Interleaved deep brain stimulation for dyskinesia management in Parkinson's disease.
Parkinson's disease
deep brain stimulation
dyskinesia
interleaving
volume of tissue activated
Journal
Movement disorders : official journal of the Movement Disorder Society
ISSN: 1531-8257
Titre abrégé: Mov Disord
Pays: United States
ID NLM: 8610688
Informations de publication
Date de publication:
11 2019
11 2019
Historique:
received:
21
02
2019
revised:
09
07
2019
accepted:
25
07
2019
pubmed:
5
9
2019
medline:
9
7
2020
entrez:
5
9
2019
Statut:
ppublish
Résumé
In patients with Parkinson's disease, stimulation above the subthalamic nucleus (STN) may engage the pallidofugal fibers and directly suppress dyskinesia. The objective of this study was to evaluate the effect of interleaving stimulation through a dorsal deep brain stimulation contact above the STN in a cohort of PD patients and to define the volume of tissue activated with antidyskinesia effects. We analyzed the Core Assessment Program for Surgical Interventional Therapies dyskinesia scale, Unified Parkinson's Disease Rating Scale parts III and IV, and other endpoints in 20 patients with interleaving stimulation for management of dyskinesia. Individual models of volume of tissue activated and heat maps were used to identify stimulation sites with antidyskinesia effects. The Core Assessment Program for Surgical Interventional Therapies dyskinesia score in the on medication phase improved 70.9 ± 20.6% from baseline with noninterleaved settings (P < 0.003). With interleaved settings, dyskinesia improved 82.0 ± 27.3% from baseline (P < 0.001) and 61.6 ± 39.3% from the noninterleaved phase (P = 0.006). The heat map showed a concentration of volume of tissue activated dorsally to the STN during the interleaved setting with an antidyskinesia effect. Interleaved deep brain stimulation using the dorsal contacts can directly suppress dyskinesia, probably because of the involvement of the pallidofugal tract, allowing more conservative medication reduction. © 2019 International Parkinson and Movement Disorder Society.
Sections du résumé
BACKGROUND
In patients with Parkinson's disease, stimulation above the subthalamic nucleus (STN) may engage the pallidofugal fibers and directly suppress dyskinesia.
OBJECTIVES
The objective of this study was to evaluate the effect of interleaving stimulation through a dorsal deep brain stimulation contact above the STN in a cohort of PD patients and to define the volume of tissue activated with antidyskinesia effects.
METHODS
We analyzed the Core Assessment Program for Surgical Interventional Therapies dyskinesia scale, Unified Parkinson's Disease Rating Scale parts III and IV, and other endpoints in 20 patients with interleaving stimulation for management of dyskinesia. Individual models of volume of tissue activated and heat maps were used to identify stimulation sites with antidyskinesia effects.
RESULTS
The Core Assessment Program for Surgical Interventional Therapies dyskinesia score in the on medication phase improved 70.9 ± 20.6% from baseline with noninterleaved settings (P < 0.003). With interleaved settings, dyskinesia improved 82.0 ± 27.3% from baseline (P < 0.001) and 61.6 ± 39.3% from the noninterleaved phase (P = 0.006). The heat map showed a concentration of volume of tissue activated dorsally to the STN during the interleaved setting with an antidyskinesia effect.
CONCLUSION
Interleaved deep brain stimulation using the dorsal contacts can directly suppress dyskinesia, probably because of the involvement of the pallidofugal tract, allowing more conservative medication reduction. © 2019 International Parkinson and Movement Disorder Society.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1722-1727Subventions
Organisme : NINR NIH HHS
ID : R01 NR014852
Pays : United States
Organisme : NIH HHS
ID : S10 OD021644
Pays : United States
Informations de copyright
© 2019 International Parkinson and Movement Disorder Society.
Références
Limousin P, Pollak P, Hoffmann D, et al. Abnormal involuntary movements induced by subthalamic nucleus stimulation in parkinsonian patients. Mov Disord 1996;11:231-235.
