Objective: This study evaluated the direct impact of localization of deep brain stimulation electrodes active contact within the different parts of subthalamic nucleus on improvement of non-motor symptoms in patients with Parkinson’s disease

Background: The work of Kurcova et al (1) studied the initial effects of subthalamic nucleus deep brain stimulation (STN-DBS) on non-motor and motor symptoms in patiens suffering from Parkinson’s disease. Results of this study showed that STN-DBS in patients with advanced PD clearly improves not only motor symptoms, but also several domains of non-motor symptoms, namely sleep, autonomic functions and quality of life. Recently, Dafsari et al. (2) used coordinates of the active electrodes and suggested that more anterior, medial and ventral subthalamic nucleus deep brain stimulation (STN-DBS) is related to more beneficial non-motor outcomes in patients with PD.

Method: Subthalamic nucleus was divided into two (dorsolateral/ventromedial) and three (dorsolateral, medial, ventromedial) parts. 37 deep brain stimulation electrodes were divided into groups according to their active contact localization. Correlation between change in non-motor symptoms before deep brain stimulation and one and four months after deep brain stimulation electrode implantation and the localization of active contact was calculated.

Results: When dividing the subthalamic nucleus into three parts, no electrode active contact was placed ventromedially, 28 active contacts were located in the medial part and 9 contacts were found dorsolaterally. After one and four months, no significant difference between medial and dorsolateral position was observed. When dividing subthalamic nucleus into two parts, 13 contacts were located in the ventromedial part and 24 contacts were placed in the dorsolateral part of the subthalamic nucleus. After one month, greater improvement in the Non-motor Symptoms Scale for Parkinson’s disease (p = 0.045) was found when the left-sided stimulation was considered, whereas no significant differences between the ventromedial and dorsolateral positions were found on the right side.

Conclusion: Our study demonstrated the relationship between improvement of non-motor symptoms and the side (or hemisphere, left/right) of the deep brain stimulation electrode active contact, rather than its precise localization within the specific parts of the subthalamic nucleus in patients treated for advanced Parkinson’s disease.

References: 1 Kurcova S, Bardon J, Vastik M et al. Bilateral subthalamic deep brain stimulation initial impact on nonmotor and motor symptoms in Parkinson’s disease. Medicine (Baltimore). 2018 Feb; 97(5): e9750. 2 Dafsari HS, Petry-Schmelzer JN, Ray-Chaudhuri K Non-motor outcomes of subthalamic stimulation in Parkinson’s disease depend on location of active contacts, Brain Stimulation (2018), https://doi.org/10.1016/j.brs.2018.03.00924

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MDS Abstracts - https://www.mdsabstracts.org/abstract/deep-brain-stimulation-lead-position-impact-on-parkinsonian-non-motor-symptoms/