PhD Scientific Days 2017

Oral Presentations: Head&Neck & Basic Sciences I.

Probabilistic tractography can reveal optimal stimulation sites in Parkinson’s disease

Előadó neve

Dr. Halász, László

Előadó munkahelye

National Institute of Clinical Neurosciences, Department of Functional Neurosurgery and Centre for Neuromodulation

Előadó telefonszáma

+36704906763

Előadó e-mail címe

l.halasz@icloud.com

Az előadás címe

Probabilistic tractography can reveal optimal stimulation sites in Parkinson’s disease

Szerző(k) neve és munkahelye

László Halász1, Dávid Kis2, László Entz1, Gertrúd Tamás4, Dániel Fabó3, Loránd Erőss1
1 National Institute of Clinical Neurosciences, Department of Functional Neurosurgery and Centre for Neuromodulation, Budapest
2 University of Szeged, Department of Neurosurgery, Szeged
3 National Institute of Clinical Neurosciences, Department of Neurology, Budapest
4 Semmelweis University, Department of Neurology, Budapest

Szekció

Oral Presentations: Head&Neck & Basic Sciences I.

Data of the presenter

Doctoral school: Clinical Medicine
Program: Clinical and Experimental Research for Reconstructive and Organ-Sparing Surgery
Supervisor: Loránd Erőss MD PhD
University: University of Szeged

email: l.halasz@icloud.com

Text of the abstract

Introduction
Patients suffering from medically intractable Parkinson’s disease accompanied by severe fluctuations and ON-OFF periods are suitable candidates for deep brain stimulation (DBS). The subthalamic nucleus (STN) became a gold standard target for DBS in the last 30 years.

Aim
We designed our study according to the concept that the STN is connected to several cortical areas. Visualizing these connections might reveal an ideal target for stimulation.

Methods
34 patients, implanted between 2013-2015 at the Department of Functional Neurosurgery and Centre for Neuromodulation at the National Institute of Clinical Neurosciences in Budapest and at the Department of Neurosurgery of the University of Szeged, were enrolled in our study. Preoperative T1, T2, and DTI images were acquired at most 3 months before surgery. Postoperative CT scans were done 6 weeks after DBS implantation to exclude surgery related artifacts. DTI datasets have been analyzed and probabilistic estimation of white matter fibres was carried out using tools available in the FMRIB Software Library (FSL 5.0.9). Preoperative and postoperative UPDRS III scores were evaluated by neurologists specializing in movement disorders.

Results
Probabilistic tractography revealed prominent connections of the STN to 7 functional regions in the brain: limbic, dorsolateral prefrontal cortex, pre-supplementary motor area, supplementary motor area, premotor cortex, primary motor cortex, primary sensory cortex. Significant correlations between the distance of optimal stimulating contact and the STN subregion projecting to SMA and the postoperative UPDRS III scores have been found in both centers.

Conclusion
Our result indicate that the best clinical outcome can be achieved in Parkinson DBS when the stimulating contact is placed into the subregion of the STN projecting to the SMA. We think that our study does not only provide valuable data during surgery, but can also aid neurologist during the programing of more advanced multi contact segmented leads.

Kind

Szabad

Előadás fájl jóváhagyás

nem rendelkezett róla

Előadó

1177

Authors (legacy)

László Halász1, Dávid Kis2, László Entz1, Gertrúd Tamás4, Dániel Fabó3, Loránd Erőss1
1 National Institute of Clinical Neurosciences, Department of Functional Neurosurgery and Centre for Neuromodulation, Budapest
2 University of Szeged, Department of Neurosurgery, Szeged
3 National Institute of Clinical Neurosciences, Department of Neurology, Budapest
4 Semmelweis University, Department of Neurology, Budapest