Bilateral subthalamic stimulation for Parkinson's disease by using three-dimensional stereotactic magnetic resonance imaging and electrophysiological guidance.

Abstract:

OBJECT:Several methods are used for stereotactically guided implantation of electrodes into the subthalamic nucleus (STN) for continuous high-frequency stimulation in the treatment of Parkinson's disease (PD). The authors present a stereotactic magnetic resonance (MR) method relying on three-dimensional (3D) T1-weighted images for surgical planning and multiplanar T2-weighted images for direct visualization of the STN, coupled with electrophysiological recording and stimulation guidance. METHODS:Twelve patients with advanced PD were enrolled in this study of bilateral STN implantation. Both STNs were visible as 3D ovoid biconvex hypointense structures located in the upper mesencephalon. The coordinates of the centers of the STNs were determined with reference to the patient's anterior commissure-posterior commissure line by using a new landmark, the anterior border of the red nucleus. Electrophysiological monitoring through five parallel tracks was performed simultaneously to define the functional target accurately. Microelectrode recording identified high-frequency, spontaneous, movement-related activity and tremor-related cells within the STNs. Acute STN macrostimulation improved contralateral rigidity and akinesia, suppressed tremor when present, and could induce dyskinesias. The central track, which was directed at the predetermined target by using MR imaging, was selected for implantation of 19 of 24 electrodes. No surgical complications were noted. CONCLUSIONS:At evaluation 6 months after surgery, continuous STN stimulation was shown to have improved parkinsonian motor disability by 64% and 78% in the "off' and "on" medication states, respectively. Antiparkinsonian drug treatment was reduced by 70% in 10 patients and withdrawn in two patients. The severity of levodopa-induced dyskinesias was reduced by 83% and motor fluctuations by 88%. Continuous high-frequency stimulation of the STN applied through electrodes implanted with the aid of 3D MR imaging and electrophysiological guidance is a safe and effective therapy for patients suffering from severe, advanced levodopa-responsive PD.

journal_name

J Neurosurg

journal_title

Journal of neurosurgery

authors

Bejjani BP,Dormont D,Pidoux B,Yelnik J,Damier P,Arnulf I,Bonnet AM,Marsault C,Agid Y,Philippon J,Cornu P

doi

10.3171/jns.2000.92.4.0615

subject

Has Abstract

pub_date

2000-04-01 00:00:00

pages

615-25

issue

4

eissn

0022-3085

issn

1933-0693

journal_volume

92

pub_type

杂志文章
  • Clinical recording of pressure on the spinal cord and cauda equina. Part 2: position changes in pressure on the cauda equina in central lumbar spinal stenosis.

    abstract::To define the site, degree, and dynamics of mechanical compression of the spinal nerve roots, pressure was measured in 42 patients with clinical symptoms and myelographic findings indicating central lumbar spinal stenosis. Pathological pressure on the cauda equina was found in 67% of the patients. The pressure in the ...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/jns.1982.57.1.0057

    authors: Magnaes B

    更新日期:1982-07-01 00:00:00

  • Calf enlargement from S-1 radiculopathy. Report of two cases.

    abstract::Two patients with painless hypertrophy of one calf had clinical and myelographic features compatible with an S-1 radiculopathy. Electromyographic studies revealed intermittent spontaneous discharges (bizarre repetitive potentials) in the affected extremity. Several patients have previously been described with S-1 radi...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/jns.1985.62.3.0442

    authors: Cooper WH,Ringel SP,Treihaft MM,Hall KA

    更新日期:1985-03-01 00:00:00

  • Measurement of flow of cerebrospinal fluid in shunts by transcutaneous thermal convection. Technical note.

