Neurology®
The most widely read and highly cited peer-reviewed Neurology journal
Quick Search
Advanced Search
This Article
Right arrow Figures Only
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Correspondence:
Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when Correspondence are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrowRequest Permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Bonneville, F.
Right arrow Articles by Dormont, D.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Bonneville, F.
Right arrow Articles by Dormont, D.
Related Collections
Right arrow Volumetric MRI
Right arrow Parkinson's disease/Parkinsonism
Right arrow Surgery/Stimulation
NEUROLOGY 2005;64:1598-1604
© 2005 American Academy of Neurology

Parkinson disease, brain volumes, and subthalamic nucleus stimulation

F. Bonneville, MD*, M. L. Welter, MD*, C. Elie, MD, S. Tezenas du Montcel, MD, PhD, D. Hasboun, MD, PhD, C. Menuel, MSc, J. L. Houeto, MD, A. M. Bonnet, MD, V. Mesnage, MD, B. Pidoux, MD, PhD, S. Navarro, MD, P. Cornu, MD, PhD, Y. Agid, MD, PhD and D. Dormont, MD

From the Service de Neuroradiologie (Drs. Bonneville, Hasboun, and Dormont), UPR 640 CNRS LENA (Drs. Bonneville, Menuel, and Dormont), Centre d’Investigation Clinique and INSERM U 289 (Drs. Welter, Houeto, Bonnet, Mesnage, and Agid), Service de Biostatistique (Drs. Elie and Tezenas du Montcel), Service d’Explorations Fonctionnelles Neurologiques (Dr. Pidoux), and Service de Neurochirurgie (Drs. Navarro and Cornu), Hôpital de la Salpêtrière, Assistance-Publique-Hôpitaux de Paris, France.

Address correspondence and reprint requests to Dr. D. Dormont, Service de Neuroradiologie, Hôpital de la Salpêtrière, 47 boulevard de l’Hôpital, 75651 Paris Cedex 13, France; e-mail: didier.dormont{at}psl.ap-hop-paris.fr

Background: High-frequency stimulation of the subthalamic nucleus (STN) is an effective treatment for advanced Parkinson disease (PD). The clinical and preoperative predictive factors of the best postoperative outcome have been identified. Radiologic predictive factors were investigated.

Methods: Forty patients with PD underwent surgery for bilateral STN stimulation. MRI was performed in stereotactic conditions before surgery. Brain parenchyma, caudate nucleus, putamen, pallidum, and red nucleus volumes and the surface of the mesencephalon were measured and normalized as percentages of the intracranial volume. Clinical evaluation was performed 1 month before and 6 months after surgery.

Results: The normalized brain parenchyma volume was lower in patients who were older and had a longer disease duration or a lower frontal score and was not predictive of the postoperative outcome. The residual scores for activities of daily living and parkinsonian motor disability were higher in patients with a smaller normalized mesencephalon. The normalized caudate nucleus volume was predictive of the pre- and postoperative levodopa-equivalent dosage.

Conclusions: Brain atrophy is not an exclusion criterion for neurosurgery, indicating that patients’ neurologic, psychiatric, and neuropsychological characteristics are the best predictive factors for neurosurgery. The fact that a smaller normalized mesencephalon surface was associated with a lower beneficial effect of the subthalamic nucleus stimulation on the parkinsonian motor disability suggests that the normalized mesencephalon surface is a predictive factor of the postoperative outcome.

*These authors contributed equally to this work.

Supported by INSERM, Assistance Publique–Hôpitaux de Paris, and the National Parkinson Foundation–Miami.

Received July 14, 2004. Accepted in final form January 18, 2005.




This article has been cited by other articles:


Home page
 Am. J. Neuroradiol.Home page
D. Dormont, D. Seidenwurm, D. Galanaud, P. Cornu, J. Yelnik, and E. Bardinet
Neuroimaging and Deep Brain Stimulation
AJNR Am. J. Neuroradiol., January 1, 2010; 31(1): 15 - 23.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Neuroradiol.Home page
T. Schonecker, A. Kupsch, A.A. Kuhn, G.-H. Schneider, and K.-T. Hoffmann
Automated Optimization of Subcortical Cerebral MR Imaging-Atlas Coregistration for Improved Postoperative Electrode Localization in Deep Brain Stimulation
AJNR Am. J. Neuroradiol., November 1, 2009; 30(10): 1914 - 1921.
[Abstract] [Full Text] [PDF]