Prognostic factors of unilateral prelemniscal radiations radiofrequency lesions: A surgical technique for the treatment of Parkinson's disease motor symptoms.

Autor: Navarro-Olvera JL; Unit of Stereotactic and Functional Neurosurgery, General Hospital of Mexico, Mexico City, Mexico; Faculty of Medicine, National Autonomous University of Mexico, Mexico City, Mexico., Velasco-Campos F; Unit of Stereotactic and Functional Neurosurgery, General Hospital of Mexico, Mexico City, Mexico., Jiménez-Ponce F; Unit of Stereotactic and Functional Neurosurgery, General Hospital of Mexico, Mexico City, Mexico., Aguado-Carrillo G; Unit of Stereotactic and Functional Neurosurgery, General Hospital of Mexico, Mexico City, Mexico., Beltrán JQ; Unit of Stereotactic and Functional Neurosurgery, General Hospital of Mexico, Mexico City, Mexico., Armas-Salazar A; Unit of Stereotactic and Functional Neurosurgery, General Hospital of Mexico, Mexico City, Mexico; Postgraduate department, School of Higher education in Medicine, National Polytechnic Institute, Mexico City, Mexico., Carrillo-Ruiz JD; Unit of Stereotactic and Functional Neurosurgery, General Hospital of Mexico, Mexico City, Mexico; Research Direction of General Hospital of Mexico, Mexico City, Mexico; Neuroscience coordination, Psychology Faculty, Anahuac University Mexico, Mexico City, Mexico. Electronic address: josecarrilloruiz@yahoo.com.
Jazyk: angličtina
Zdroj: Clinical neurology and neurosurgery [Clin Neurol Neurosurg] 2023 Feb; Vol. 225, pp. 107588. Date of Electronic Publication: 2023 Jan 10.
DOI: 10.1016/j.clineuro.2023.107588
Abstrakt: Objective: A group of patients with Parkinson's disease (PD) were managed with unilateral prelemniscal radiation radiofrequency lesions (U-Raprl). The current study aims to evaluate prognostic factors that could influence clinical response.
Methods: Patients previously diagnosed with PD managed with U-Raprl were included in the study, classifying them into two groups according to their percentage of clinical response (Results: Thirty-four patients were included, where the most prevalent symptoms were tremor and rigidity, with 52.9% percentage of males, 59.3 ± 6.4 mean age, and 7.4 ± 2.1 of mean evolution of PD. Analysis shows differences between groups (p < 0.05) according to the HYS, UPDRS, and levodopa intake, after the intervention. The analysis of the groups according to their response showed differences between the HYS (p < 0.01, ∆ > 1.5), Age (p < 0.0001, ∆ = 2.38), Evolution (p < 0.0001, ∆ = 2.38), and post-operative UPDRS (p < 0.01, ∆ = 1.38). The qualitative analysis of the distribution regarding the responder group shows that those patients with an age under 58 years, an evolution fewer than 7 years, and a preoperative HYS score smaller than 2, showed a response ≥ 50% according to the UPDRS-III in all cases.
Conclusion: U-Raprl is a highly effective procedure with a 5-year persistence of improvement. The most relevant prognostic factors to consider for a clinical response according to UPDRS-III greater than 50% are age under 58 years, less than 7 years of PD evolution, and HYS less or equal to 3.
Competing Interests: Conflict of interest The authors certify that there is no conflict of interest with any financial organization regarding the material discussed in the manuscript.
(Copyright © 2023 Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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