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.

Basic information

Original name

Successful asymmetrical deep brain stimulation using right subthalamic and left pallidal electrodes in a patient with Parkinson's disease

Authors

BALÁŽ, Marek, Pavel FILIP, Martina BOČKOVÁ, Věra FEITOVÁ, Ivo ŘÍHA, Dušan HRABOVSKÝ and Jan CHRASTINA

Edition

British journal of neurosurgery, London, Informa Healthcare, 2024, 0268-8697

Other information

Language

English

Type of outcome

Článek v odborném periodiku

Field of Study

30210 Clinical neurology

Country of publisher

United Kingdom of Great Britain and Northern Ireland

Confidentiality degree

není předmětem státního či obchodního tajemství

References:

Impact factor

Impact factor: 1.100 in 2022

Organization unit

Faculty of Medicine

DOI

UT WoS

000609567400001

Keywords in English

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

Tags

Tags

International impact, Reviewed
Změněno: 4/3/2024 08:38, Mgr. Tereza Miškechová

Abstract

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.