Stereotactic MRI in Dyt1 Dystonia: Focal Signal Abnormalities in the Basal Ganglia Do Not Contraindicate Deep Brain Stimulation
| Autor: | Alain Bonafe, B. Biolsi, P. Delort, Laura Cif, Xavier Vasques, C. Tancu, Sophie Gavarini, Philippe Coubes, S. Plagnol, Nathalie Vayssiere |
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| Rok vydání: | 2008 |
| Předmět: |
Dystonia
Pathology medicine.medical_specialty Movement disorders Deep brain stimulation medicine.diagnostic_test business.industry medicine.medical_treatment Magnetic resonance imaging Primary Dystonia equipment and supplies medicine.disease 030218 nuclear medicine & medical imaging 03 medical and health sciences 0302 clinical medicine Dyskinesia Stereotaxic technique Basal ganglia medicine Surgery Neurology (clinical) medicine.symptom business human activities 030217 neurology & neurosurgery |
| Zdroj: | Stereotactic and Functional Neurosurgery. 86:245-252 |
| ISSN: | 1423-0372 1011-6125 |
| Popis: | Aims: To study stereotactic magnetic resonance imaging (MRI) features of the basal ganglia in DYT1 primary dystonia. Methods: Twenty-five genetically confirmed DYT1 dystonia patients (age range, 8–66 years; mean age, 22 years) underwent brain MRI under general anesthesia at the time of globus pallidus internus (GPi) deep brain stimulation (DBS) surgery. MR images were retrospectively reviewed for signal intensity alterations. Clinical improvement of patients was assessed by comparing pre- and postoperative Burke-Fahn-Marsden Dystonia Rating Scale scores. Results: Seventeen patients out of 25 (68%) exhibited T1-weighted hypointense/T2-weighted hyperintense signal abnormalities in the putamen and globus pallidus on MR images. Signals were isointense with cerebrospinal fluid in all sequences. The mean volume of focal signal abnormalities was 15 mm3 (maximum, 154.5 mm3). The total volume of focal signal abnormalities in the basal ganglia was correlated with the duration of the disease (p = 0.01). Although clinical outcome did not differ as a function of the presence of focal signal abnormalities overall, patients with signals within the GPi tended to show lesser improvement (p = 0.04). Conclusions: T1-hypointense/T2-hyperintense signal abnormalities are common findings in the putamen and globus pallidus of DYT1 patients but do not contraindicate DBS. However, their presence within the GPi may reduce the efficacy of DBS treatment. |
| Databáze: | OpenAIRE |
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