Outcomes after stereotactically guided pallidotomy for advanced Parkinson's disease

Kondziolka, Douglas; Bonaroti, Eugene A.; Baser, Susan; Brandt, F; Kim, Young Soo; Lunsford, L. Dade

doi:10.3171/jns.1999.90.2.0197

Cited by 68 publications

(30 citation statements)

References 33 publications

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“…' Although it may be true that the pioneers of modern non-MER-guided pallidotomy did not 'use' a movement disorder neurologist and established outcome scales in their early publication [36], this is not the case anymore, neither in their publications nor in publications from other non-MER groups [7,9,10,11,47,53]. Furthermore, the use of scales and movement disorder neurologists, in itself, is no guarantee that results will be more accurately reported.…”

Section: Results Of Surgerymentioning

confidence: 95%

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Do Microelectrode Techniques Increase Accuracy or Decrease Risks in Pallidotomy and Deep Brain Stimulation?

Hariz

Fodstad

1999

Stereotact Funct Neurosurg

161

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Several recent publications have stated that the use of microelectrode recording (MER) during pallidotomy or deep brain stimulation (DBS) contributes to decreasing risks and side effects of surgery, and that such a technique is a prerequisite for minimizing lesion size and for accurate placement of the stereotactic lesion or the DBS electrode. To evaluate the consistency of these statements, we reviewed hundreds of papers and congress reports on MER- and non-MER-guided procedures published since 1992. This review showed that MER groups published more often than non-MER groups. While side effects of surgery were not uncommon in both groups, the rate of severe complications, such as hematoma, and mortality appeared to be higher when microelectrodes were used, both in ablative surgery and in DBS procedures. Besides, the nonaccurate placement of lesions or DBS electrodes, as assessed on published MRI figures, was not uncommon in MER publications. Lesion volume was, when reported, not different in both techniques. The electrical parameters of stimulation of implanted electrodes in the thalamic ventral intermediate (Vim) nucleus for treatment of tremor were higher in MER-guided surgery. The available literature suggests that MER techniques may increase the risks of surgery without enhancing its accuracy, compared to MRI-based macrostimulation techniques. To date, there is no randomized trial by one and the same group on the use of micro- versus macroelectrodes in surgery for movement disorders. A prerequisite for such a trial in the future must imply that the investigators have an equal nonprejudiced attitude towards, and equal confidence and experience in, either technique. Since such a prerequisite does not exist so far in the functional stereotactic community, a critical and comparative study of the available literature remains the only way to evaluate the pros and cons of either technique, in terms of targeting accuracy and surgical complications.

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Section: Results Of Surgerymentioning

confidence: 95%

“…Compared to MER groups, the reported complications of macroelectrode teams were generally milder, the occurrence of hematoma was extremely rare, and the mortality was virtually nil [5,7,9,10,32,41,47].…”

Section: Surgical Risks and Complications In Pallidotomymentioning

confidence: 99%

Do Microelectrode Techniques Increase Accuracy or Decrease Risks in Pallidotomy and Deep Brain Stimulation?

Hariz

Fodstad

1999

Stereotact Funct Neurosurg

161

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“…These results have been con®rmed in a randomized, single-blind, multicenter trial (De Bie et al, 1999). However, only a few studies have a follow up of more than 1 year (Laitinen et al, 1992;Fazzini et al, 1997;Lang et al, 1997;Kondziolka et al, 1999;Samii et al, 1999;Baron et al, 2000;Fine et al, 2000). Improvements of ipsilateral dyskinesias and of axial symptoms were lost after 2 years, whereas the dramatic reduction in contralateral dyskinesias persisted (Lang et al, 1997;Baron et al, 2000;Fine et al, 2000;Hariz, 2000b).…”

Section: Pallidotomymentioning

confidence: 87%

Mirthful laughter induced by subthalamic nucleus stimulation

et al. 2001

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Copper salts, which are abundant, relatively inexpensive and possess low toxicity, have long been used as versatile catalysts for various reactions in organic synthesis. Recently, the development of Cu‐catalyzed or ‐mediated CH functionalization reactions has gained significant attention. Since the pioneering work of Daugulis on the introduction of 8‐aminoquinoline and picolinic acid auxiliaries as removable directing groups in transition metal‐catalyzed CH bond activations, the combination of copper salts with these bidentate directing groups has emerged as an innovative strategy for the construction of carbon‐carbon or carbon‐heteroatom bonds through CH bond cleavage. In addition to the 8‐aminoquinoline and picolinamide systems, several other bidentate directing groups including the 2‐aminophenyloxazoline group by Yu and Dai and the PIP system by Shi, have been developed as well. This review intends to cover most of the recent advances on copper‐catalyzed or ‐mediated direct sp2 and sp3 CH bond functionalizations assisted by these bidentate directing groups. The major achievements in this area are discussed and catalogued by the type of bonds formed (CC, CO, CN, CS, CP etc.). Special attention is paid to the reaction mechanisms. Selected examples of substrates are listed as well. In addition, a personal outlook is given at the end.

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“…Because of its ability to precisely resolve the boundaries of subcortical targets, [1][2][3][4] magnetic resonance imaging (MRI) is gradually replacing computed tomography (CT) and ventriculography for functional stereotaxy. [5][6][7] High-field MRI in stereotactic condition shows the patient's own atlas of brain structures using adequate sequences such as the T2-weighted sequence with a long acquisition time for subthalamic nucleus (STN) visualization. 8 MRI is the most precise imaging modality and provides a visualization of the anterior and posterior commissures.…”

Section: Intraoperative Stimulation Is Mandatorymentioning

confidence: 99%

Intraoperative micro- and macrostimulation of the subthalamic nucleus in Parkinson's disease

et al. 2002

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Studying the clinical effects induced by electrical stimulation of the subthalamic nucleus (STN) area in a parkinsonian patient under local anesthesia is a mandatory step to determine the precise location of the final chronic electrode. Using multiple microelectrodes, preferably in a concentric parallel array allows a precise mapping of the STN region. The most reliable features to determine the suitable target are stimulation-induced dyskinesias and rigidity decrease at a low intensity without adverse effects or only at far higher intensities. New skills are needed to assess all stimulation-induced effects and interpret them in anatomo-functional terms.

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Outcomes after stereotactically guided pallidotomy for advanced Parkinson's disease

Cited by 68 publications

References 33 publications

Do Microelectrode Techniques Increase Accuracy or Decrease Risks in Pallidotomy and Deep Brain Stimulation?

Do Microelectrode Techniques Increase Accuracy or Decrease Risks in Pallidotomy and Deep Brain Stimulation?

Mirthful laughter induced by subthalamic nucleus stimulation

Intraoperative micro- and macrostimulation of the subthalamic nucleus in Parkinson's disease

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