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Microsubthalamotomy: An immediate predictor of long‐term subthalamic stimulation efficacy in Parkinson disease
Author(s) -
Maltête David,
Derrey Stéphane,
Chastan Nathalie,
Debono Bertrand,
Gérardin Emmanuel,
Fréger Pierre,
Mihout Bruno,
Menard Jean François,
Hannequin Didier
Publication year - 2008
Publication title -
movement disorders
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.352
H-Index - 198
eISSN - 1531-8257
pISSN - 0885-3185
DOI - 10.1002/mds.22054
Subject(s) - parkinson's disease , deep brain stimulation , subthalamic nucleus , medicine , physical medicine and rehabilitation , term (time) , degenerative disease , stimulation , central nervous system disease , psychology , disease , neuroscience , physics , quantum mechanics
A microsubthalamotomy (mSTN) effect is commonly described after implantation that improves Parkinson's motor disability and is considered to be an obvious sign of good placement of the definitive electrode within the subthalamic nucleus (STN). There has been no formal study, however, demonstrating whether this mSTN effect can predict the long‐term efficacy of STN stimulation in Parkinson Disease. The mSTN effect was defined by the percentage improvement of unified parkinson's disease rating scale (UPDRS III) baseline score assessed the third day morning following STN implantation, after at least a 12 hour withdrawal of dopaminergic treatment and before the programmable pulse generator was switched on. It was assessed in 30 consecutive patients with PD submitted for STN stimulation. Multiple stepwise regression analysis showed that mSTN effect ( P = 0.005) and global mean intensity of stimulation ( P = 0.004) were accurate independent predictors of the 6‐month postoperative UPDRS III motor score improvement in the off ‐drug/ on ‐stimulation condition. © 2008 Movement Disorder Society