STN DBS of Advanced Parkinson's Disease Experienced in a Specialized Monitoring Unit with a Prospective Protocol

Lee, Ji Yeoun; Han, Jung Ho; Kim, Han Joon; Jeon, Beom S.; Kim, Dong Gyu; Paek, Sun Ha

doi:10.3340/jkns.2008.44.1.26

Cited by 24 publications

(18 citation statements)

References 36 publications

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“…Before determination of DBS, all surgical candidates are admitted to the MDC for 3 days and 24 hours a day, as previously described [1] . During admission, neurological evaluations including UPDRS, Hoehn and Yahr staging, Schwab and England Activities of Daily Living (SEADL), the levodopa equivalent daily dose (LEDD), and all past medical histories are performed and computed in a MDC DB.…”

Section: Resultsmentioning

confidence: 99%

“…However, when evaluating patients with movement disorders such as Parkinson's disease (PD), most neurologists only observe patients during a limited period of fluctuations in their daily lives at the outpatient clinic. So this might be a pitfall for a precise evaluation and optimal treatment plan of patients with varying and unexpected patterns of movement disorders [1] . In order to have a good DBS program a system is required which can handle such a vast amount of data generated by a DBS program [1] .…”

Section: Introductionmentioning

confidence: 99%

“…So this might be a pitfall for a precise evaluation and optimal treatment plan of patients with varying and unexpected patterns of movement disorders [1] . In order to have a good DBS program a system is required which can handle such a vast amount of data generated by a DBS program [1] . Data include pre-and postoperative clinical condition (including video), medications and stimulation-related parameters.…”

Section: Introductionmentioning

confidence: 99%

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Data Management System in a Movement Disorder Center: Technical Report

Paek¹,

Kim²,

Lim³

et al. 2010

Stereotact Funct Neurosurg

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Objective: We designed a specialized monitoring unit and data management system with systematic storage and easy access for a deep brain stimulation program of patients with movement disorders. Methods: All patients were monitored and evaluated in a specialized 24-hour monitoring system whenever it was needed, postoperatively as well as preoperatively. We digitized all the data and developed a data management system that allowed for systematic storage and easy access to the data on demand by users in the offices and outpatient clinics. Conclusion: We describe our data management system and how it provides benefit to patients in order that others may use it as a template for designing their own data management system.

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Data Management System in a Movement Disorder Center: Technical Report

Paek¹,

Kim²,

Lim³

et al. 2010

Stereotact Funct Neurosurg

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show abstract

“…Therefore, the outcome of DBS programming is highly dependent on the physician's capability and the capacity of the DBS care facility (Moro et al, 2002;Moro et al, 2006). We have developed a fusion method that combines images of pre-operative magnetic resonance imaging (MRI) and postoperative computed tomography (CT) (Kim et al, 2008a;Kim et al, 2008b;Lee et al, 2008;Kim et al, 2009;Paek et al, 2010). This fusion method enabled us to determine the 3-dimensional (3D) location of the leads and each contact in relation to the STN.…”

Section: Fusion-image-based Reprogrammingmentioning

confidence: 99%

“…The Movement Disorder Center of Seoul National University Hospital (SNUH MDC) was launched in March, 2005; at that time, DBS began to be covered by the National Health Insurance system in Korea. During the past six years, we have systematically approached the analysis of clinical outcome in terms of electrode position after bilateral STN stimulation (Heo et al, 2008;Kim et al, 2008a;Kim et al, 2008b;Lee et al, 2008;Kim et al, 2009;Lee et al, 2010a;Lee et al, 2010b;Paek et al, 2010). In this chapter, I would like to briefly touch on these issues based on a review of the literature as well as on our own experience.…”

Section: Introductionmentioning

confidence: 99%

Estimation of Electrode Position with Fused Images of Preoperative MRI and Postoperative CT Using the Mutual Information Technique After STN DBS in Patients with Advanced Parkinson's Disease

Paek¹

2011

Diagnostics and Rehabilitation of Parkinson's Disease

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Long-term cognitive outcome of bilateral subthalamic deep brain stimulation in Parkinson’s disease

et al. 2014

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The effect of subthalamic deep brain stimulation (STN DBS) on cognition in Parkinson's disease (PD) remains controversial, and it is unclear which factors are related to cognitive decline and dementia after STN DBS, especially over the long term. To this end, we analyzed the cognitive outcome of 103 non-demented patients with PD who were followed-up for at least 12 months after bilateral STN DBS surgery. Preoperatively, the patients were evaluated with the Unified Parkinson's Disease Rating Scale and neuropsychological tests. The rate of global cognitive decline and the incidence of dementia during follow-up for up to 7 years (mean 42.4 ± 24.5 months) were calculated, and preoperative clinical and neuropsychological factors associated with postoperative global cognitive decline or dementia were analyzed. The prevalence of mild cognitive impairment (MCI) and its relation to later cognitive decline or dementia were also evaluated. The annual decline in the mini-mental state examination score was 0.4 ± 1.7 with impaired attention and executive function and a higher levodopa equivalent dose at baseline being the predictors of a faster global cognitive decline after STN DBS. Dementia developed in 13 patients with an incidence rate of 35.7 per 1,000 person-years. Impaired executive function at baseline predicted dementia. At baseline, 63.1 % of the patients had PD-MCI, and these patients were more likely to develop dementia than those without PD-MCI. This study showed that dysfunctions in the frontostriatal circuitry at baseline were associated with a risk of subsequent global cognitive decline and dementia in patients with PD who underwent STN DBS. In addition, preoperative PD-MCI was a risk factor for dementia after STN DBS.

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STN DBS of Advanced Parkinson's Disease Experienced in a Specialized Monitoring Unit with a Prospective Protocol

Cited by 24 publications

References 36 publications

Data Management System in a Movement Disorder Center: Technical Report

Data Management System in a Movement Disorder Center: Technical Report

Estimation of Electrode Position with Fused Images of Preoperative MRI and Postoperative CT Using the Mutual Information Technique After STN DBS in Patients with Advanced Parkinson's Disease

Long-term cognitive outcome of bilateral subthalamic deep brain stimulation in Parkinson’s disease

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