BALÁŽ, Marek, Pavel FILIP, Martina BOČKOVÁ, Věra FEITOVÁ, Ivo ŘÍHA, Dušan HRABOVSKÝ and Jan CHRASTINA. Successful asymmetrical deep brain stimulation using right subthalamic and left pallidal electrodes in a patient with Parkinson's disease. British journal of neurosurgery. London: Informa Healthcare, 2024, 5 pp. ISSN 0268-8697. Available from: https://dx.doi.org/10.1080/02688697.2021.1876210.
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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
Original language English
Type of outcome Article in a journal
Field of Study 30210 Clinical neurology
Country of publisher United Kingdom of Great Britain and Northern Ireland
Confidentiality degree is not subject to a state or trade secret
WWW URL
Impact factor Impact factor: 1.100 in 2022
Organization unit Faculty of Medicine
Doi http://dx.doi.org/10.1080/02688697.2021.1876210
UT WoS 000609567400001
Keywords in English Deep brain stimulation; Parkinson's disease; asymmetrical targets; subthalamic nucleus; globus pallidus internus
Tags 14110119, 14110127, 14110131
Tags International impact, Reviewed
Changed by Changed by: Mgr. Tereza Miškechová, učo 341652. Changed: 4/3/2024 08:38.
Abstract
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.
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