Surgical implantation of STN-DBS leads using intraoperative MRI guidance: technique, accuracy, and clinical benefit at 1-year follow-up

详细信息    查看全文

• 作者：Stephan Chabardes ; Stephanie Isnard ; Anna Castrioto…
• 关键词：DBS ; Subthalamic nucleus ; MRI ; Parkinson disease
• 刊名：Acta Neurochirurgica
• 出版年：2015
• 出版时间：April 2015
• 年：2015
• 卷：157
• 期：4
• 页码：729-737
• 全文大小：1,305 KB
• 参考文献：1. Anheim, M, Batir, A, Fraix, V, Silem, M, Chabardes, S, Seigneuret, E, Krack, P, Benabid, AL, Pollak, P (2008) Improvement in Parkinson disease by subthalamic nucleus stimulation based on electrode placement: effects of reimplantation. Arch Neurol 65: pp. 612-616
  2. Benabid, AL, Chabardes, S, Mitrofanis, J, Pollak, P (2009) Deep brain stimulation of the subthalamic nucleus for the treatment of Parkinson's disease. Lancet Neurol 8: pp. 67-81 CrossRef
  3. Chabardes, S, Polosan, M, Krack, P, Bastin, J, Krainik, A, David, O, Bougerol, T, Benabid, AL (2013) Deep brain stimulation for obsessive–compulsive disorder: subthalamic nucleus target. World Neurosurg 80: pp. e31-e38
  4. Chhabra, V, Sung, E, Mewes, K, Bakay, RA, Abosch, A, Gross, RE (2010) Safety of magnetic resonance imaging of deep brain stimulator systems: a serial imaging and clinical retrospective study. J Neurosurg 112: pp. 497-502 CrossRef
  5. Dormont, D, Ricciardi, KG, Tande, D, Parain, K, Menuel, C, Galanaud, D, Navarro, S, Cornu, P, Agid, Y, Yelnik, J (2004) Is the subthalamic nucleus hypointense on T2-weighted images? A correlation study using MR imaging and stereotactic atlas data. AJNR Am J Neuroradiol 25: pp. 1516-1523
  6. Fraix, V, Chabardes, S, Krainik, A, Seigneuret, E, Grand, S, Bas, JF, Krack, P, Benabid, AL, Pollak, P (2010) Effects of magnetic resonance imaging in patients with implanted deep brain stimulation systems. J Neurosurg 113: pp. 1242-1245 CrossRef
  7. Golombeck, MA, Thiele, J, Dossel, O (2002) Magnetic resonance imaging with implanted neurostimulators: numerical calculation of the induced heating. Biomed Tech (Berl) 47: pp. 660-663 CrossRef
  8. Hariz, MI (2002) Safety and risk of microelectrode recording in surgery for movement disorders. Stereotact Funct Neurosurg 78: pp. 146-157 CrossRef
  9. Henderson, JM, Tkach, J, Phillips, M, Baker, K, Shellock, FG, Rezai, AR (2005) Permanent neurological deficit related to magnetic resonance imaging in a patient with implanted deep brain stimulation electrodes for Parkinson's disease: case report. Neurosurgery 57: pp. E1063 CrossRef
  10. Hirabayashi, H, Tengvar, M, Hariz, MI (2002) Stereotactic imaging of the pallidal target. Mov Disord 17: pp. S130-S134 CrossRef
  11. Holloway, KL, Gaede, SE, Starr, PA, Rosenow, JM, Ramakrishnan, V, Henderson, JM (2005) Frameless stereotaxy using bone fiducial markers for deep brain stimulation. J Neurosurg 103: pp. 404-413 CrossRef
  12. Kimmelman, J, Duckworth, K, Ramsay, T, Voss, T, Ravina, B, Emborg, ME (2011) Risk of surgical delivery to deep nuclei: a meta-analysis. Mov Disord 26: pp. 1415-1421 CrossRef
  13. Limousin, P, Pollak, P, Benazzouz, A, Hoffmann, D, Bas, JF, Broussolle, E, Perret, JE, Benabid, AL (1995) Effect of parkinsonian signs and symptoms of bilateral subthalamic nucleus stimulation. Lancet 345: pp. 91-95 CrossRef
  14. Mallet, L, Polosan, M, Jaafari, N, Baup, N, Welter, ML, Fontaine, D, Montcel, ST, Yelnik, J, Chereau, I, Arbus, C, Raoul, S, Aouizerate, B, Damier, P, Chabardes, S, Czernecki, V, Ardouin, C, Krebs, MO, Bardinet, E, Chaynes, P, Burbaud, P, Cornu, P, Derost, P, Bougerol, T, Bataille, B, Mattei, V, Dormont, D, Devaux, B, Verin, M, Houeto, JL, Pollak, P, Benabid, AL, Agid, Y, Krack, P, Millet, B, Pelissolo, A (2008) Subthalamic nucleus stimulation in severe obsessive-compulsive disorder. N Engl J Med 359: pp. 2121-2134 CrossRef
  The Unified Parkinson’s Disease Rating Scale (UPDRS): status and recommendations. Mov Disord 18: pp. 738-750 CrossRef <
• 刊物主题：Neurosurgery; Interventional Radiology; Neuroradiology; Neurology; Surgical Orthopedics; Minimally Invasive Surgery;
• 出版者：Springer Vienna
• ISSN：0942-0940

文摘

Background Improvement of surgical accuracy during DBS-lead implantation has been described recently, leading to “frameless-or “MRI-verified-techniques. However, combining a high-quality definition of the STN using intraoperative 1.5 MRI with the possibility to reduce errors due to co-registration and to monitor lead progression during surgical insertion while checking the absence of surgical complication is an appealing method. We report here surgical methodology, safety, application accuracy, and clinical benefit of STN-lead implantation under MRI guidance. Methods Two patients with a severe PD state were treated by bilateral STN–DBS. Leads were implanted under general anesthesia using intraoperative MRI guidance (ClearPoint system). Lead implantation accuracy was measured on T1 axial images at the level of the target. Clinical improvement was measured on the pre- and post-UPDRS 3 scale at 1-year follow-up. Results Surgery was safe and uneventful in both cases. Radial error was 0.36 (right) and 0.86?mm (left) in case 1, and 0.41 (right) and 0.14?mm (left) in case 2. No edema or hemorrhage were noticed. Conclusions Intraoperative MRI guidance allows DBS lead implantation with high accuracy and with great clinical efficacy. A larger cohort of patients is needed to confirm these initial results.