Unilateral subthalamotomy in patients with Parkinson’s disease

Authors

DOI:

https://doi.org/10.5281/zenodo.12207194

Keywords:

ablation techniques, parkinson disease, subthalamic nucleus

Abstract

Introduction: subthalamotomy is a viable option for Parkinson's disease. The resulting postoperative dyskinesia and extranuclear lesion limit its application.

Objetivo: describir los resultados de la subtalamotomía en pacientes con enfermedad de Parkinson.

Métodos: se realizó un estudio descriptivo de serie de nueve pacientes que cumplieron con los criterios de la investigación. The time between diagnosis and operation, the intercommissural distance, the electrophysiological and therapeutic intranuclear recording paths, the number of lesions and their relationship with the posterior commissure were evaluated. Ethical principles were met.

Results: the mean between diagnosis and surgical intervention was 5.7 years. The anterior commissure-posterior commissure distance averaged 28.3 mm. 53 records were made, 46 of these were intranuclear. Two ablative lesions were carried out per patient, by intranuclear path. Dyskinesia was observed in one case, coinciding with the largest number of records.

Conclusions: subthalamotomy is a safe technique. The lesion outside the dorsolateral region found in one of the patients was related to postoperative dyskinesia.

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Author Biographies

Ernesto Enrique Horta Tamayo, Hospital Clínico-Quirúrgico “Lucía Iñiguez Landín”.  Holguín.

Especialista de Primer Grado de Neurocirugía. Profesor Asistente. Investigador Agregado. Hospital Clínico-Quirúrgico “Lucía Iñiguez Landín”.  Holguín.

Julio César Selva Infante, Hospital Clínico-Quirúrgico “Lucía Iñiguez Landín”.  Holguín.

Especialista de Segundo Grado de Neurocirugía. Profesor Auxiliar. Hospital Clínico-Quirúrgico “Lucía Iñiguez Landín”.  Holguín.

Luis Cesar Acosta González, Hospital Clínico-Quirúrgico “Lucía Iñiguez Landín”. Holguín.

Especialista de Primer Grado de Neurocirugía. Hospital Clínico-Quirúrgico “Lucía Iñiguez Landín”. Holguín.

References

Harrison PJ, Luciano S. Incidence of Parkinson’s disease, dementia, cerebrovascular disease and stroke in bipolar disorder compared to other psychiatric disorders: An electronic health records network study of 66 million people. Bipolar Disord [Internet]. 2021 [citado 7 Oct 2021];23(5):454-62. Disponible en: https://ora.ox.ac.uk/objects/uuid:93632fd5-850c-4ed2-9449-8274e913ed5f/download_file?file_format=&safe_filename=Harrison_Luciano_2020_incidence_of_parkinson.pdf&type_of_work=Journal+article

Gao C, Liu J, Tan Y, Chen S. Freezing of gait in Parkinson’s disease: pathophysiology, risk factors and treatments. Transl Neurodegener [Internet]. 2020 [citado 7 Oct 2021];9(1):[aprox. 22 p]. Disponible en: https://translationalneurodegeneration.biomedcentral.com/articles/10.1186/s40035-020-00191-5

Ye Z, Zhang G, Zhang Y, Li S, Liu N, Zhou X, et al. The Role of the Subthalamic Nucleus in Sequential Working Memory in De Novo Parkinson’s Disease. Mov Disord [Internet]. 2021 [citado 7 Oct 2021];36(1):87-95. Disponible en: https://movementdisorders.onlinelibrary.wiley.com/doi/epdf/10.1002/mds.28344

Khawaldeh S, Tinkhauser G, Shah SA, Peterman K, Debove I, Nguyen TAK, et al. Subthalamic nucleus activity dynamics and limb movement prediction in Parkinson’s disease. Brain [Internet]. 2020 [citado 7 Oct 2021];143(2):582-96. Disponible en: https://doi.org/10.1093/brain/awz417

