Optimal target localisation and eight-year outcome for subthalamic stimulation in patients with Parkinson's disease.

Abstract:

:Objective: Deep brain stimulation of the subthalamic nucleus (STN-DBS) is a useful therapy to improve motor functions and reduce dependence on medication in patients with Parkinson's disease (PD). The purpose of the study is to assess the long-term clinical outcomes of STN-DBS and to determine the optimal placement of electrodes that for the most positive outcomes.Methods: A consecutive series of 42 PD patients were evaluated using the Unified Parkinson's Disease Rating Scale (UPDRS) before and after STN-DBS lead implantation. Postoperatively, patients were evaluated during both the medication 'ON' period (medication suppressed symptoms) and the medication 'OFF' period (when medication failed to suppress symptoms), and the results were compared to the baseline values prior to surgery. Follow-up assessments, focusing on motor functions, were performed 1, 3, 5, and 8 years after the initial implantation surgery. The locations of electrodes were measured and compared against the clinical outcomes.Results: STN-DBS remarkably improved the UPDRS-II, -III, and -IV dyskinesia and motor fluctuation scores in the OFF-medication condition when compared to baseline values. In addition, the dose of levodopa needed to elicit an effect declined sharply in the OFF-medication condition. Over time, the axial signs progressively worsened even with continuous stimulation and a levodopa response. The location of electrodes correlated with the most beneficial outcomes was the dorsal STN margin.Conclusions: Our results confirm that overall, stimulation-induced motor improvement is still evident after 8 years. However, the primary best outcome declines with the progressive loss of favourable axial signs.

journal_name

Br J Neurosurg

authors

Guo S,Li J,Zhang Y,Li Y,Zhuang P

doi

10.1080/02688697.2020.1775786

subject

Has Abstract

pub_date

2020-06-12 00:00:00

pages

1-6

eissn

0268-8697

issn

1360-046X

pub_type

杂志文章
  • High thoracic ossification of ligamentum flavum causing partial Horner syndrome.

    abstract::We report a case of high thoracic ossification of the ligamentum flavum (OLF) causing a partial Horner's syndrome. A 57-year-old man developed a walking disorder, as well as right-sided miosis and anhidrosis. Magnetic resonance imaging demonstrated a spinal cord compressing T2-T3 OLF. The patient improved after surger...

    journal_title:British journal of neurosurgery

    pub_type: 杂志文章

    doi:10.1080/02688697.2018.1441976

    authors: Kim DH,Lee SH,Lee JS,Song GS,Son DW

    更新日期:2018-02-28 00:00:00

  • Spinal cord compression from precipitation of drug solute around an epidural catheter.

    abstract::We report a previously undescribed complication of long-term epidural catheter placement for the administration of analgesia in terminal malignancy. Spinal cord compression resulted from a drug-related precipitate forming around the epidural catheter tip, which was successfully treated by surgical decompression. ...

    journal_title:British journal of neurosurgery

    pub_type: 杂志文章

    doi:10.1080/02688699844673

    authors: Johnston MK,Harland SP

    更新日期:1998-10-01 00:00:00

  • Stereotactic LINAC radiosurgery.

    abstract::A system of stereotactic radiosurgery using a linear accelerator is described and the experience with a variety of neurosurgical lesions including gliomas, acoustic neurinomas and arteriovenous malformations is recorded. The system is simple, inexpensive and effective and can be used with any CT scanner and linear acc...

    journal_title:British journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3109/02688698909002808

    authors: Hitchcock E,Kitchen G,Dalton E,Pope B

    更新日期:1989-01-01 00:00:00

  • Rathke's cleft cysts within a growth hormone producing pituitary adenoma.

    abstract::Two cases with a unique association of Rathke's cleft cysts and a growth hormone-secreting pituitary adenoma in the same tumour tissue are reported. The embryological pathogenesis, diagnostic evaluation and treatment of these lesions are discussed. ...