Limousin P, Krack P, Pollak P, et al. Electrical stimulation of the subthalamic nucleus in advanced Parkinson's disease. N Engl J Med 1998;339:1105-1111.
Benabid AL, Benazzouz A, Limousin P, et al. Dyskinesias and the subthalamic nucleus. Ann Neurol 2000;47:S189-S192.
Herzog J, Pinsker M, Wasner M, et al. Stimulation of subthalamic fibre tracts reduces dyskinesias in STN-DBS. Mov Disord 2007;22:679-684.
Katayama Y, Oshima H, Kano T, et al. Direct effect of subthalamic nucleus stimulation on levodopa-induced peak-dose dyskinesia in patients with Parkinson's disease. Stereotact Funct Neurosurg 2006;84:176-179.
Miocinovic S, Khemani P, Whiddon R, et al. Outcomes, management, and potential mechanisms of interleaving deep brain stimulation settings. Parkinsonism Relat Disord 2014;20:1434-1437.
Kern DS, Picillo M, Thompson JA, et al. Interleaving stimulation in Parkinson's disease, tremor, and dystonia. Stereotact Funct Neurosurg 2018;96:379-391.
Ramirez-Zamora A, Kahn M, Campbell J, et al. Interleaved programming of subthalamic deep brain stimulation to avoid adverse effects and preserve motor benefit in Parkinson's disease. J Neurol 2015;262:578-584.
Zhang S, Zhou P, Jiang S, et al. Interleaving subthalamic nucleus deep brain stimulation to avoid side effects while achieving satisfactory motor benefits in Parkinson disease: a report of 12 cases. Medicine (Baltimore) 2016;95:e5575.
Volkmann J, Moro E, Pahwa R. Basic algorithms for the programming of deep brain stimulation in Parkinson's disease. Mov Disord 2006;21:S284-S289.
Picillo M, Lozano AM, Kou N, et al. Programming deep brain stimulation for Parkinson's disease: the Toronto Western Hospital Algorithms. Brain Stim 2016;9:425-437.
Defer GL, Widner H, Marié RM, et al. Core assessment program for surgical interventional therapies in Parkinson's disease (CAPSIT-PD). Mov Disord 1999;14:572-584.
Tomlinson CL, Stowe R, Patel S, et al. Systematic review of levodopa dose equivalency reporting in Parkinson's disease. Mov Disord 2010;25:2649-2653.
Koss AM, Alterman RL, Tagliati M, Shils JL. Calculating total electrical energy delivered by deep brain stimulation systems. Ann Neurol 2005;58:168-169.
Butson CR, Cooper SE, Henderson JM, McIntyre CC. Patient-specific analysis of the volume of tissue activated during deep brain stimulation. NeuroImage 2007;34:661-670.
Xiao Y, Fonov V, Beriault S, et al. Multi-contrast unbiased MRI atlas of a Parkinson's disease population. Int J CARS 2014;10:329-341.
Castrioto A, Lhommée E, Moro E, Krack P. Mood and behavioural effects of subthalamic stimulation in Parkinson's disease. Lancet Neurol 2014;13:287-305.
Thobois S, Ardouin C, Lhommée E, et al. Non-motor dopamine withdrawal syndrome after surgery for Parkinson's disease: predictors and underlying mesolimbic denervation. Brain 2010;133:1111-1127.
Thobois S, Lhommée E, Klinger H, et al. Parkinsonian apathy responds to dopaminergic stimulation of D2/D3 receptors with piribedil. Brain 2013;136:1568-1577.
Fasano A, Aquino CC, Krauss JK, et al. Axial disability and deep brain stimulation in patients with Parkinson disease. Nature Rev Neurol 2015;11:98-110.
Johnson MD, Miocinovic S, McIntyre CC, Vitek JL. Mechanisms and targets of deep brain stimulation in movement disorders. Neurotherapeutics 2008;5:294-308.
Kopell BH, Rezai AR, Chang JW, Vitek JL. Anatomy and physiology of the basal ganglia: Implications for deep brain stimulation for Parkinson's disease. Mov Disord 2006;21:S238-S246.
