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Abstract Details

Outcomes of Deep Brain Stimulation Surgery in Parkinson's Disease: Real Life Experience from a Tertiary Care Center
Movement Disorders
P1 - Poster Session 1 (5:30 PM-6:30 PM)
10-038

To determine whether the number of micro- and macro-electrode insertions in DBS surgery for Parkinson’s disease (PD) affects clinical outcomes and whether the second side implanted is more technically difficult.
DBS surgery is commonly performed for patients with PD who develop complications of medical therapy. Bilateral leads in the STN or GPi are usually placed in a single procedure, and multiple micro- and macro-electrode passes may be required based on intraoperative findings. No studies have evaluated whether the number of passes correlates with clinical outcomes. CSF loss during surgery may lead to brain shift but it is unclear whether this makes the second side implanted more technically challenging.

Retrospective chart review of all DBS implants for PD at our institution from November 2010 through November 2016.

Fifty-four patients underwent DBS for PD during the time studied. There was no difference in number of passes on each side: mean microelectrode passes were 1.56 ± 0.86 for the left hemisphere (the first implanted at our center) and 1.58 ± 0.78 for the right hemisphere (p=0.67). There was no correlation between total microelectrode passes and change in UPDRS motor score from pre-operative evaluation to six months postoperatively (p=0.73 for medication ON state). Subgroup analysis demonstrated correlations between tremor-predominant phenotype and improvement in ON state UPDRS motor score (p=0.028), and between shorter disease duration (<10 years) and improvement in OFF state UPDRS motor score (p=0.027).
This study refutes the notion of clinically meaningful brain shift during bilateral DBS lead placement and shows no correlation between number of microelectrode passes and motor outcomes. We reaffirmed improved motor outcomes with DBS surgery earlier in the disease course, as well as improvement in tremor beyond that from medications. Further prospective data is needed to evaluate whether non-motor (i.e. cognitive) outcomes are affected by number of microelectrode passes.
Authors/Disclosures
Ryan T. Brennan, DO (Medical College of Wisconsin)
PRESENTER 		Dr. Brennan has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Abbvie.
David M. Whitney, MD Dr. Whitney has nothing to disclose.
Amy Hellman, MD, FAAN (University of Nebraska Medical Center) The institution of Dr. Hellman has received research support from COBRE-NIH. The institution of Dr. Hellman has received research support from Neurocrine.
John M. Bertoni, MD, PhD, FAAN (University of Nebraska Medical Center) Dr. Bertoni has nothing to disclose.
Diego Torres-Russotto, MD, FAAN (Miami Neuroscience Institute - Baptist Health South Florida) Dr. Torres-Russotto has received personal compensation for serving as an employee of Movement Disorders Consulting, Inc. The institution of Dr. Torres-Russotto has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Acorda. The institution of Dr. Torres-Russotto has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for AbbVie. The institution of Dr. Torres-Russotto has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Neurocrine. The institution of Dr. Torres-Russotto has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Revance. The institution of Dr. Torres-Russotto has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Anneal. Dr. Torres-Russotto has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Acorda. Dr. Torres-Russotto has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for IPSEN. Dr. Torres-Russotto has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Teva. The institution of Dr. Torres-Russotto has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for AbbVie. The institution of Dr. Torres-Russotto has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Neurocrine. Dr. Torres-Russotto has received personal compensation in the range of $0-$499 for serving as an officer or member of the Board of Directors for Your Nest Asset Solutions, LLC. Dr. Torres-Russotto has received personal compensation in the range of $0-$499 for serving as an officer or member of the Board of Directors for Bright Future Asset Solutions, LLC.
Danish Bhatti, MD, FAAN (University of Central Florida College of Medicine) Dr. Bhatti has nothing to disclose.