    journal_title:British journal of neurosurgery

    pub_type: 杂志文章

    doi:10.1080/02688699550041755

    authors: Nishio S Fujiwara T Morioka M Fukui S

    更新日期:1995-01-01 00:00:00

  • Frameless stereotactic placement of ventriculoperitoneal shunts in undersized ventricles: a simple modification to free-hand procedures.

    abstract::The aim of this report is to introduce a simple modification to the free-hand frameless stereotactic placement of ventriculoperitoneal shunts in undersized ventricles. In this technical note, we describe our experience with ventricular catheter placement in two children suffering from shunt dependent idiopathic intrac...

    journal_title:British journal of neurosurgery

    pub_type: 杂志文章

    doi:10.1080/02688690500495166

    authors: Woerdeman PA,Willems PW,Han KS,Hanlo PW,Berkelbach van der Sprenkel JW

    更新日期:2005-12-01 00:00:00

  • A case report of the management of multiple metachronous haemangioblastomas in a patient with von Hippel - Lindau disease.

    abstract::Cerebellar haemangioblastomas commonly arise in patients with von Hippel - Lindau disease. We present the case of a 47-year-old male who has successfully undergone 10 separate procedures for symptomatic cerebellar haemangioblastomas. To our knowledge, this case is unique with respect to the frequency of symptomatic re...

    journal_title:British journal of neurosurgery

    pub_type: 杂志文章

    doi:10.1080/02688690701552864

    authors: Newman S,Wasserberg J

    更新日期:2008-02-01 00:00:00

  • Intrasellar pituitary tissue pressure, tumour size and endocrine status--an international comparison in 107 patients.

    abstract::In a two-centre study, intrasellar pituitary tissue pressure was measured at transsphenoidal surgery in 107 patients with pituitary adenomas or intrasellar cysts. 'Normal' ISP in patients under anaesthesia with small microadenomas (< 5 mm diameter) or a partial empty sella was 12 +/- 3 mmHg. Raised ISP (> 15 mmHg) was...

    journal_title:British journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3109/02688699409029619

    authors: Lees PD,Fahlbusch R,Zrinzo A,Pickard JD

    更新日期:1994-01-01 00:00:00

  • Intracranial and orbital cavernous angiomas: a review of 74 surgical cases.

    abstract::We present a surgical series of 74 patients (30 males and 44 females) with pathologically verified cavernous angiomas of the intracranial and orbital compartments. Patients were admitted between 1975 and 1991; six had a family history of cerebral cavernomas, and two had multiple (two) lesions. The 76 malformations wer...

    journal_title:British journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3109/02688699308995075

    authors: Acciarri N,Padovani R,Giulioni M,Gaist G,Acciarri R

    更新日期:1993-01-01 00:00:00

  • Comparison of complications in cranioplasty with various materials: a systematic review and meta-analysis.

    abstract::Objective: Meta-analysis to evaluate complications in the use of autogenous bone and bone substitutes and to compare bone substitutes, specifically HA, polyetheretherketone (PEEK) and titanium materials.Methods: Search of PubMed, Cochrane, Embase and Google scholar to identify all citations from 2010 to 2019 reporting...

    journal_title:British journal of neurosurgery

    pub_type: 杂志文章,meta分析

    doi:10.1080/02688697.2020.1742291

    authors: Liu L,Lu ST,Liu AH,Hou WB,Cao WR,Zhou C,Yin YX,Yuan KS,Liu HJ,Zhang MG,Zhang HJ

    更新日期:2020-08-01 00:00:00

  • Subtotal petrosectomy in the treatment of cerebrospinal fluid fistulae of the lateral skull base.

    abstract::Cerebrospinal fluid (CSF) fistulae almost invariably lead to meningitis, even in the absence of other clinically obvious sequelae of the fistula such as a CSF fluid leak. The only effective means of reducing the risk of meningitis is surgical closure of the fistula. If surgery is to be recommended to patients with CSF...

    journal_title:British journal of neurosurgery

    pub_type: 杂志文章

    doi:10.1080/02688699745646

    authors: Hamilton JW,Foy PM,Lesser TH

    更新日期:1997-12-01 00:00:00

  • Health-related quality of life in patients with skull base tumours.