    abstract::With the goal of developing a practical method of performing noninvasive measurements of flow in cerebrospinal fluid (CSF) shunts, transcutaneous thermal convection CSF shunt flow measurement was investigated using dimensional analysis, numerical modeling, and bench testing. Using appropriate manufacturing practices a...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/ped.2005.103.4.0366

    authors: Neff S

    更新日期:2005-10-01 00:00:00

  • Mechanisms of edema after gamma knife surgery for meningiomas. Report of two cases.

    abstract::The authors describe two patients in whom tumor swelling and brain swelling (and possible tumor swelling), respectively, developed after undergoing gamma knife surgery. One had a skull defect with a palpable parasagittal tumor. One had neurofibromatosis Type 2 with multiple tumors, one of which was parasagittal. ...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/jns.2005.102.s_supplement.0001

    authors: El Shehaby A,Ganz JC,Reda WA,Hafez A

    更新日期:2005-01-01 00:00:00

  • Prognostic significance of magnetic resonance imaging in the acute phase of cervical spine injury.

    abstract::Fifty-seven patients with acute cervical spine injuries and associated major neurological deficit were examined within 2 weeks of injury by magnetic resonance (MR) imaging. All patients had abnormal scans, indicating intramedullary lesions. This study was undertaken to determine if the early MR imaging pattern had a p...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/jns.1992.76.2.0218

    authors: Schaefer DM,Flanders AE,Osterholm JL,Northrup BE

    更新日期:1992-02-01 00:00:00

  • Acute postoperative seizures following anterior temporal lobectomy for intractable partial epilepsy.

    abstract:OBJECT:Recurrence of seizures immediately following epilepsy surgery can be emotionally devastating, and raises concerns about the chances of successfully attaining long-term seizure control. The goals of this study were to investigate the frequency of acute postoperative seizures (APOS) occurring in the 1st postoperat...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/jns.1998.89.2.0177

    authors: Malla BR,O'Brien TJ,Cascino GD,So EL,Radhakrishnan K,Silbert P,Marsh WR

    更新日期:1998-08-01 00:00:00

  • Transsphenoidal approach to infrasellar tumors involving the cavernous sinus.

    abstract::The authors review their 2-year experience with a rhinoseptal transsphenoidal approach to skull-base tumors of various pathologies involving both the sphenoid and cavernous sinuses. Eight patients with cranial nerve palsies attributable to compression of the contents of the cavernous sinus and/or optic canal are inclu...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/jns.1990.73.4.0513

    authors: Hashimoto N,Kikuchi H

    更新日期:1990-10-01 00:00:00

  • Effects of ventricular entry on patient outcome during glioblastoma resection.

    abstract:OBJECTIVE:Tumor proximity to the ventricle and ventricular entry (VE) during surgery have both been associated with worse prognoses; however, the interaction between these two factors is poorly understood. Given the benefit of maximal tumor resection, it is imperative for surgical planning and technique to know if VE h...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/2020.7.JNS201362

    authors: Young JS,Gogos AJ,Pereira MP,Morshed RA,Li J,Barkovich MJ,Hervey-Jumper SL,Berger MS

    更新日期:2021-01-08 00:00:00

  • Acetazolamide therapy for symptomatic plateau waves in patients with brain tumors. Report of three cases.

    abstract::In this report, the authors describe three patients with malignant gliomas who experienced paroxysmal neurological symptoms triggered by standing. The symptoms were attributed to acute elevations of intracranial pressure, an uncommon phenomenon called "plateau waves." In each instance, the attacks occurred despite the...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/jns.2002.97.1.0224

    authors: Watling CJ,Cairncross JG

    更新日期:2002-07-01 00:00:00

  • Intravertebral vacuum phenomenon in osteoporotic compression fracture: report of 67 cases with quantitative evaluation of intravertebral instability.

    abstract:OBJECT:The objectives of this study were to: 1) describe the incidence and clinical features of intravertebral vacuum phenomenon (IVVP) in a relatively large number of cases; 2) quantitatively evaluate intravertebral instability and determine the factors affecting instability; and 3) evaluate the efficacy of percutaneo...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/spi.2004.100.1.0024

    authors: Kim DY,Lee SH,Jang JS,Chung SK,Lee HY

    更新日期:2004-01-01 00:00:00

  • Integration of three-dimensional corticospinal tractography into treatment planning for gamma knife surgery.

