2024
Successful asymmetrical deep brain stimulation using right subthalamic and left pallidal electrodes in a patient with Parkinson's disease
BALÁŽ, Marek, Pavel FILIP, Martina BOČKOVÁ, Věra FEITOVÁ, Ivo ŘÍHA et. al.Základní údaje
Originální název
Successful asymmetrical deep brain stimulation using right subthalamic and left pallidal electrodes in a patient with Parkinson's disease
Autoři
Vydání
British journal of neurosurgery, London, Informa Healthcare, 2024, 0268-8697
Další údaje
Jazyk
angličtina
Typ výsledku
Článek v odborném periodiku
Obor
30210 Clinical neurology
Stát vydavatele
Velká Británie a Severní Irsko
Utajení
není předmětem státního či obchodního tajemství
Odkazy
Impakt faktor
Impact factor: 1.100 v roce 2022
Organizační jednotka
Lékařská fakulta
UT WoS
000609567400001
Klíčová slova anglicky
Deep brain stimulation; Parkinson's disease; asymmetrical targets; subthalamic nucleus; globus pallidus internus
Příznaky
Mezinárodní význam, Recenzováno
Změněno: 4. 3. 2024 08:38, Mgr. Tereza Miškechová
Anotace
V originále
Purpose: Despite the best efforts of neurologists, the results of pharmacotherapy in the late stages of Parkinson's disease are often disappointing and accompanied by debilitating side effects. Under these circumstances, deep brain stimulation is a viable treatment option. The aim of the meticulous pre-surgical planning is not only precise electrode implantation, but also the avoidance of intraoperative vascular conflicts potentially causing intracerebral bleeding. Material and methods: In this report, we present a patient with early-onset Parkinson's disease whose cerebral vascular anatomy precluded standard bilateral subthalamic nucleus electrode implantation. Initially, right subthalamic stimulation alone provided a very mild clinical benefit that was not reflected in the patient's quality of life. In this patient, an unusual configuration of intracerebral electrodes with right subthalamic and left pallidal stimulation electrodes was applied 15 months after the initial subthalamic electrode implantation. Results: The procedure has had a highly beneficial long-term effect without any significant complications. The greatest improvement was noted using the setting 1.8 V, 130 Hz, 90 mu s at the right side (STN) and 3.7 V, 130 Hz, 120 mu s at the left side (GPi). This allowed the patient to return to his daily life activities. Conclusions: The reported case provides a new perspective of treatment possibilities in complex functional neurosurgical cases requiring exceptional individualisation of the treatment approach.