Long-term follow-up of Parkinsonian patients operated on with deep brain electromodulation without intraoperative microrecording.

作者信息

Lopez Darelys Teresa, Manzano Gabriel E, Medina Asveth, Prieto Maria Jose, Abud Juan Pointcarré, Salazar Luis, Vargas Maria Fernanda, Torres Napoleon, Sacchettoni Sergio Antonio

机构信息

Department of Neurosurgery, Hospital Hernan Henriquez Aravena, Temuco, Chile.

Department of Neurosurgery, Hospital Regional de Coyhaique, Coyhaique, Aysen, Chile.

出版信息

Surg Neurol Int. 2023 Dec 22;14:435. doi: 10.25259/SNI_673_2023. eCollection 2023.

Abstract

BACKGROUND

Deep brain electromodulation (DBEM), also known as deep brain stimulation in different intracerebral targets, is the most widely used surgical treatment due to its effects in reducing motor symptoms of Parkinson's disease. The intracerebral microelectrode recording has been considered for decades as a necessary tool for the success of Parkinson's surgery. However, some publications give more importance to intracerebral stimulation as a better predictive test. Since 2002, we initiated a technique of brain implant of electrodes without micro recording and based solely on image-guided stereotaxis followed by intraoperative macrostimulation. In this work, we analyze our long-term results, taking into account motor skills and quality of life (QL) before and after surgery, and we also establish the patient's time of clinical improvement.

METHODS

This is a descriptive clinical study in which the motor state of the patients was evaluated with the unified Parkinson's disease scale (UPDRS) and the QL using the Parkinson's disease QL questionnaire 39 questionnaires before surgery, in the "on" state of the medication; and after surgery, under active stimulation and in the "on" state.

RESULTS

Twenty-four patients with ages ranging from 37 to 78 years undergoing surgery DBEM on the subthalamic nucleus were studied. An improvement of 41.4% in motor skills and 41.7% in QL was obtained.

CONCLUSION

When microrecording is not available, the results that can be obtained, based on preoperative imaging and clinical intraoperative findings, are optimal and beneficial for patients.

摘要
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/318d/10783682/b77888c2f2b0/SNI-14-435-g001.jpg

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