Session Information
Date: Wednesday, September 25, 2019
Session Title: Surgical Therapy
Session Time: 1:15pm-2:45pm
Location: Les Muses Terrace, Level 3
Objective: To determine whether intraoperative test stimulation is indicative of postoperative stimulation results.
Background: It is unknown whether intraoperative testing during awake Deep Brain Stimulation (DBS) of the subthalamic nucleus (STN) can be used to postoperatively identify the best settings for chronic stimulation.
Method: Records of consecutive Parkinson’s Disease patients who received STN DBS between September 2012 and December 2017 were retrospectively analyzed. The best depth identified after intraoperative stimulation via the microelectrode’s stimulation tip was compared with the depth of the contact selected for chronic stimulation after a standard monopolar contact review. Moreover, thresholds for induction of clinical effects (optimal improvement of rigidity and induction of side-effects) were compared between stimulation at the postoperatively selected contact and at the corresponding intraoperative depth.
Results: Records of 119 patients were analyzed (mean (SD) age 60.5 (6.5) years, 31.9% female, 238 STNs). In 75% of cases, the postoperatively selected contact corresponded with the intraoperative depth with the largest therapeutic window or was immediately dorsal to it. Higher stimulation intensities were required postoperatively than intraoperatively to relieve rigidity (p=0.002) and induce capsular side-effects (p=0.016).
Conclusion: In the majority of cases, intraoperative stimulation may identify the optimal contact or point to the one immediately below it. Postoperatively, relief of rigidity and induction of capsular side-effects occur at higher stimulation intensities than during intraoperative test stimulation. The observed differences could be explained by differences related to the stimulation conditions or differences in electrode design resulting in different properties of the stimulation field. Previously presented at the European Society for Stereotactic and Functional Neurosurgery (ESSFN) conference in Edinburgh, 2018.
To cite this abstract in AMA style:
V. Geraedts, R. van Ham, J. Marinus, J. van Hilten, A. Mosch, C. Hoffmann, N. Vd Gaag, MF. Contarino. Intraoperative test stimulation of the subthalamic nucleus reduces the search space for chronic stimulation settings in Parkinson’s disease [abstract]. Mov Disord. 2019; 34 (suppl 2). https://www.mdsabstracts.org/abstract/intraoperative-test-stimulation-of-the-subthalamic-nucleus-reduces-the-search-space-for-chronic-stimulation-settings-in-parkinsons-disease/. Accessed June 15, 2025.« Back to 2019 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/intraoperative-test-stimulation-of-the-subthalamic-nucleus-reduces-the-search-space-for-chronic-stimulation-settings-in-parkinsons-disease/