    abstract::The objective of the investigation was to report on the health-related quality of life (HRQoL) of patients diagnosed with skull base tumours using the Short Form Health Survey questionnaire (SF-36). Those patients suffering with vestibular schwannoma were examined to determine the effect facial nerve function had on t...

    journal_title:British journal of neurosurgery

    pub_type: 杂志文章

    doi:10.1080/02688690120114183

    authors: Kelleher MO,Fernandes MF,Sim DW,O'Sullivan MG

    更新日期:2002-02-01 00:00:00

  • Outcomes and quality of life assessment in patients undergoing endoscopic surgery for pituitary adenomas.

    abstract::The endoscopic technique is increasingly being used for the resection of pituitary adenomas. Its efficacy and safety have been generally accepted, but its impact on the quality of life of the patients treated has not been previously addressed. Most of the studies assessing the quality of life after long-term cure of p...

    journal_title:British journal of neurosurgery

    pub_type: 杂志文章

    doi:10.1080/02688690802220379

    authors: Karabatsou K,O'Kelly C,Ganna A,Dehdashti AR,Gentili F

    更新日期:2008-10-01 00:00:00

  • Extradural arachnoid cysts: a study of seven cases.

    abstract::Analysis of the management of 7 cases of extradural arachnoid cyst is presented. A brief review of the literature on the subject is presented. Seven cases of extradural arachnoid cysts were treated surgically between the years 1996 to 2002. These patients were analysed retrospectively. The average follow-up period was...

    journal_title:British journal of neurosurgery

    pub_type: 杂志文章

    doi:10.1080/02688690400012368

    authors: Kulkarni AG,Goel A,Thiruppathy SP,Desai K

    更新日期:2004-10-01 00:00:00

  • Stupp-treated glioblastoma accompanied by EBV-positive primary CNS lymphoma.

    abstract::We describe a patient who within 2 months of undergoing radio-chemotherapy for glioblastoma developed an Epstein-Barr virus-positive primary diffuse large B-cell CNS lymphoma. To our knowledge, this is the first such case reported in the literature showing that new tumefactions following aggressive treatment for gliob...

    journal_title:British journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3109/02688697.2013.829554

    authors: Zakaria Z,Fenton E,Khalil A,Sattar MT,Molnar P

    更新日期:2014-04-01 00:00:00

  • Subarachnoid haemorrhage in a child from an aneurysm of a persistent primitive hypoglossal artery.

    abstract::We report a 10-year-old boy who presented with a subarachnoid haemorrhage from a ruptured hypoglossal artery aneurysm. The aneurysm was clipped via a transcondylar approach. The embryology, occurrence and the surgical approach to aneurysms at this site are discussed. ...

    journal_title:British journal of neurosurgery

    pub_type: 杂志文章

    doi:10.1080/02688699646952

    authors: Duffill J,Lang DA,Dwyer GN

    更新日期:1996-12-01 00:00:00

  • Primary petrous bone Ewing's sarcoma.

    abstract::A case of primary Ewing's sarcoma involving a large portion of the petrous temporal bone in an eighteen month old child is reported. The lesion was treated by radical surgery and adjuvant chemotherapy and radiotherapy. An extremely rare age of presentation, an unusual location and an excellent response to treatment ar...

    journal_title:British journal of neurosurgery

    pub_type: 杂志文章,评审

    doi:10.1080/02688690050004606

    authors: Desai K,Goel A,Nadkarni TD

    更新日期:2000-04-01 00:00:00

  • Platinum distribution in malignant glioma following intraoperative intravenous infusion of carboplatin.

    abstract::The objective of this paper was to determine the time course and extent of platinum uptake into human malignant glioma tissue. An intraoperative, intravenous infusion of carboplatin was given to nine patients (seven glioblastoma and two anaplastic glioma) undergoing tumour excision. Carboplatin dosage was calculated i...

    journal_title:British journal of neurosurgery

    pub_type: 杂志文章

    doi:10.1080/02688699943871

    authors: Whittle IR,Malcolm G,Jodrell DI,Reid M

    更新日期:1999-04-01 00:00:00

  • Impact of 1p/19q codeletion on the diagnosis and prognosis of different grades of meningioma.

