Park Hye Ran, Lee Jae Min, Ehm Gwanhee, Yang Hui-Jun, Song In Ho, Lim Yong Hoon, Kim Mi-Ryoung, Kim Keyoung Ran, Lee Woong-Woo, Kim Young Eun, Hwang Jae Ha, Shin Chae Won, Park Hyeyoung, Kim Jin Wook, Kim Han-Joon, Kim Cheolyoung, Kim Dong Gyu, Jeon Beom Seok, Paek Sun Ha
Department of Neurosurgery, Soonchunhyang University Seoul Hospital, Seoul, Republic of Korea.
Department of Neurosurgery, Seoul National University Hospital, Seoul, Republic of Korea.
Acta Neurochir (Wien). 2017 Jul;159(7):1349-1355. doi: 10.1007/s00701-017-3182-4. Epub 2017 Apr 17.
The correlation between the electrode location and the clinical outcome for internal globus pallidus (GPi) deep brain stimulation (DBS) has not been fully elucidated.
The aim of this study was to determine the discrepancies between the theoretical target planned by magnetic resonance imaging (MRI) and the actual electrode location in postoperative MRI, as well as to find the correlation between the final electrode locations and the clinical outcome after GPi DBS.
Thirty-six patients who underwent GPi DBS for dystonia were included in this retrospective study. The X coordinate was defined as the lateral distance from the midline, the Y coordinate as the anterior distance from the midcommissural point, and the Z coordinate as the inferior distance from the intercommissural line.
All coordinates showed a significant difference between theoretical and actual values for all electrode locations (p < 0.05). In particular, greater differences were exhibited for Y than for the X and Z coordinates. There was no significant difference in the accuracy of the localization of the left-side versus the right-side electrode for any coordinates. The patients whose electrodes were located within or near the posteroventral GPi showed better clinical outcomes.
The actual electrode location was slightly more posterior to the theoretically planned target. Electrodes concentrated near the posteroventral GPi tended to yield favorable outcomes.
内侧苍白球（GPi）深部脑刺激（DBS）的电极位置与临床疗效之间的相关性尚未完全阐明。
本研究旨在确定磁共振成像（MRI）规划的理论靶点与术后MRI中实际电极位置之间的差异，并找出GPi DBS术后最终电极位置与临床疗效之间的相关性。
本回顾性研究纳入了36例因肌张力障碍接受GPi DBS治疗的患者。将X坐标定义为距中线的横向距离，Y坐标定义为距连合中点的前方距离，Z坐标定义为距连合间线的下方距离。
所有电极位置的所有坐标在理论值与实际值之间均显示出显著差异（p < 0.05）。特别是，Y坐标的差异比X和Z坐标的差异更大。对于任何坐标，左侧电极与右侧电极的定位准确性均无显著差异。电极位于后腹侧GPi内或附近的患者临床疗效更好。
实际电极位置比理论规划靶点略靠后。集中在后腹侧GPi附近的电极往往能产生较好的疗效。
