Surgical repositioning of misplaced subthalamic electrodes in Parkinson's disease: location of effective and ineffective leads.

Abstract:

:There is no clear consensus regarding the optimal location for placing deep brain stimulation (DBS) electrodes within the subthalamic nucleus (STN) target region in Parkinson's disease. In cases of poor symptom control or adverse effects following lead placement, leads presumed to be inadequately positioned may be corrected by surgical revision. We retrospectively analyzed a series of 8 patients who underwent surgical lead revision, to study the anatomic boundaries of effective lead placement. Reoperation to achieve changes of 2-5 mm in DBS lead position targeting the dorsolateral part of the STN produced significant clinical improvement in these patients. Improvements were due to better symptom control, reduction of stimulation-induced adverse effects or both. In many cases, leads in a peripheral zone of the STN were repositioned to a more central location within the sensorimotor territory of the nucleus. These results are contrasted with findings in other studies demonstrating optimal lead placement in STN border zones or neighboring white-matter tracts.

authors

Richardson RM,Ostrem JL,Starr PA

doi

10.1159/000230692

subject

Has Abstract

pub_date

2009-01-01 00:00:00

pages

297-303

issue

5

eissn

1011-6125

issn

1423-0372

pii

000230692

journal_volume

87

pub_type

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