    abstract:BACKGROUND:Meningiomas are one of the most common tumours to affect the central nervous system. Genetic mutations are important in meningeal tumourigenesis, progression and prognosis. In this study, we aimed to examine the effect of 1p/19q deletion on the diagnosis and prognosis of meningioma subtypes using the fluores...

    journal_title:British journal of neurosurgery

    pub_type: 杂志文章

    doi:10.1080/02688697.2016.1181155

    authors: Basaran R,Uslu S,Gucluer B,Onoz M,Isik N,Tiryaki M,Yakicier C,Sav A,Elmaci I

    更新日期:2016-10-01 00:00:00

  • High serum sICAM-1 is correlated with cerebral microbleeds and hemorrhagic transformation in ischemic stroke patients.

    abstract::Object: Intercellular adhesion molecule 1 (ICAM-1) is an adhesive protein involved in inflammatory responses and endothelial dysfunction. ICAM-1 expression is upregulated in cerebrovascular tissue affected by stroke. We investigated whether serum soluble ICAM-1 (sICAM-1) levels are associated with cerebral microbleeds...

    journal_title:British journal of neurosurgery

    pub_type: 杂志文章

    doi:10.1080/02688697.2018.1518515

    authors: Wu BN,Wu J,Hao DL,Mao LL,Zhang J,Huang TT

    更新日期:2018-12-01 00:00:00

  • Cerebral venous oxygen saturation monitoring: is dominant jugular bulb cannulation good enough?

    abstract::Venous oxygen saturation at the clinically dominant jugular bulb (SjO2) and that at the confluence of the cerebral sinuses (SccsO2) were compared by direct simultaneous blood sampling of 13 severely head injured patients. The side of dominant jugular bulb (JB) was determined by neck compression test. The right side wa...

    journal_title:British journal of neurosurgery

    pub_type: 杂志文章

    doi:10.1080/02688699647276

    authors: Lam JM,Chan MS,Poon WS

    更新日期:1996-08-01 00:00:00

  • Racial differences between Maori and European New Zealanders in aneurysmal subarachnoid haemorrhage.

    abstract::Racial differences in the incidence and rate of rupture of intracranial aneurysms are well recognized. A retrospective study of racial differences between Maori and European New Zealanders presenting to the Auckland Regional Neurosurgical Unit between 1985 and 1990 was conducted. It was found that the incidence per 10...

    journal_title:British journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3109/02688699309103475

    authors: Marks PV,Hope JK,Cluroe AD,Furneaux CE

    更新日期:1993-01-01 00:00:00

  • Lumbar subcutaneous shunt: a novel technique for therapeutic decision making in normal pressure hydrocephalus (NPH) and benign intracranial hypertension (BIH).

    abstract::Selecting patients who will benefit from a permanent CSF diversion procedure in benign intracranial hypertension (BIH) or communicating hydrocephalus due to normal pressure hydrocephalus (NPH) has inherent problems. The percutaneous introduction of a lumbar subcutaneous shunt (LSS) under local anaesthesia facilitates ...

    journal_title:British journal of neurosurgery

    pub_type: 杂志文章

    doi:10.1080/02688690802007883

    authors: Ushewokunze S,Haja Mydin HN,Prasad R,Mendelow AD

    更新日期:2008-10-01 00:00:00

  • Surgical treatment of aneurysmal subarachnoid haemorrhage in the presence of 24-h endovascular availability: management and results.

    abstract::Endovascular treatment of ruptured intracranial aneurysms increasingly supersedes surgical repair. This study focuses on the management and results in 109 individuals treated surgically when both treatment modalities were available. The management principles were immediate identification of the origin of haemorrhage, ...

    journal_title:British journal of neurosurgery

    pub_type: 杂志文章

    doi:10.1080/02688690701593553

    authors: Sorteberg W,Slettebø H,Eide PK,Stubhaug A,Sorteberg A

    更新日期:2008-02-01 00:00:00

  • Middle cerebral artery atherosclerotic stenosis mimicking a cerebral aneurysm: pitfall in preoperative evaluation of cerebral aneurysms.

