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Minimizing BrainShift in StereotacticFunctionalNeurosurgery Erika PetersenEtienne HollIrene Martínez‐Torres2010 год

Minimizing Brain Shift in Stereotactic Functional Neurosurgery
статья из журнала

Страница публикацииПубликация в OpenAlex
Аннотация: Stereotactic functional neurosurgical interventions depend on precise anatomic targeting before lesioning or deep brain stimulation (DBS) electrode placement.To examine the degree of subcortical brain shift observed when adopting an image-guided approach to stereotactic functional neurosurgery.Coordinates for the anterior and posterior commissural points (AC and PC) were recorded on thin-slice stereotactic magnetic resonance imaging (MRI) scans performed before and immediately after DBS electrode implantation in 136 procedures. The changes in length of AC-PC and in stereotactic coordinates for AC and PC were calculated for each intervention. In patients with Parkinson disease undergoing bilateral subthalamic nucleus (STN) DBS with at least 6 months of follow-up, pre- and postoperative scores of the motor part of the Unified Parkinson's Disease Rating Scale (UPDRS-III) were reviewed.Mean (SD) change in AC-PC length (DeltaAC-PC) was 0.6 (0.4) mm. There was no statistically significant difference in DeltaAC-PC between groups when examining anatomic target subgroups (P =.95), age subgroups (P = .63), sex (P = .59), and unilateral versus bilateral implantation (P =.15). The mean (SD) vector changes for the commissural points were: -0.1 (0.3) mm in X, -0.4 (0.6) mm in Y, and -0.1 (0.7) mm in Z for the AC; and -0.1 (0.3) mm in X, -0.2 (0.7) mm in Y, and 0.0 (0.7) mm in Z for the PC. There was a negligible correlation between the magnitude of brain shift and percentage improvement in UPDRS-III off-medication in patients undergoing STN DBS for PD (R <0.01).Brain shift has long been considered an issue in stereotactic targeting during DBS procedures. However, with the image-guided approach and surgical technique used in this study, subcortical brain shift was extremely limited and did not appear to adversely affect clinical outcome.
Год издания: 2010
Авторы: Erika Petersen, Etienne Holl, Irene Martínez‐Torres, Thomas Foltynie, Patricia Limousin, Marwan Hariz, Ludvic Zrinzo
Издательство: Lippincott Williams & Wilkins
Источник: Operative Neurosurgery
Ключевые слова: Neurological disorders and treatments, Parkinson's Disease Mechanisms and Treatments, Genetic Neurodegenerative Diseases
Другие ссылки: Operative Neurosurgery (HTML)
PubMed (HTML)