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Discrete changes in brain volume after deep brain stimulation in patients with Parkinson’s disease
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  • Published on:
    Brain Atrophy is Inevitable Following Deep Brain Stimulation and Not Likely Caused by the Lead
    • Daniel Martinez-Ramirez, Phyician Scientist, Neurologist Tecnologico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Ave. Ignacio Morones Prieto 3000, Monterrey, N.L., México,
    • Other Contributors:
      • Erik H Middlebrooks, Physican Scientist, Radiologist
      • Leonardo Almeida, Physician Scientist, Neurologist
      • Michael S Okun, Physician Scientist, Neurologist

    Brain Atrophy is Inevitable Following Deep Brain Stimulation and Not Likely Caused by the Lead

    To the Editor,

    We read the observational DBS cohort study by Kern DS et al with great interest. We agree that deep brain stimulation (DBS) implantation has been associated with brain atrophy. We previously published an experience that not cited in the present study and we wonder whether the authors accidentally cited one of our review articles rather than the primary source (2014). It is critical for the DBS field to be aware of the clinical implications of atrophy.

    Kern DS et al analyzed 32 Parkinson’s disease (PD) patients who completed bilateral staged DBS implant surgeries targeting the subthalamic nucleus (STN)(1). The patients had an average duration between the two DBS surgeries of 141 days and this duration offered an opportunity to compare pre-post atrophy measures. The authors observed a significant reduction in whole brain volumes of the ipsilateral or first implanted side. Also, the authors noted that all basal ganglia-thalamocortical brain regions (BGTC) ipsilateral to the DBS implantation had significantly reduced volumes, whereas non-BGTC structures seemed to be unaffected. The authors suggested the possibility that intracranial volumetric changes may occur following STN DBS electrode implantation as a direct result of the implantation itself.

    We believe it unlikely that DBS electrode implantation is a primary reason for volume loss. We...

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    Conflict of Interest:
    None declared.