    abstract::We report a case of an aneurysm-like finding of MCA with severe atherosclerosis on standard radiological evaluation, which led us to plan surgical clipping. In particular, patients, whose modalities usually performed for preoperative assessment of cerebral aneurysms, such as DSA, 3D CTA and MRA, are insufficient. ...

    journal_title:British journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3109/02688697.2011.633639

    authors: Shibahashi K,Kimura T,Morita A

    更新日期:2012-06-01 00:00:00

  • Validation and accuracy of intraoperative CT scan using the Philips AlluraXper FD20 angiography suite for assessment of spinal instrumentation.

    abstract:BACKGROUND:With the concept of the hybrid operating room gaining popularity, the authors adapted a hybrid angiographic suite with intraoperative computed tomography (iCT) to evaluate accuracy of pedicle screw placement in spinal fusion. This retrospective review examines how well iCT detected extrapedicular screw viola...

    journal_title:British journal of neurosurgery

    pub_type: 杂志文章

    doi:10.1080/02688697.2017.1297764

    authors: Nevzati E,Fandino J,Schatlo B,Heimberg M,Marbacher S,Remonda L,Fathi AR

    更新日期:2017-12-01 00:00:00

  • Effect of valproic acid on the outcome of glioblastoma multiforme.

    abstract:BACKGROUND:Glioblastoma multiforme (GBM) is the most aggressive type of primary brain tumor. It is a rapidly progressive, highly recurrent, fatal intracranial neoplasm, and the demand for novel treatment is urgent. Valproic acid (VPA) is a potential anticancer agent that belongs to a class of histone deacetylase (HDAC)...

    journal_title:British journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3109/02688697.2011.638996

    authors: Tsai HC,Wei KC,Tsai CN,Huang YC,Chen PY,Chen SM,Lu YJ,Lee ST

    更新日期:2012-06-01 00:00:00

  • Huge calcified chronic subdural haematoma.

    abstract::Huge calcified chronic subdural hematoma is quite rare. We reported a such case in a old man. The intraoperative photographs of the case fully demonstrated the morphology of the calcified chronic subdural hematoma. ...

    journal_title:British journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3109/02688697.2010.520763

    authors: Rao Z,Li J,Yin H,You C

    更新日期:2010-12-01 00:00:00

  • Concepts of neurosurgical management of chronic subdural haematoma: historical perspectives.

    abstract::The history of chronic subdural haematoma (CSH), spanning from its possibly earliest beginnings throughout the centuries until the early 1980s, was investigated within the context of four different epochs. In the 'era of uncertainty', successful trephination, the modem method of choice for the treatment of CSH, was de...

    journal_title:British journal of neurosurgery

    pub_type: 传,历史文章,杂志文章

    doi:10.1080/02688690410001660418

    authors: Weigel R,Krauss JK,Schmiedek P

    更新日期:2004-02-01 00:00:00

  • Paget's disease complicated by hydrocephalus and syringomyelia.

    abstract::The authors report a case of Paget's disease involving the skull with the rare but severe complications of hydrocephalus and syringomyelia related to basilar impression. Complications of Paget's disease of the skull are briefly discussed and current treatment strategies outlined. ...

    journal_title:British journal of neurosurgery

    pub_type: 杂志文章

    doi:10.1080/026886902320909178

    authors: Raubenheimer PJ,Taylor AG,Soule SG

    更新日期:2002-10-01 00:00:00

  • Debate--does a reversible penumbra exist in intracerebral haemorrhage?

    abstract::Intracerebral haemorrhage is a devastating condition lacking effective therapies, with an uncertain role for surgery in many. Early research described an ischaemic penumbra around the haematoma, representing an area of potential therapeutic intervention. This article discusses the evidence for and against the existenc...

    journal_title:British journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3109/02688697.2011.578773

    authors: Kirkman MA

    更新日期:2011-08-01 00:00:00