Mitchell KT, Ostrem JL. Surgical Treatment of Parkinson Disease. Neurol Clin. [Internet]. 2020 [citado 7 Oct 2021];38(2):293-307. Disponible en: https://pubmed.ncbi.nlm.nih.gov/32279711/

Hacker ML, Turchan M, Heusinkveld LE, Currie AD, Millan SH, Molinari AL, et al. Deep brain stimulation in early-stage Parkinson disease: Five-year outcomes. Neurology [Internet]. 2020 [citado 7 de octubre de 2021];95(4):e393-401.Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7455319/pdf/NEUROLOGY2019026872.pdf

Rodriguez-Rojas R, Carballo-Barreda M, Alvarez L, Guridi J, Pavon N, Garcia-Maeso I, et al. Subthalamotomy for Parkinson’s disease: clinical outcome and topography of lesions. J Neurol Neurosurg Psychiatry [Internet]. 2018 [citado 7 Oct 2021];89(6):572-8. Disponible en: https://pubmed.ncbi.nlm.nih.gov/29222224/

Vilela-Filho O, Silva DJ, Morais BA, Souza JT, Ragazzo PC. Possible mechanisms involved in subthalamotomy-induced dyskinesia in patients with Parkinson’s disease. Stereotact Funct Neurosurg. [Internet]. 2013 [citado 7 Oct 2021];91(5):323-7. Disponible en: https://www.karger.com/Article/Pdf/346499

Álvarez L, Macias R, Lopez G, Álvarez E, Pavon N, Rodríguez-Oroz MC, et al. Bilateral subthalamotomy in Parkinson’s disease: initial and long-term response. Brain J Neurol. [Internet]. 2005 [citado 7 Oct 2021];128:570-83. Disponible en: https://academic.oup.com/brain/article/128/3/570/693021

Merello M, Tenca E, Pérez-Lloret S, Martín ME, Bruno V, Cavanagh S, et al. Prospective randomized 1-year follow-up comparison of bilateral subthalamotomy versus bilateral subthalamic stimulation and the combination of both in Parkinson’s disease patients: a pilot study. Br J Neurosurg [Internet]. 2008 [citado 7 Oct 2021];22(3):415-22. Disponible en: https://www.tandfonline.com/doi/full/10.1080/02688690801971667?scroll=top&needAccess=true&role=tab

Máñez-Miró JU, Rodríguez-Rojas R, Del Álamo M, Martínez-Fernández R, Obeso JA. Present and future of subthalamotomy in the management of Parkinson´s disease: a systematic review. Expert Rev Neurother [Internet]. 2021[citado 7 Oct 2021];21(5):533-45. Diaponible en: https://www.tandfonline.com/doi/full/10.1080/14737175.2021.1911649

Kostiuk K, Lomadze V, Vasyliv N. Stereotactic thalamotomy and contralateral subthalamotomy in treatment of parkinson’s disease. Georgian Med News [Internet]. 2017[citado 7 Oct 2021];(272):12-7. Dispopnible en: https://pubmed.ncbi.nlm.nih.gov/29227251/

López-Flores G, Fernández R, Macías R, Alvarez LL, Teijeiro-Amador J, Alvarez E, et al. Subtalamotomía estereotáctica. Técnica quirúrgica. Rev. CENIC Cienc. Biol [Internet]. 2004 [citado 7 Oct 2021];35(2):9. Disponible en: https://revista.cnic.edu.cu/index.php/RevBiol/article/download/1196/929

Carballo-Barreda M, Rodríguez-Rojas R, López-Flores G, Torres-Montoya A. Sistema tridimensional de planeamiento quirúrgico para PC. EAC. [Internet]. 2005 [citado 7 Oct 2021];26(1):19-24. Disponible en: https://docplayer.es/25020524-Sistema-tridimensional-de-planeamiento-quirurgico-para-pc.html

Schaltenbrand G, Wahren W, Schaltenbrand G, Wahren W. Atlas for stereotaxy of the human brain with guide to the atlas for stereotaxy of the human brain, Pkg. 2nd edition. New York: Thieme; 197.

