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Sub-acute delayed failure of subthalamic DBS in Parkinson's disease: the role of micro-lesion effect

Russmann, H.
Staedler, C.
Ghika, J.
Villemure, J-G.
Published in Parkinsonism & Related Disorders. 2008, vol. 14, no. 2, p. 109-13
Abstract OBJECTIVE: To study delayed failure after subthalamic nucleus (STN) deep brain stimulation in Parkinson's disease (PD) patients. METHODS: Out of 56 consecutive bilaterally STN-implanted PD patients, we selected subjects who, after initial clinical improvement (1 month after surgery), lost benefit (delayed failure, DF). RESULTS: Five patients developed sub-acutely severe gait disorders (DF). In 4/5 DF patients, a micro-lesion effect, defined as improvement without stimulation, was observed; immediate post-operative MRI demonstrated electrode located above or behind to the STN. CONCLUSIONS: Patients presenting micro-lesion effect should be carefully monitored, as this phenomenon can mask electrodes misplacement and evolution in DF.
Keywords Activities of Daily LivingAgedAntiparkinson Agents/therapeutic useCohort StudiesCombined Modality TherapyElectrodes, Implanted/adverse effectsFemaleFollow-Up StudiesGait Disorders, Neurologic/complicationsHumansHypokinesia/complicationsMaleMicroelectrodes/adverse effectsMiddle AgedParkinson Disease/psychology/therapyStereotaxic TechniquesSubthalamic Nucleus/physiologyTreatment Failure
PMID: 18065255
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Research group Groupe Pierre Burkhard (neurologie) (154)
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GRANZIERA, Cristina et al. Sub-acute delayed failure of subthalamic DBS in Parkinson's disease: the role of micro-lesion effect. In: Parkinsonism & Related Disorders, 2008, vol. 14, n° 2, p. 109-13. doi: 10.1016/j.parkreldis.2007.06.013 https://archive-ouverte.unige.ch/unige:1874

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Deposited on : 2009-06-02

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