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Electrode Location in a Microelectrode Recording-Based Model of the Subthalamic Nucleus Can Predict Motor Improvement After Deep Brain Stimulation for Parkinson’s Disease

1
Department of Neurology and Clinical Neurophysiology, University of Amsterdam, Amsterdam UMC, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
2
Department of Neurosurgery, University of Amsterdam, Amsterdam UMC, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
*
Author to whom correspondence should be addressed.
Brain Sci. 2019, 9(3), 51; https://doi.org/10.3390/brainsci9030051
Received: 13 February 2019 / Revised: 20 February 2019 / Accepted: 20 February 2019 / Published: 1 March 2019
(This article belongs to the Collection Collection on Clinical Neuroscience)
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Abstract

Motor improvement after deep brain stimulation (DBS) in the subthalamic nucleus (STN) may vary substantially between Parkinson’s disease (PD) patients. Research into the relation between improvement and active contact location requires a correction for anatomical variation. We studied the relation between active contact location relative to the neurophysiological STN, estimated by the intraoperative microelectrode recordings (MER-based STN), and contralateral motor improvement after one year. A generic STN shape was transformed to fit onto the stereotactically defined MER sites. The location of 43 electrodes (26 patients), derived from MRI-fused CT images, was expressed relative to this patient-specific MER-based STN. Using regression analyses, the relation between contact location and motor improvement was studied. The regression model that predicts motor improvement based on levodopa effect alone was significantly improved by adding the one-year active contact coordinates (R2 change = 0.176, p = 0.014). In the combined prediction model (adjusted R2 = 0.389, p < 0.001), the largest contribution was made by the mediolateral location of the active contact (standardized beta = 0.490, p = 0.002). With the MER-based STN as a reference, we were able to find a significant relation between active contact location and motor improvement. MER-based STN modeling can be used to complement imaging-based STN models in the application of DBS. View Full-Text
Keywords: deep brain stimulation; Parkinson’s disease; subthalamic nucleus deep brain stimulation; Parkinson’s disease; subthalamic nucleus
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Verhagen, R.; Bour, L.J.; Odekerken, V.J.J.; van den Munckhof, P.; Schuurman, P.R.; de Bie, R.M.A. Electrode Location in a Microelectrode Recording-Based Model of the Subthalamic Nucleus Can Predict Motor Improvement After Deep Brain Stimulation for Parkinson’s Disease. Brain Sci. 2019, 9, 51.

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