Relationship between neuropsychological outcome and DBS surgical trajectory and electrode location

York, Michele K.; Wilde, Elisabeth A.; Simpson, Richard K.; Jankovic, Joseph

doi:10.1016/j.jns.2009.08.003

Cited by 112 publications

(84 citation statements)

References 26 publications

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“…We thank Dr. Saleh for his comments regarding our manuscript, "Relationship between Neuropsychological Outcome and DBS Surgical Trajectory Electrode Location" [1]. We agree with several of the points that he raised, particularly those regarding the limitations of the current technology and the use of atlases in localization of a structure for any individual.…”

supporting

confidence: 55%

Acknowledgement of Technological Limitations While Moving Literature Forward

York¹,

Wilde²,

Simpson³

et al. 2010

Journal of the Neurological Sciences

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supporting

confidence: 55%

Acknowledgement of Technological Limitations While Moving Literature Forward

York¹,

Wilde²,

Simpson³

et al. 2010

Journal of the Neurological Sciences

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“…York et al [16] reported the occurrence of caudate penetration in 17 PD patients, but their focus was on trajectory angle and contact localization on verbal fluency. For the other 3 reports, neuropsychological examinations were comparable to those of our study, which enabled direct comparisons.…”

Section: Discussionmentioning

confidence: 99%

Electrode Penetration of the Caudate Nucleus in Deep Brain Stimulation Surgery for Parkinson’s Disease

Bot

Munckhof

Schmand

et al. 2018

Stereotact Funct Neurosurg

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Objective: To evaluate the possible influence of electrode trajectories penetrating the caudate nucleus (CN) on cognitive outcomes in deep brain stimulation (DBS) surgery for Parkinson’s disease (PD). Background: It is currently unclear how mandatory CN avoidance during trajectory planning is. Design/Methods: Electrode trajectories were determined to be inside, outside, or in border region of the CN. Pre- and postoperative neuropsychological tests of each trajectory group were compared in order to evaluate possible differences in cognitive outcomes 12 months after bilateral STN DBS. Results: One hundred six electrode tracks in 53 patients were evaluated. Bilateral penetration of the CN occurred in 15 (28%) patients, while unilateral penetration occurred in 28 (53%). In 19 (36%) patients tracks were located in the border region of the CN. There was no electrode penetration of the CN in 10 (19%) patients. No difference in cognitive outcomes was found between the different groups. Conclusion: Cognitive outcome was not influenced by DBS electrode tracks penetrating the CN. It is both feasible and sensible to avoid electrode tracks through the CN when possible, considering its function and anatomical position. However, penetration of the CN can be considered without major concerns regarding cognitive decline when this facilitates optimal trajectory planning due to specific individual anatomical variations.

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“…York et al [16] investigated the relation of surgical lead trajectory and neuropsychological outcome, 6 months after STN DBS in PD patients. Their findings showed some significant changes in time but no significant relationships between the neuropsychological tests and the trajectory intersecting the caudate nucleus.…”

Section: Discussionmentioning

confidence: 99%

“…Their findings showed some significant changes in time but no significant relationships between the neuropsychological tests and the trajectory intersecting the caudate nucleus. However, they found a relationship between mental state changes, verbal memory, fluency, depressive changes, and the electrode tip location in the STN, the distance from the active electrode to the midpoint of the AC-PC line, and the angle of the electrode tip to the midcommissural point in relation to the midsagittal plane [16]. Witt et al [8] also investigated the lead trajectory in PD patients who underwent STN DBS.…”

Section: Discussionmentioning

confidence: 99%

Neuropsychological Outcome in Subthalamic Nucleus Stimulation Surgeries with Electrodes Passing through the Caudate Nucleus

İşler

Albi²,

Schaper

et al. 2016

Stereotact Funct Neurosurg

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Background: Deep brain stimulation (DBS) of the subthalamic nucleus (STN) in Parkinson disease (PD) is associated with postoperative cognitive decline. One of the proposed underlying mechanisms is the surgical procedure with the lead trajectory penetrating the caudate nucleus. Objective: To study whether penetration of the caudate nucleus affects neuropsychological outcome. Methods: Neuropsychological and imaging data of 30 PD patients who underwent bilateral STN DBS were analysed. Lead trajectories were evaluated leading to a group with (n = 10) and a group without penetration of the caudate nucleus (n = 20). The neuropsychological performance of each group was compared to baseline, both at 3 and 12 months postoperatively. Results: Only the Trail-Making Test part B (TMT-B) showed an interaction effect within the groups over time at 3 months postoperatively. At 12 months postoperatively, there was only a main effect of time with a decrease in performance in TMT-B for both groups. Also verbal fluency showed a significant decrease over time for both groups at 3 and 12 months postoperatively. Conclusion: Caudate nucleus penetration affects cognitive flexibility only in the short term after surgery.

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Relationship between neuropsychological outcome and DBS surgical trajectory and electrode location

Cited by 112 publications

References 26 publications

Acknowledgement of Technological Limitations While Moving Literature Forward

Acknowledgement of Technological Limitations While Moving Literature Forward

Electrode Penetration of the Caudate Nucleus in Deep Brain Stimulation Surgery for Parkinson’s Disease

Neuropsychological Outcome in Subthalamic Nucleus Stimulation Surgeries with Electrodes Passing through the Caudate Nucleus

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