RT Journal Article
SR Electronic
T1 Discrete changes in brain volume after deep brain stimulation in patients with Parkinson’s disease
JF Journal of Neurology, Neurosurgery & Psychiatry
JO J Neurol Neurosurg Psychiatry
FD BMJ Publishing Group Ltd
SP 928
OP 937
DO 10.1136/jnnp-2019-322688
VO 91
IS 9
A1 Drew S Kern
A1 Daniel Uy
A1 Remy Rhoades
A1 Steven Ojemann
A1 Aviva Abosch
A1 John A Thompson
YR 2020
UL http://jnnp.bmj.com/content/91/9/928.abstract
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.