    abstract:OBJECT:In the radiosurgical treatment of critically located lesions, the effort to minimize the risk of complication is essential. In this study the integration of diffusion-tensor (DT) imaging-based tractography was clinically applied to treatment planning for gamma knife surgery (GKS). METHODS:Seven patients with ce...

    journal_title:Journal of neurosurgery

    pub_type: 临床试验,杂志文章

    doi:10.3171/jns.2005.102.4.0673

    authors: Maruyama K,Kamada K,Shin M,Itoh D,Aoki S,Masutani Y,Tago M,Kirino T

    更新日期:2005-04-01 00:00:00

  • Prognostic factors in the persistence of posttraumatic epilepsy after penetrating head injuries sustained in war.

    abstract:OBJECT:The goal of this paper was to investigate the long-term outcome and the possible prognostic factors that might have influenced the persistence of posttraumatic epilepsy after penetrating head injuries sustained during the Iraq-Iran war (1980-1988). METHODS:In this retrospective study, the authors evaluated 189 ...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/2008.4.17519

    authors: Eftekhar B,Sahraian MA,Nouralishahi B,Khaji A,Vahabi Z,Ghodsi M,Araghizadeh H,Soroush MR,Esmaeili SK,Masoumi M

    更新日期:2009-02-01 00:00:00

  • Factors influencing the complication rate of subduroperitoneal shunt placement for the treatment of subdural hematomas in infants.

    abstract:OBJECT:In this study the authors' goal was to identify the complication rate of subduroperitoneal (SDP) shunts for the treatment of subdural hematomas (SDHs) in infants and to determine the influences on and predictive factors for these complications. METHODS:The authors present a case series spanning the years 1994 t...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/ped.2007.106.3.172

    authors: Kurschel S,Puget S,Bourgeois M,Zerah M,Ofner P,Renier D

    更新日期:2007-03-01 00:00:00

  • Pathogenesis of Chiari malformation: a morphometric study of the posterior cranial fossa.

    abstract::To investigate overcrowding in the posterior cranial fossa as the pathogenesis of adult-type Chiari malformation, the authors studied the morphology of the brainstem and cerebellum within the posterior cranial fossa (neural structures consisting of the midbrain, pons, cerebellum, and medulla oblongata) as well as the ...

    journal_title:Journal of neurosurgery

    pub_type: 临床试验,杂志文章

    doi:10.3171/jns.1997.86.1.0040

    authors: Nishikawa M,Sakamoto H,Hakuba A,Nakanishi N,Inoue Y

    更新日期:1997-01-01 00:00:00

  • Fluid-fluid level in pituitary tumors: analysis of management of 106 cases.

    abstract:OBJECT:The management issues of 106 cases of pituitary tumors with a fluid level within the fluid content of the cystic part of the tumor (a "fluid-fluid" level) were reviewed. METHODS:Between 2000 and March 2009, 1660 pituitary tumors were treated neurosurgically at K.E.M. Hospital. Investigations of 106 of these cas...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/2009.11.JNS091083

    authors: Goel A,Shah A,Jhawar SS,Goel NK

    更新日期:2010-06-01 00:00:00

  • Risk of ventriculostomy-related hemorrhage in patients with acutely ruptured aneurysms treated using stent-assisted coiling.

    abstract:OBJECT:Intracranial stenting has improved the ability to treat wide-neck aneurysms via endovascular techniques. However, stent placement necessitates the use of antiplatelet agents, and the latter may complicate the treatment of patients with acutely ruptured aneurysms who demonstrate hydrocephalus and require ventricu...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/2010.9.JNS10445

    authors: Kung DK,Policeni BA,Capuano AW,Rossen JD,Jabbour PM,Torner JC,Howard MA,Hasan D

