Tiefe Hirnstimulation des Nucleus subthalamicus: Die Rolle der intraoperativen Makrostimulation in Bezug auf präoperative Planung und postoperatives motorisches / nichtmotorisches Outcome
Deep brain stimulation of the subthalamic nucleus: The role of intraoperative macrostimulation relating to preoperative planings and postoperative motoric / nonmotoric outcome
von Anabel Pinter
Datum der mündl. Prüfung:2016-07-20
Erschienen:2016-06-23
Betreuer:Prof. Dr. Heyo K. Kroemer
Gutachter:Prof. Dr. Claudia Trenkwalder
Gutachter:PD Dr. Bawarjan Schatlo
Gutachter:Prof. Dr. Margarete Schön
Dateien
Name:Dissertation Anabel Pinter final - PDF mit B...pdf
Size:4.46Mb
Format:PDF
Zusammenfassung
Englisch
Deep brain stimulation (DBS) of subthalamic nucleus (STN) is effective to treat symptoms of Parkinson’s disease. Determining the optimal target point a specification based on microelectrode recording (MER) and macrostimulation has been established. As this requires the patients to be conscious during surgery the patients can be exposed to great psychological pressure. The present doctoral thesis evaluates the dispensability of intraoperative macrostimulation as part of DBS in patients with Parkinson’s disease. The study includes 94 deep brain stimulation lead placements in 47 patients. The patients were allocated to three groups according to intraoperative test results (group I: macrostimulation confirmed both STN predetermined by MER, group II: macrostimulation confirmed one STN, group III: macrostimulation confirmed none STN). The clinical outcome of the groups was compared by using indices of Parkinson’s disease (e.g. LEDD, UPDRS III, performance index). All groups benefited from DBS. After surgical procedure the motor activity improved and the overall medication could be reduced. However, there was no significant difference between the groups. To date macrostimulation as part of DBS is not dispensable. Further studies are needed to identify preoperative predictors to determine those patients in whom intraoperative macrostimulation provides no benefit.
Keywords: Macrostimulation; Deep brain stimulation; Parkinson's disease
Schlagwörter: Makrostimulation; Tiefe Hirnstimulation; Morbus Parkinson