Relationship of brain edema after deep brain stimulation surgery with motor and cognitive function
Yamato Nishiguchi,
Keita Matsuura,
Yoshinori Hirata,
Akane Mizutani,
Natsuko Katoh,
Hidehiro Ishikawa,
Koichi Miyashita,
Takaya Utsunomiya,
Hiroyuki Kajikawa,
Hirofumi Nishikawa,
Tomohiro Araki,
Akihiro Shindo,
Hidekazu Tomimoto
Affiliations
Yamato Nishiguchi
Department of Neurology, Graduate School of Medicine, Mie University, Mie 514-8507, Japan; Corresponding author.
Keita Matsuura
Department of Neurology, Graduate School of Medicine, Mie University, Mie 514-8507, Japan; Department of Neurology, Suzuka Kaisei Hospital, Mie 513-8505, Japan
Yoshinori Hirata
Department of Neurology, Graduate School of Medicine, Mie University, Mie 514-8507, Japan
Akane Mizutani
Department of Neurology, Graduate School of Medicine, Mie University, Mie 514-8507, Japan
Natsuko Katoh
Department of Neurology, Graduate School of Medicine, Mie University, Mie 514-8507, Japan
Hidehiro Ishikawa
Department of Neurology, Graduate School of Medicine, Mie University, Mie 514-8507, Japan
Koichi Miyashita
Department of Neurology, Graduate School of Medicine, Mie University, Mie 514-8507, Japan; Department of Neurology, Suzuka Kaisei Hospital, Mie 513-8505, Japan
Takaya Utsunomiya
Department of Neurology, Graduate School of Medicine, Mie University, Mie 514-8507, Japan; Department of Neurology, Suzuka Kaisei Hospital, Mie 513-8505, Japan
Hiroyuki Kajikawa
Department of Neurology, Suzuka Kaisei Hospital, Mie 513-8505, Japan
Hirofumi Nishikawa
Department of Neurology, Graduate School of Medicine, Mie University, Mie 514-8507, Japan; Department of Neurosurgery, Suzuka Kaisei Hospital, Mie 513-8505, Japan
Tomohiro Araki
Department of Neurosurgery, Suzuka Kaisei Hospital, Mie 513-8505, Japan
Akihiro Shindo
Department of Neurology, Graduate School of Medicine, Mie University, Mie 514-8507, Japan
Hidekazu Tomimoto
Department of Neurology, Graduate School of Medicine, Mie University, Mie 514-8507, Japan
Background: Some patients with Parkinson's disease (PD) develop peri-lead brain edema after deep brain stimulation (DBS) surgery. The influence of edema on neurological function is not well characterized. We investigated the relationship of brain edema after DBS surgery with motor and cognitive function. Methods: Thirteen patients with PD (6 males and 7 females; mean age: 61.2 years) who underwent bilateral subthalamic nucleus (STN) DBS surgery were included. All patients underwent magnetic resonance imaging (MRI) examination on day 6 post-DBS surgery. The volume of edema was measured either in the frontal white matter or STN on fluid attenuated inversion recovery (FLAIR) images. We examined the relationship between these volumes and changes in cognitive and motor function. Results: Patients were divided into those with frontal subcortical edema (FE) ≥3,000 mm3 (FE + group; n = 7) and <3,000 mm3 (FE–group; n = 6). In the FE + group, the postoperative Mini-Mental State Examination score worsened by 2.4 points after one week compared with that immediately before surgery, while that in the FE-group worsened only by 0.2 points (p = 0.038). On comparing patients with peri-STN edema (SE) ≥1,000 mm3 (SE + group; n = 3) and those with SE < 1,000 mm3 (SE-group; n = 10) showed that frequency of DBS tuning in the early postoperative period of the SE + group was lesser than that in the SE-group. Conclusions: Development of FE after DBS surgery was related to transient cognitive decline. On the other hand, SE seemed associated with altered motor function and reduces the requirement for tuning in the initial period after DBS implantation.