    更新日期:2011-04-01 00:00:00

  • Encoding of speed and direction of movement in the human supplementary motor area.

    abstract:OBJECT:The supplementary motor area (SMA) plays an important role in planning, initiation, and execution of motor acts. Patients with SMA lesions are impaired in various kinematic parameters, such as velocity and duration of movement. However, the relationships between neuronal activity and these parameters in the huma...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/2008.10.JNS08466

    authors: Tankus A,Yeshurun Y,Flash T,Fried I

    更新日期:2009-06-01 00:00:00

  • Detection of small trigeminal neurinomas.

    abstract::Four cases of trigeminal neurinoma are reviewed with particular attention to clinical signs and symptoms, lumbar puncture, electroencephalogram, brain scan, plain skull and tomographic radiographs, and angiographic and pneumoencephalographic findings. Pneumoencephalography, with special tomographic projections to iden...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/jns.1976.45.5.0568

    authors: Levinthal R,Benston JR

    更新日期:1976-11-01 00:00:00

  • Effect of stimulation of the medullary reticular formation on cerebral vasomotor tonus and intracranial pressure.

    abstract::The authors report the results of a study to evaluate the effect of stimulation of the medullary reticular formation on cerebral vasomotor tonus and intracranial pressure (ICP) after the hypothalamic dorsomedial nucleus and midbrain reticular formation were destroyed. Systemic arterial pressure (BP), ICP, and local ce...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/jns.1987.66.4.0548

    authors: Nagao S,Nishiura T,Kuyama H,Suga M,Murota T

    更新日期:1987-04-01 00:00:00

  • Effect of subarachnoid hemorrhage on endothelium-dependent vasodilation.

    abstract::The effect of subarachnoid hemorrhage (SAH) on endothelium-dependent vasodilation of the isolated rabbit basilar artery was examined using an isometric tension recording method. The SAH was induced by injecting 5 ml of fresh arterial blood into the cisterna magna. Sixty-two rabbits were separated into four groups acco...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/jns.1987.66.6.0915

    authors: Nakagomi T,Kassell NF,Sasaki T,Fujiwara S,Lehman RM,Johshita H,Nazar GB,Torner JC

    更新日期:1987-06-01 00:00:00

  • Acoustic neurinoma presenting as subarachnoid hemorrhage. Case report.

    abstract::A case of an acoustic neurinoma presenting as a subarachnoid hemorrhage is described. This is the second such case in the literature. ...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/jns.1978.49.4.0602

    authors: Gleeson RK,Butzer JF,Grin OD Jr

    更新日期:1978-10-01 00:00:00

  • Resolution of brain edema in severe brain injury at controlled high and low intracranial pressures.

    abstract::A series of 87 patients with severe brain injury were studied. Intracranial pressure (ICP) monitoring and external ventricular drainage were used to control ICP at high and low levels. Clearance of ytterbium-169-labeled diethylenetriaminepentaacetic acid (169Yb-DTPA), Evans blue dye, and ventricular cerebrospinal flui...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/jns.1984.61.4.0707

    authors: Cao M,Lisheng H,Shouzheng S

    更新日期:1984-10-01 00:00:00

  • A reassessment of vascular endothelial growth factor in central nervous system pathology.

    abstract::Overexpression of vascular endothelial growth factor (VEGF) is associated with several central nervous system (CNS) diseases and abnormalities, and is often postulated as a causative factor and promising therapeutic target in these settings. The authors' goal was to reassess the contribution of VEGF to the biology and...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章,评审

    doi:10.3171/jns.2005.103.5.0853

    authors: Merrill MJ,Oldfield EH

    更新日期:2005-11-01 00:00:00

  • Spontaneous cerebrospinal fluid rhinorrhea associated with dysplastic optic discs and a basal encephalocele: case report.

