Scholarlink

Background <p>The effectiveness of deep brain stimulation (DBS) for Parkinson’s disease (PD) depends on implantation accuracy. DBS initially employed a stereotactic frame (frame-based, FB), but technological advancements led to the development of less invasive methods based on fiducial markers (F + F) or intraoperative imaging (F-F). This study compares the accuracy and efficacy of three DBS-STN implantation techniques.</p> Methods <p>This retrospective study involved 18 patients with PD who underwent bilateral STN DBS between 2018 and 2023. Patients were divided into three groups: FB (<i>n</i> = 6), F + F (<i>n</i> = 7), and F-F (<i>n</i> = 5). Postoperative CT and preoperative MRI fusion were used to evaluate electrode accuracy via deviations from planned targets in x, y, z axes, and calculate the radial error (RE) and vector error (VE). We analyzed Unified Parkinson’s Disease Rating Scale (UPDRS) III scores in four “on/off medication-stimulation” combinations, LEDD, and disease stage before DBS, and 3 and 12 months post-DBS.</p> Results <p>No statistically significant differences were observed between the three methods in|Δx| (FB = 1.30 ± 0.91; F + F = 1.05 ± 0.93; F-F = 1.33 ± 1.09&#xa0;mm),|Δy| (FB = 0.95 ± 0.98; F + F = 1.11 ± 1.17; F-F = 1.28 ± 1.14&#xa0;mm), RE (FB = 1.82 ± 0.29; F + F = 1,71 ± 0,36; F-F = 1,91 ± 1,49&#xa0;mm) and VE (FB = 3,14 ± 0,35&#xa0;mm; F + F = 4,92 ± 0,54&#xa0;mm; F-F = 4,42 ± 1,22&#xa0;mm). All groups demonstrated significant UPDRS III (&gt; 50%) and LEDD reduction (&gt; 40%) at 12 months, with no intergroup differences.</p> Conclusions <p>The study concludes that all three techniques provide equivalent accuracy and clinical efficacy. Centers should select DBS-STN methods based on available resources and expertise.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Deep brain stimulation in Parkinson’s disease: a comparison of accuracy and clinical outcomes of frame-based, frameless and frameless fiducial-less techniques

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2025年3月13日

查看全文
  • Riccardo Antonio Ricciuti,
  • Matteo Maria Ottaviani,
  • Fabrizio Mancini,
  • Massimo Marano,
  • Daniele Marruzzo,
  • Francesca Barbieri,
  • Riccardo Paracino,
  • Pierfrancesco De Domenico,
  • Serena Pagano,
  • Vincenzo Di Lazzaro,
  • Mauro Dobran

摘要

Background

The effectiveness of deep brain stimulation (DBS) for Parkinson’s disease (PD) depends on implantation accuracy. DBS initially employed a stereotactic frame (frame-based, FB), but technological advancements led to the development of less invasive methods based on fiducial markers (F + F) or intraoperative imaging (F-F). This study compares the accuracy and efficacy of three DBS-STN implantation techniques.

Methods

This retrospective study involved 18 patients with PD who underwent bilateral STN DBS between 2018 and 2023. Patients were divided into three groups: FB (n = 6), F + F (n = 7), and F-F (n = 5). Postoperative CT and preoperative MRI fusion were used to evaluate electrode accuracy via deviations from planned targets in x, y, z axes, and calculate the radial error (RE) and vector error (VE). We analyzed Unified Parkinson’s Disease Rating Scale (UPDRS) III scores in four “on/off medication-stimulation” combinations, LEDD, and disease stage before DBS, and 3 and 12 months post-DBS.

Results

No statistically significant differences were observed between the three methods in|Δx| (FB = 1.30 ± 0.91; F + F = 1.05 ± 0.93; F-F = 1.33 ± 1.09 mm),|Δy| (FB = 0.95 ± 0.98; F + F = 1.11 ± 1.17; F-F = 1.28 ± 1.14 mm), RE (FB = 1.82 ± 0.29; F + F = 1,71 ± 0,36; F-F = 1,91 ± 1,49 mm) and VE (FB = 3,14 ± 0,35 mm; F + F = 4,92 ± 0,54 mm; F-F = 4,42 ± 1,22 mm). All groups demonstrated significant UPDRS III (> 50%) and LEDD reduction (> 40%) at 12 months, with no intergroup differences.

Conclusions

The study concludes that all three techniques provide equivalent accuracy and clinical efficacy. Centers should select DBS-STN methods based on available resources and expertise.