forename: Abhimanyu
authors.initials: A
authors.lastname: Mahajan
authors.affiliation: Parkinson's Disease and Movement Disorders Program, Henry Ford Hospital, 6777 West Maple Road, West Bloomfield, MI, 48322, USA.
authors.forename: Peter
authors.initials: P
authors.lastname: LeWitt
authors.affiliation: Parkinson's Disease and Movement Disorders Program, Henry Ford Hospital, 6777 West Maple Road, West Bloomfield, MI, 48322, USA.
authors.forename: Patricia
authors.initials: P
authors.lastname: Kaminski
authors.affiliation: Division of Neuropsychology, Henry Ford Health System, 1 Ford Place, Suite 1E, Detroit, MI, 48202, USA.
authors.forename: Melissa
authors.initials: M
authors.lastname: Womble
authors.affiliation: Division of Neuropsychology, Henry Ford Health System, 1 Ford Place, Suite 1E, Detroit, MI, 48202, USA.
authors.forename: Adrianna
authors.initials: A
authors.lastname: Zec
authors.affiliation: Parkinson's Disease and Movement Disorders Program, Henry Ford Hospital, 6777 West Maple Road, West Bloomfield, MI, 48322, USA.|William Beaumont Health System, 3601 W 13 Mile Rd, Royal Oak, MI, 48073, USA.
authors.forename: Danette
authors.initials: D
authors.lastname: Taylor
authors.affiliation: Parkinson's Disease and Movement Disorders Program, Henry Ford Hospital, 6777 West Maple Road, West Bloomfield, MI, 48322, USA.|Department of Neurosurgery, Henry Ford Hospital, 2799 West Grand Blvd, Detroit, MI, 48202, USA.
authors.forename: Julia
authors.initials: J
authors.lastname: Wall
authors.affiliation: Department of Neurosurgery, Henry Ford Hospital, 2799 West Grand Blvd, Detroit, MI, 48202, USA.
authors.forename: Jason M
authors.initials: JM
authors.lastname: Schwalb
mesh_terms: D000368:Aged; D046690:Deep Brain Stimulation / Q000379:methods*; D005260:Female; D005917:Globus Pallidus / Q000000981:diagnostic imaging / Q000601:surgery; D006801:Humans; D053783:Magnetic Resonance Imaging, Interventional / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D058117:Neural Prostheses; D009483:Neuropsychological Tests; D019635:Neurosurgical Procedures / Q000379:methods*; D010300:Parkinson Disease / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000523:psychology / Q000628:therapy*; D012189:Retrospective Studies; D020531:Subthalamic Nucleus / Q000000981:diagnostic imaging / Q000601:surgery; D016896:Treatment Outcome
keywords: Deep brain stimulation; Globus pallidus; Intraoperative MRI; Parkinson’s disease; Subthalamic nucleus