PT  - JOURNAL ARTICLE
AU  - Drew S Kern
AU  - Daniel Uy
AU  - Remy Rhoades
AU  - Steven Ojemann
AU  - Aviva Abosch
AU  - John A Thompson
TI  - Discrete changes in brain volume after deep brain stimulation in patients with Parkinson’s disease
AID  - 10.1136/jnnp-2019-322688
DP  - 2020 Sep 01
TA  - Journal of Neurology, Neurosurgery & Psychiatry
PG  - 928--937
VI  - 91
IP  - 9
4099  - http://jnnp.bmj.com/content/91/9/928.short
4100  - http://jnnp.bmj.com/content/91/9/928.full
SO  - J Neurol Neurosurg Psychiatry2020 Sep 01; 91
AB  - Objectives Deep brain stimulation (DBS), targeting the subthalamic nucleus (STN) and globus pallidus interna, is a surgical therapy with class 1 evidence for Parkinson’s disease (PD). Bilateral DBS electrodes may be implanted within a single operation or in separate staged surgeries with an interval of time that varies patient by patient. In this study, we used the variation in the timing of implantation from the first to the second implantation allowing for examination of potential volumetric changes of the basal ganglia in patients with PD who underwent staged STN DBS.Methods Thirty-two patients with a mean time interval between implantations of 141.8 (±209.1; range: 7–700) days and mean duration of unilateral stimulation of 244.7 (±227.7; range: 20–672) days were included in this study. Using volumetric analysis of whole hemisphere and subcortical structures, we observed whether implantation or stimulation affected structural volume.Results We observed that DBS implantation, but not the duration of stimulation, induced a significant reduction of volume in the caudate, pallidum, putamen and thalamus ipsilateral to the implanted hemisphere. These findings were not dependent on the trajectory of the implanted electrode nor on first surgery pneumocephalus (0.07%: %Δ for intracranial volume between first and second surgery). In addition, unique regional atrophy differences were evident in each of the structures.Conclusion Our results demonstrate that DBS implantation surgery may affect hemisphere volume at the level of subcortical structures connected to the surgical target.