Deep brain stimulation therapy for Parkinson's disease using frameless stereotaxy: Comparison with frame-based surgery
Journal
European Journal of Neurology
Journal Volume
17
Journal Issue
11
Pages
1377-1385
Date Issued
2010
Author(s)
Lu H.-H.
Tsai C.-W.
Abstract
Background and purpose: Deep brain stimulation (DBS) surgery has been performed using frame-based stereotaxy traditionally; however, in recent years, it has also been performed using frameless stereotaxy. The purpose of this study was to compare the experience at our centre in performing DBS surgery using frameless surgery for patients with Parkinson's disease with that of using frame-based surgery.Methods: Twenty-four patients with advanced Parkinson's disease underwent DBS surgery, 12 with frameless and 12 with frame-based stereotaxy. After identifying the subthalamus by microelectrode recording (MER), the DBS electrodes were implanted and connected to an implanted programmable generator in all patients. Programming was started 1 month after the operation and the outcome of the patients was followed up regularly for at least 12 months.Results: After 1 year of follow-up, the patients who received frameless surgery showed no difference in the degree of improvement in clinical motor function compared with the patients who received frame-based surgery (P = 0.819); the average improvement was 60.9% and 56.9%, respectively, in the stimulation alone/medication-off state, as evaluated by the Unified Parkinson's Disease Rating Scale-III motor subscore. However, the frameless group had significantly shorter total MER time (P = 0.0127) and a smaller number of trajectories (P = 0.0096) than the frame-based group.Conclusions: Our data indicate that frameless DBS surgery has a similar outcome when compared with frame-based surgery; however, frameless surgery can decrease the operation time, MER time, and MER trajectory number. ? 2010 The Author(s). Journal compilation ? 2010 EFNS.
SDGs
Other Subjects
adult; article; brain depth stimulation; clinical article; controlled study; female; follow up; frameless stereotactic procedure; human; intermethod comparison; male; microelectrode; motor performance; operation duration; outcome assessment; Parkinson disease; priority journal; scoring system; statistical significance; subthalamus; surgical approach; surgical technique; treatment outcome; Unified Parkinson Disease Rating Scale; Adult; Aged; Algorithms; Deep Brain Stimulation; Electrodes; Female; Follow-Up Studies; Humans; Male; Middle Aged; Neuronavigation; Parkinson Disease; Statistics, Nonparametric; Stereotaxic Techniques; Subthalamic Nucleus; Treatment Outcome
Type
journal article