Reduction of Side Effects by Segmented Electrodes in Case of Subthalamic Nucleus Deep Brain Stimulation in Parkinson Disease: A Case Report
| Autor: | Maximilian Swoboda, Frank P. Schwarm, Eberhard Uhl, I. Reuter, Malgorzata Kolodziej |
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| Rok vydání: | 2019 |
| Předmět: |
0303 health sciences
Deep brain stimulation business.industry medicine.medical_treatment Subthalamic nucleus deep brain stimulation 03 medical and health sciences 0302 clinical medicine Electrode Medicine business Neuroscience 030217 neurology & neurosurgery Reduction (orthopedic surgery) 030304 developmental biology |
| Zdroj: | Journal of Neurological Research and Therapy. 3:6-11 |
| ISSN: | 2470-5020 |
| DOI: | 10.14302/issn.2470-5020.jnrt-19-2630 |
| Popis: | Patients suffering treatment resistant Parkinson´s disease (PD) are potential candidates for deep brain stimulation (DBS). Commonly most implanted electrodes have a cylindrical shape with quadripolar electrode contacts and generate a symmetrical stimulation field around the lead. To reduce side effects through activation of neighboring fibers a new electrode design with segmented contacts was developed and enables a better adaption of the field of stimulation as well as a multi-target stimulation to improve therapeutic benefits. We report about a 51-year-old male patient with a 15-year history of treatment-refractory PD, who was implanted with bilateral segmented electrodes in the subthalamic nucleus (STN) with St. Jude Medical Infinity™ DBS System (Abbott/St. Jude Medical, Saint Paul, Minnesota, USA). Despite a clear mood-enhancing effect, stimulation with ring electrodes caused motor side effects including rigor and speech disorder. With segmented electrodes an effective and gentle stimulation was achieved. The stimulation of the anterior segments in the central position of the electrode in the STN showed no side-effects and allowed a reduction of initial symptoms in an low stimulation amplitude. Despite precise preoperatively planning and intraoperative trial stimulation, side effects of STN stimulation are very common. The application of segmented electrodes permits more options to reduce side effects rather than using ring electrodes. Studies with larger samples sizes are needed to establish the optional DBS electrode. |
| Databáze: | OpenAIRE |
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