Long-term follow-up of Parkinsonian patients operated on with deep brain electromodulation without intraoperative microrecording.

Autor:	Lopez DT; Department of Neurosurgery, Hospital Hernan Henriquez Aravena, Temuco, Chile., Manzano GE; Department of Neurosurgery, Hospital Regional de Coyhaique, Coyhaique, Aysen, Chile., Medina A; Department of Internal Medicine, Hospital Militar Coronel Elbano Paredes Vivas, Maracay, Venezuela., Prieto MJ; Department of General Medicine, CESFAM El Aguilucho, Santiago de Chile, Chile., Abud JP; Department of Neurosurgery, Hospital Vargas of Caracas, San José, Caracas., Salazar L; Department of Neurosurgery, Clinica Chilemex, Ciudad Guayana, Venezuela., Vargas MF; Department of Neurosurgery, Centro Medico Docente La Trinidad, Baruta, Venezuela., Torres N; Department of Neuroscience, CEA LETI CLINATEC, Grenoble, France., Sacchettoni SA; Department of Neuro-diagnostics, Neurology Mobile System Associates, Miami, Florida, United States.
Jazyk:	angličtina
Zdroj:	Surgical neurology international [Surg Neurol Int] 2023 Dec 22; Vol. 14, pp. 435. Date of Electronic Publication: 2023 Dec 22 (Print Publication: 2023).
DOI:	10.25259/SNI_673_2023
Abstrakt:	Background: Deep brain electromodulation (DBEM), also known as deep brain stimulation in different intracerebral targets, is the most widely used surgical treatment due to its effects in reducing motor symptoms of Parkinson's disease. The intracerebral microelectrode recording has been considered for decades as a necessary tool for the success of Parkinson's surgery. However, some publications give more importance to intracerebral stimulation as a better predictive test. Since 2002, we initiated a technique of brain implant of electrodes without micro recording and based solely on image-guided stereotaxis followed by intraoperative macrostimulation. In this work, we analyze our long-term results, taking into account motor skills and quality of life (QL) before and after surgery, and we also establish the patient's time of clinical improvement. Methods: This is a descriptive clinical study in which the motor state of the patients was evaluated with the unified Parkinson's disease scale (UPDRS) and the QL using the Parkinson's disease QL questionnaire 39 questionnaires before surgery, in the "on" state of the medication; and after surgery, under active stimulation and in the "on" state. Results: Twenty-four patients with ages ranging from 37 to 78 years undergoing surgery DBEM on the subthalamic nucleus were studied. An improvement of 41.4% in motor skills and 41.7% in QL was obtained. Conclusion: When microrecording is not available, the results that can be obtained, based on preoperative imaging and clinical intraoperative findings, are optimal and beneficial for patients. Competing Interests: There are no conflicts of interest. (Copyright: © 2023 Surgical Neurology International.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu