Relationship between electrode position of deep brain stimulation and motor symptoms of Parkinson’s disease

Abstract

Background To investigate the relationship between the position of bilateral STN-DBS location of active contacts and the clinical efficacy of STN-DBS on motor symptoms in Parkinson’s disease (PD) patients. Methods Retrospectively analyze the clinical data of 57 patients with PD who underwent bilateral STN-DBS from March 2018 to December 2018. Unified Parkinson’s Disease Rating Scale-Part III (UPDRS-III) score, levodopa equivalent day dose (LEDD), Parkinson’s Disease Quality of Life Scale (PDQ-39) before operation and within 6 months after operation, determine the location of activated contacts and volume of tissue activated (VTA) in the Montreal Neurological Institute (MNI) space, and analyze their correlation with the improvement rate of motor symptoms (UPDRS-III score improvement rate). Results After 6 months of follow up, the UPDRS-III scores of 57 patients (Med-off) were improved by 55.4 ± 18.9% (P<0.001) compared with that before operation. The improvement rate of PDQ-39 scores [(47.4 ± 23.2)%, (P < 0.001)] and the reduction rate of LEDD [(40.1 ± 24.3)%, (P < 0.01)] at 6 months postoperation were positively correlated with the improvement rate of motor symptoms (Med-off)(PDQ-39:r = 0.461, P<0.001; LEDD: r = 0.354, P = 0.007), the improvement rate of UPDRS-III (Med-off) and the Z-axis coordinate of the active contact in the MNI space were positively correlated (left side: r = 0.349,P = 0.008;right side: r = 0.369,P = 0.005). In the MNI space, there was no correlation between the UPDRS-III scores improvement rate (Med-off) at 6 months after operation and bilateral VTA in the STN motor subregion, STN associative subregion and STN limbic subregion of the active electrode contacts of 57 patients (all P > 0.05). At 6 months after surgery, the difference between the Z-axis coordinate in the different improvement rate subgroups(<25, 25 to 50%, and>50%) in the MNI space was statistically significant (left side: P = 0.030; right side: P = 0.024). In the MNI space, there was no statistically significant difference between the groups in the VTA of the electrode active contacts (all P > 0.05). Conclusion STN-DBS can improve the motor symptoms of PD patients and improve the quality of life. The closer the stimulation is to the STN dorsolateral sensorimotor area, the higher the DBS is to improve the motor symptoms of PD patients.

Subthalamic Nucleus-Deep Brain Stimulation Improves Autonomic Dysfunction in Parkinson’s Disease

“…As mentioned in our previous article [5], UPDRS-III scores (Medication-off) were improved (55.42%), the PDQ-39 scores were improved (47.39%) and the LEDD had decreased by 40.08% at 6 months after surgery. The improvement rate of HAMA scores and HAMD scores of 57 patients was [41.7(34.9) %;37.5(33.4) % respectively (both P<0.001)].…”

“…Between March and December 2018, a total of 57 subjects were hospitalized at the Department of Neurosurgery of the Beijing Tiantan Hospital a liated to Capital Medical University, the First Hospital of Hebei Medical University and General Hospital of Ningxia Medical University for optimizing a previously performed STN-DBS, As mentioned in our previous article [5].…”

“…The study was approved by the Medical Ethics Committee of the First Hospital of Hebei Medical University and the Medical Ethics Committee of Beijing Tiantan Hospital a liated to Capital Medical University, the ethical principles involved in this research strictly in accordance with the "Declaration of Helsinki" and all patients provided written informed consent, As mentioned in our previous article [5].…”

“…As mentioned in our previous article [5], the study group comprised 34 males and 23 females. The levodopa equivalent daily dose (LEDD) of the 57 patients preoperative was (866.3 ± 357.0) (125-1625) mg/d, the preoperative Hoehn-Yahr stage was (2.9±0.3) (2-4).…”

Deep brain stimulation effect on anterior pallidum reduces motor impulsivity in Parkinson's disease

“…1D). While the VTA estimation was not validated by another method, prior studies in Parkinson's disease [36,37], essential tremor [38], and dystonia [39] have shown a good correlation between VTA overlap with target structure and clinical outcomes.…”