Evolution of Globus Pallidus Targeting for Parkinson's and Dystonia Deep Brain Stimulation: A 15-Year Experience

• DOI: 10.3389/fneur.2021.679918
• Publication Date: 2021-08-12T05:19:38Z
• Authors: Vanessa M. Holanda; Robert Stephen Ei...; Leonardo Almeida; Takashi Tsuboi; Huimin Wang; Michael S. Okun; Wissam Deeb; Addie Patterson; Aparna Wagle Shukla; Janine Lobo Lopes; Kelly Douglas Foote
• Keywords: Lead (geology); Movement Disorders

Objective: The aim of this study is to evaluate the evolution GPi DBS targeting. Methods: This retrospective, single-center included patients implanted with leads for dystonia or PD during years 2004 2018 at University Florida Fixel Institute Neurological Diseases. Each patient underwent a high-resolution targeting on day prior surgery, which was fused high resolution CT scan that acquired procedure. Intraoperative target location selected using digitized 3D Schaltenbrand-Bailey atlas. All head without contrast approximately one month after lead implantation and accurate measurement neuroanatomical position fusion pre-operative post-operative image studies. Results: We analyzed 253 352 80 141 leads. During 15 follow-up, locations in group migrated more laterally (β = 0.09, p < 0.0001), posteriorly [slope (β) 0.04, 0.05], dorsally 0.07, 0.001), whereas did not significantly change aside from trend dorsal direction 0.06, 0.053). Conclusion: evolving likely results multiple factors including improvements techniques clinical feedback intraoperatively post-operatively. Our demonstrates potential importance systematic protocol ensure quality control inform optimize programming.