    abstract::A 24-year-old man presented with a history of recurrent meningitis secondary to cerebrospinal fluid (CSF) rhinorrhea. The patient had bilateral optic disc dysplasia in association with a basal encephalocele, but had no midline facial anomalies. The syndrome is rare, and this is the first report of a patient with this ...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/jns.1981.54.6.0807

    authors: Bullard DE,Crockard HA,McDonald WI

    更新日期:1981-06-01 00:00:00

  • Surgical treatment for vertebral artery-posterior inferior cerebellar artery aneurysms: special reference to the importance of the cerebellomedullary fissure dissection.

    abstract:OBJECT:The cerebellomedullary fissure (CMF) is a space between the cerebellum and the medulla oblongata, which often adhere to each other. The purpose of the present study was to demonstrate the importance of the unilateral CMF dissection for clipping vertebral artery (VA)-posterior inferior cerebellar artery (PICA) an...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/2012.10.JNS12603

    authors: Kawashima M,Takase Y,Matsushima T

    更新日期:2013-02-01 00:00:00

  • Lipoma of the cerebellopontine angle. Case report.

    abstract::The authors present a surgical case of a lipoma of the cerebellopontine angle in a 28-year-old woman. ...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/jns.1977.46.4.0544

    authors: Fukui M,Tanaka A,Kitamura K,Okudera T

    更新日期:1977-04-01 00:00:00

  • Usefulness of inferior petrosal sinus venous endocrine markers in Cushing's disease.

    abstract::Bilateral and simultaneous sampling of the inferior petrosal sinuses in patients with Cushing's disease has been used to establish the presence and laterality of adrenocorticotropic hormone (ACTH)-producing microadenomas prior to transsphenoidal surgery. Successful preoperative lateralization depends upon equivalent d...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/jns.1988.68.2.0205

    authors: Zovickian J,Oldfield EH,Doppman JL,Cutler GB Jr,Loriaux DL

    更新日期:1988-02-01 00:00:00

  • Transtentorial transcollateral sulcus approach to the ventricular atrium: an endoscope-assisted anatomical study.

    abstract::OBJECTIVE Conventional approaches to the atrium of the lateral ventricle may be associated with complications related to direct cortical injury or brain retraction. The authors describe a novel approach to the atrium through a retrosigmoid transtentorial transcollateral sulcus corridor. METHODS Bilateral retrosigmoid ...

    journal_title:Journal of neurosurgery

    pub_type: 评论,杂志文章

    doi:10.3171/2016.3.JNS151289

    authors: Jeelani Y,Gokoglu A,Anor T,Al-Mefty O,Cohen AR

    更新日期:2017-04-01 00:00:00

  • Outcome after laminectomy for lumbar spinal stenosis. Part I: Clinical correlations.

    abstract::All patients who underwent decompressive lumbar laminectomy in the Washtenaw County, Michigan metropolitan area during a 7-year period were studied for the purpose of defining long-term outcome, clinical correlations, and the need for subsequent fusion. Outcome was determined by questionnaire and physical examination ...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/jns.1994.81.5.0699

    authors: Tuite GF,Stern JD,Doran SE,Papadopoulos SM,McGillicuddy JE,Oyedijo DI,Grube SV,Lundquist C,Gilmer HS,Schork MA

    更新日期:1994-11-01 00:00:00

  • Factors predicting language lateralization in patients with perisylvian vascular malformations. Clinical article.

    abstract:OBJECT:The authors conducted a study to determine the factors associated with right-sided language dominance in patients with cerebrovascular malformations. METHODS:Twenty-two patients with either arteriovenous malformations (AVMs [15 cases]) or cavernous malformations (7 cases) underwent functional MR (fMR) imaging s...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/2010.2.JNS091595

    authors: Lee DJ,Pouratian N,Bookheimer SY,Martin NA

    更新日期:2010-10-01 00:00:00