Whittier JR, Mettler FA. Studies on the subthalamus of the rhesus monkey. II. Hyperkinesia and other physiologic effects of subthalamic lesions, with special reference to the subthalamic nucleus of Luys. J Comp Neurol 1949;90:319-372.
Carpenter MB, Whittier JR, Mettler FA. Analysis of choreoid hyperkinesia in the rhesus monkey. Surgical and pharmacological analysis of hyperkinesia resulting from lesions in the subthalamic nucleus ol luys. J Comp Neurol 1950;92:293-331.
Hassler R, Mundinger F, Riechert T. Stereotaxis in Parkinson syndrome. With an Atlas of the Basal Ganglio in Parkinsonism. Berlin: Springer; 1979.
Guiot G, Brion S. Treatment of abnormal movement by pallidal coagulation. Rev Neurol (Paris) 1953;89:578-580.
Cooper IS. The Vital Probe: My Life as a Brain Surgeon. New York: Norton; 1981
Forel A. Untersuchungen über die Haubenregion und ihre oberen Verknüpfungen im Gehirne des Menschen und einiger Säugethiere, mit Beiträgen zu den Methoden der Gehirnuntersuchung. Eur Arch Psychiatry Clin Neurosci 1877;7:393-495.
Gallay MN, Jeanmonod D, Liu J, Morel A. Human pallidothalamic and cerebellothalamic tracts: anatomical basis for functional stereotactic neurosurgery. Brain Struct Funct 2008;212:443-463.
Hamani C, Saint-Cyr JA, Fraser J, et al. The subthalamic nucleus in the context of movement disorders. Brain 2004;127:4-20.
Kim JH, Chang WS, Jung HH, Chang JW. Effect of subthalamic deep brain stimulation on levodopa-induced dyskinesia in Parkinson's disease. Yonsei Med J 2015;56:1316-6.
Wojtecki L, Vesper J, Schnitzler A. Interleaving programming of subthalamic deep brain stimulation to reduce side effects with good motor outcome in a patient with Parkinson's disease. Parkinsonism Relat Disord 2011;17:293-294.
Fleury V, Pollak P, Gere J, et al. Subthalamic stimulation may inhibit the beneficial effects of levodopa on akinesia and gait. Mov Disord 2016;31:1389-1397.
Eklund E, Qvist J, Sandström L, et al. Perceived articulatory precision in patients with Parkinson's disease after deep brain stimulation of subthalamic nucleus and caudal zona incerta. Clin Linguist Phon 2015;29:150-166.
Merola A, Zibetti M, Angrisano S, et al. Parkinson's disease progression at 30 years: a study of subthalamic deep brain-stimulated patients. Brain 2011;134:2074-2084.
Fasano A, Romito LM, Daniele A, et al. Motor and cognitive outcome in patients with Parkinson's disease 8 years after subthalamic implants. Brain 2010;133:2664-2676.
Su D, Chen H, Hu W, et al. Frequency-dependent effects of subthalamic deep brain stimulation on motor symptoms in Parkinson's disease: a meta-analysis of controlled trials. Sci Rep 2018;8:1-9.
Merola A, Zibetti M, Artusi CA, et al. 80 Hz versus 130 Hz subthalamic nucleus deep brain stimulation: effects on involuntary movements. Parkinsonism Relat Disord 2013;19:453-456.
Pollo C, Kaelin-Lang A, Oertel MF, et al. Directional deep brain stimulation: an intraoperative double-blind pilot study. Brain 2014;137:2015-2026.
Slopsema JP, Peña E, Patriat R, et al. Clinical deep brain stimulation strategies for orientation-selective pathway activation. J Neural Eng 2018;15:056029.
Gunalan K, Chaturvedi A, Howell B, et al. Creating and parameterizing patient-specific deep brain stimulation pathway-activation models using the hyperdirect pathway as an example. PLoS ONE 2017;12:e0176132.