The atypical subthalamic nucleus--an anatomical variant relevant for stereotactic targeting
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The atypical subthalamic nucleus--an anatomical variant relevant for stereotactic targeting. / Reese, René; Pinsker, Markus O; Herzog, Jan; Wodarg, Fritz; Steigerwald, Frank; Pötter-Nerger, Monika; Falk, Daniela; Deuschl, Günther; Mehdorn, H Maximilian; Volkmann, Jens.
in: MOVEMENT DISORD, Jahrgang 27, Nr. 4, 04.2012, S. 544-8.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - The atypical subthalamic nucleus--an anatomical variant relevant for stereotactic targeting
AU - Reese, René
AU - Pinsker, Markus O
AU - Herzog, Jan
AU - Wodarg, Fritz
AU - Steigerwald, Frank
AU - Pötter-Nerger, Monika
AU - Falk, Daniela
AU - Deuschl, Günther
AU - Mehdorn, H Maximilian
AU - Volkmann, Jens
N1 - Copyright © 2012 Movement Disorder Society.
PY - 2012/4
Y1 - 2012/4
N2 - BACKGROUND: The improvement of PD motor symptoms by DBS of the STN depends on exact targeting.METHODS: A combination of MRI and multitrajectory microrecordings was used for localization of the STN in a group of 228 consecutive PD patients.RESULTS: In 1% of our cases, the STN was consistently shifted in the anterior (3.3 ± 0.8mm) and medial (3.0 ± 0.9 mm) direction within the target plane, compared to controls. Adjustment of the original target coordinates after intraoperative reevaluation of the MRI and confirmation by typical subthalamic neuronal recordings along the deviant trajectory allowed the implantation of clinically effective electrodes in all cases. The relative improvement of the motor UPDRS at 6-months follow-up in patients with an atypical and typical STN was comparable.CONCLUSION: An atypical position of the STN does not need to complicate DBS surgery, if detected by a combination of MRI-based targeting and electrophysiological guidance.
AB - BACKGROUND: The improvement of PD motor symptoms by DBS of the STN depends on exact targeting.METHODS: A combination of MRI and multitrajectory microrecordings was used for localization of the STN in a group of 228 consecutive PD patients.RESULTS: In 1% of our cases, the STN was consistently shifted in the anterior (3.3 ± 0.8mm) and medial (3.0 ± 0.9 mm) direction within the target plane, compared to controls. Adjustment of the original target coordinates after intraoperative reevaluation of the MRI and confirmation by typical subthalamic neuronal recordings along the deviant trajectory allowed the implantation of clinically effective electrodes in all cases. The relative improvement of the motor UPDRS at 6-months follow-up in patients with an atypical and typical STN was comparable.CONCLUSION: An atypical position of the STN does not need to complicate DBS surgery, if detected by a combination of MRI-based targeting and electrophysiological guidance.
KW - Cohort Studies
KW - Deep Brain Stimulation
KW - Female
KW - Humans
KW - Magnetic Resonance Imaging
KW - Male
KW - Parkinson Disease
KW - Stereotaxic Techniques
KW - Subthalamic Nucleus
KW - Journal Article
U2 - 10.1002/mds.24902
DO - 10.1002/mds.24902
M3 - SCORING: Journal article
C2 - 22371222
VL - 27
SP - 544
EP - 548
JO - MOVEMENT DISORD
JF - MOVEMENT DISORD
SN - 0885-3185
IS - 4
ER -