J 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

BALÁŽ, Marek (703 Slovensko, domácí), Pavel FILIP (703 Slovensko, domácí), Martina BOČKOVÁ (203 Česká republika, domácí), Věra FEITOVÁ (203 Česká republika), Ivo ŘÍHA (203 Česká republika, domácí), Dušan HRABOVSKÝ (703 Slovensko, domácí) a Jan CHRASTINA (203 Česká republika, garant, domácí)

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

DOI

UT WoS

000609567400001

Klíčová slova anglicky

Deep brain stimulation; Parkinson's disease; asymmetrical targets; subthalamic nucleus; globus pallidus internus

Štítky

Příznaky

Mezinárodní význam, Recenzováno
Změněno: 5. 11. 2024 14:22, 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.