Could ZI have a role in DBS for Parkinson’s Disease? An observational study to optimize DBS target localization |
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| Institution: | 1. Movement Disorders Center, Department of Neurology, School of Medicine, University of São Paulo, Ribeirão Preto, Brazil;2. Neurosurgery Division, Department of Neurology, School of Medicine, University of São Paulo, São Paulo, Brazil;3. Movement Disorders Center, Department of Neurology, School of Medicine, University of São Paulo, São Paulo, Brazil;1. Department of Neurology, Movement Disorders Unit, Charité — University Medicine (CVK), Berlin, Germany;2. Center for Adaptive Rationality (ARC), Max-Planck-Institute for Human Development, Berlin, Germany |
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| Abstract: | Deep Brain Stimulation (DBS) of the subthalamic nucleus (STN) is a well-recognized intervention for Parkinson’s Disease (PD). We used LEAD-DBS, a toolbox facilitating DBS electrode reconstructions and computer simulations based on postoperative MRI and CT imaging, to investigate the interaction and followed benefits of electrical field generated by STN-DBS and surrounding areas, such as caudal Zona Incerta (cZI). Thirty-two PD patients, treated with directional STN-DBS in the period 2016–2018 at the Walton Center NHS Foundation Trust, were retrospectively recruited. Their MRI and CT imaging were analyzed with LEAD-DBS to measure the volume of tissue activated (VTA). Considering the clinical outcome based on the UPDRS III score improvement of 62.65% at 6 months follow up, we found a VTA intersection of 21.5% with motor STN and 61.7% with cZI. These observations may support the contribution of cZI deep stimulation to improve clinical outcome of PD patients treated with DBS, promoting the intriguing path of dual targeting. |
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| Keywords: | Parkinson’s Disease DBS STN ZI VTA Directional stimulation |
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