Subthalamic Deep Brain Stimulation Lead Asymmetry Impacts the Parkinsonian Gait Disorder
BackgroundThe preferable position of Deep Brain Stimulation (DBS) electrodes is proposed to be located in the dorsolateral subthalamic nucleus (STN) to improve general motor performance. The optimal DBS electrode localization for the post-operative improvement of balance and gait is unknown.MethodsI...
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| Format: | Article |
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Frontiers Media S.A.
2022-03-01
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| Series: | Frontiers in Human Neuroscience |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fnhum.2022.788200/full |
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| author | Frederik P. Schott Alessandro Gulberti Alessandro Gulberti Hans O. Pinnschmidt Christian Gerloff Christian K. E. Moll Miriam Schaper Johannes A. Koeppen Wolfgang Hamel Monika Pötter-Nerger |
| author_facet | Frederik P. Schott Alessandro Gulberti Alessandro Gulberti Hans O. Pinnschmidt Christian Gerloff Christian K. E. Moll Miriam Schaper Johannes A. Koeppen Wolfgang Hamel Monika Pötter-Nerger |
| author_sort | Frederik P. Schott |
| collection | DOAJ |
| description | BackgroundThe preferable position of Deep Brain Stimulation (DBS) electrodes is proposed to be located in the dorsolateral subthalamic nucleus (STN) to improve general motor performance. The optimal DBS electrode localization for the post-operative improvement of balance and gait is unknown.MethodsIn this single-center, retrospective analyses, 66 Parkinson’s disease (PD) patients (24 female, age 63 ± 7 years) were assessed pre- and post-operatively (8.45 ± 4.2 months after surgery) by using MDS-UPDRS, freezing of gait (FoG) score, Giladi’s gait and falls questionnaire and Berg balance scale. The clinical outcome was related to the DBS electrode coordinates in x, y, z plane as revealed by image-based reconstruction (SureTune™). Binomial generalized linear mixed models with fixed-effect variables electrode asymmetry, parkinsonian subtype, medication, age class and clinical DBS induced changes were analyzed.ResultsSubthalamic nucleus-deep brain stimulation improved all motor, balance and FoG scores in MED OFF condition, however there were heterogeneous results in MED ON condition. DBS electrode reconstructed coordinates impacted the responsiveness of axial symptoms. FoG and balance responders showed slightly more medially located STN electrode coordinates and less medio-lateral asymmetry of the electrode reconstructed coordinates across hemispheres compared to non-responders.ConclusionDeep brain stimulation electrode reconstructed coordinates, particularly electrode asymmetry on the medio-lateral axis affected the post-operative responsiveness of balance and FoG symptoms in PD patients. |
| first_indexed | 2024-04-13T17:00:32Z |
| format | Article |
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| institution | Directory Open Access Journal |
| issn | 1662-5161 |
| language | English |
| last_indexed | 2024-04-13T17:00:32Z |
| publishDate | 2022-03-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Human Neuroscience |
| spelling | doaj.art-91d6bd9272694494a66ba29e193615472022-12-22T02:38:40ZengFrontiers Media S.A.Frontiers in Human Neuroscience1662-51612022-03-011610.3389/fnhum.2022.788200788200Subthalamic Deep Brain Stimulation Lead Asymmetry Impacts the Parkinsonian Gait DisorderFrederik P. Schott0Alessandro Gulberti1Alessandro Gulberti2Hans O. Pinnschmidt3Christian Gerloff4Christian K. E. Moll5Miriam Schaper6Johannes A. Koeppen7Wolfgang Hamel8Monika Pötter-Nerger9Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, GermanyDepartment of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, GermanyDepartment of Neurophysiology and Pathophysiology, University Medical Center Hamburg-Eppendorf, Hamburg, GermanyDepartment of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Hamburg, GermanyDepartment of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, GermanyDepartment of Neurophysiology and Pathophysiology, University Medical Center Hamburg-Eppendorf, Hamburg, GermanyDepartment of Neurosurgery, University Medical Center Hamburg-Eppendorf, Hamburg, GermanyDepartment of Neurosurgery, University Medical Center Hamburg-Eppendorf, Hamburg, GermanyDepartment of Neurosurgery, University Medical Center Hamburg-Eppendorf, Hamburg, GermanyDepartment of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, GermanyBackgroundThe preferable position of Deep Brain Stimulation (DBS) electrodes is proposed to be located in the dorsolateral subthalamic nucleus (STN) to improve general motor performance. The optimal DBS electrode localization for the post-operative improvement of balance and gait is unknown.MethodsIn this single-center, retrospective analyses, 66 Parkinson’s disease (PD) patients (24 female, age 63 ± 7 years) were assessed pre- and post-operatively (8.45 ± 4.2 months after surgery) by using MDS-UPDRS, freezing of gait (FoG) score, Giladi’s gait and falls questionnaire and Berg balance scale. The clinical outcome was related to the DBS electrode coordinates in x, y, z plane as revealed by image-based reconstruction (SureTune™). Binomial generalized linear mixed models with fixed-effect variables electrode asymmetry, parkinsonian subtype, medication, age class and clinical DBS induced changes were analyzed.ResultsSubthalamic nucleus-deep brain stimulation improved all motor, balance and FoG scores in MED OFF condition, however there were heterogeneous results in MED ON condition. DBS electrode reconstructed coordinates impacted the responsiveness of axial symptoms. FoG and balance responders showed slightly more medially located STN electrode coordinates and less medio-lateral asymmetry of the electrode reconstructed coordinates across hemispheres compared to non-responders.ConclusionDeep brain stimulation electrode reconstructed coordinates, particularly electrode asymmetry on the medio-lateral axis affected the post-operative responsiveness of balance and FoG symptoms in PD patients.https://www.frontiersin.org/articles/10.3389/fnhum.2022.788200/fulldeep brain stimulationsubthalamic nucleusParkinson’s diseasebalancegait disorderfreezing of gait |
| spellingShingle | Frederik P. Schott Alessandro Gulberti Alessandro Gulberti Hans O. Pinnschmidt Christian Gerloff Christian K. E. Moll Miriam Schaper Johannes A. Koeppen Wolfgang Hamel Monika Pötter-Nerger Subthalamic Deep Brain Stimulation Lead Asymmetry Impacts the Parkinsonian Gait Disorder Frontiers in Human Neuroscience deep brain stimulation subthalamic nucleus Parkinson’s disease balance gait disorder freezing of gait |
| title | Subthalamic Deep Brain Stimulation Lead Asymmetry Impacts the Parkinsonian Gait Disorder |
| title_full | Subthalamic Deep Brain Stimulation Lead Asymmetry Impacts the Parkinsonian Gait Disorder |
| title_fullStr | Subthalamic Deep Brain Stimulation Lead Asymmetry Impacts the Parkinsonian Gait Disorder |
| title_full_unstemmed | Subthalamic Deep Brain Stimulation Lead Asymmetry Impacts the Parkinsonian Gait Disorder |
| title_short | Subthalamic Deep Brain Stimulation Lead Asymmetry Impacts the Parkinsonian Gait Disorder |
| title_sort | subthalamic deep brain stimulation lead asymmetry impacts the parkinsonian gait disorder |
| topic | deep brain stimulation subthalamic nucleus Parkinson’s disease balance gait disorder freezing of gait |
| url | https://www.frontiersin.org/articles/10.3389/fnhum.2022.788200/full |
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