López-Flores G, Miguel-Morales J, Teijeiro-Amador J, Vitek J, Perez-Parra S, Fernández-Melo R, et al. Anatomic and neurophysiological methods for the targeting and lesioning of the subthalamic nucleus: Cuban experience and review. Neurosurgery [Internet]. 2003 [citado 21 de octubre de 2021];52(4):817-31. Disponible en: https://pubmed.ncbi.nlm.nih.gov/12657177/

Asociación Médica Mundial. Declaración de Helsinki de la AMM. Principios éticos para las investigaciones médicas en seres humanos. Ratificada en la 64ª Asamblea General, Fortaleza, Brasil, octubre 2013. Helsinki: 18ª Asamblea Mundial; 1964 [citado 7 Oct 2021]. Disponible en: http://www.anmat.gov.ar/comunicados/HELSINSKI_2013.pdf

Drummond PS, Pourfar MH, Hill TC, Mogilner AY, Kondziolka DS. Subthalamic Gamma Knife Radiosurgery in Parkinson’s Disease: A Cautionary Tale. Stereotact Funct Neurosurg. [Internet]. 2020 [citado 7 Oct 2021];98(2):110-7. Disponible en: https://www.karger.com/Article/FullText/505709

Kreimer S. Focused Ultrasound Subthalamotomy in One Hemisphere: A Treatment for Highly Asymmetric Parkinson's Disease? Neurology Today [Internet]. 2021 [citado 7 Oct 2021];21(3):1-14. Disponible en: https://journals.lww.com/neurotodayonline/Fulltext/2021/02040/Focused_Ultrasound_Subthalamotomy_in_One.1.aspx?context=LatestArticles

Ricardo Y, Pavon N, Alvarez L, Casabona E, Teijeiro J, Díaz A, et al. Long-term effect of unilateral subthalamotomy for Parkinson’s disease. J Neurol Neurosurg Psychiatry. [Internet]. 2019 [citado 7 Oct 2021];90(12):1380-1. Disponible en: https://jnnp.bmj.com/content/90/12/1380.full#

Avecillas-Chasin JM, Alonso-Frech F, Nombela C, Villanueva C, Barcia JA. Stimulation of the Tractography-Defined Subthalamic Nucleus Regions Correlates With Clinical Outcomes. Neurosurgery [Internet]. 2019 [citado 7 Oct 2021];85(2):E294-303. Disponible en: https://www.researchgate.net/profile/Josue-Avecillas-Chasin/publication/330857516_Stimulation_of_the_Tractography-Defined_Subthalamic_Nucleus_Regions_Correlates_With_Clinical_Outcomes/links/5d64148892851c619d780a88/Stimulation-of-the-Tractography-Defined-Subthalamic-Nucleus-Regions-Correlates-With-Clinical-Outcomes.pdf

Jorge A, Dastolfo-Hromack C, Lipski WJ, Kratter IH, Smith LJ, Gartner-Schmidt JL, et al. Anterior Sensorimotor Subthalamic Nucleus Stimulation Is Associated With Improved Voice Function. Neurosurgery [Internet]. 2020 [citado 7 Oct 2021];87(4):788-95. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7490159/pdf/nyaa024.pdf

Zhang J, Li J, Chen F, Liu X, Jiang C, Hu X, et al. STN versus GPi deep brain stimulation for dyskinesia improvement in advanced Parkinson’s disease: A meta-analysis of randomized controlled trials. Clin Neurol Neurosurg [Internet]. 2021 [citado 7 Oct 2021];201:106450. Disponible en: https://www.sciencedirect.com/science/article/abs/pii/S0303846720307939?via%3Dihub

Published

2023-03-27

How to Cite

1.
Horta Tamayo EE, Selva Infante JC, Acosta González LC. Unilateral subthalamotomy in patients with Parkinson’s disease. Mediciego [Internet]. 2023 Mar. 27 [cited 2024 Jul. 4];29(1):e3292. Available from: https://revmediciego.sld.cu/index.php/mediciego/article/view/3292

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