The Dominant-STN phenomenon in bilateral STN DBS for Parkinson's disease

Anna Castrioto; Christopher Meaney; Clement Hamani; Filomena Mazzella; Yu-Yan Poon; Andres M. Lozano; Mojgan Hodaie; Elena Moro

Neurobiology of Disease (Jan 2011)

The Dominant-STN phenomenon in bilateral STN DBS for Parkinson's disease

Anna Castrioto,
Christopher Meaney,
Clement Hamani,
Filomena Mazzella,
Yu-Yan Poon,
Andres M. Lozano,
Mojgan Hodaie,
Elena Moro

Affiliations

Anna Castrioto: Movement Disorders Center, Toronto Western Hospital, University of Toronto, University Health Network, Toronto, ON, Canada; Clinica Neurologica, Università degli Studi di Perugia, Perugia, Italy
Christopher Meaney: Dalla Lana School of Public Health, Department of Biostatistics, University of Toronto, Toronto, ON, Canada
Clement Hamani: Department of Neurosurgery, Toronto Western Hospital, University of Toronto, University Health Network, Toronto, ON, Canada
Filomena Mazzella: Movement Disorders Center, Toronto Western Hospital, University of Toronto, University Health Network, Toronto, ON, Canada
Yu-Yan Poon: Movement Disorders Center, Toronto Western Hospital, University of Toronto, University Health Network, Toronto, ON, Canada
Andres M. Lozano: Department of Neurosurgery, Toronto Western Hospital, University of Toronto, University Health Network, Toronto, ON, Canada
Mojgan Hodaie: Department of Neurosurgery, Toronto Western Hospital, University of Toronto, University Health Network, Toronto, ON, Canada
Elena Moro: Movement Disorders Center, Toronto Western Hospital, University of Toronto, University Health Network, Toronto, ON, Canada; Corresponding author. Movement Disorders Center, Toronto Western Hospital, 399 Bathurst St, McL7-402, Toronto, ON, Canada M5T 2S8. Fax: +1 416 603 5004.

Journal volume & issue: Vol. 41, no. 1
pp. 131 – 137

Abstract

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In some patients with Parkinson's disease (PD) and bilateral STN-DBS the motor benefit from one STN alone appears similar to the improvement obtained with bilateral STN-DBS. Thus, we hypothesized that some patients have a “dominant-STN,” whose stimulation achieves similar results than bilateral stimulation.Twenty-two consecutive PD patients with bilateral STN-DBS were assessed in 4 randomized conditions: bilateral off-stimulation, bilateral on-stimulation, unilateral right- and unilateral left-stimulation. A hierarchical agglomerative cluster analysis of the motor UPDRS scores in these 4 conditions showed that 11 patients (50%) presented with a “dominant-STN.” Interestingly, in 3 of these patients the dominant-STN was ipsilateral to the most affected side of the body.Our results support the presence of different phenotypes of response to bilateral STN stimulation. In our sample 50% of the patients presented with a dominant-STN, suggesting that a non-negligible part of PD patients might not need bilateral STN-DBS surgery.

Published in Neurobiology of Disease

ISSN: 0969-9961 (Print); 1095-953X (Online)
Publisher: Elsevier
Country of publisher: United States
LCC subjects: Medicine: Internal medicine: Neurosciences. Biological psychiatry. Neuropsychiatry
Website: https://www.journals.elsevier.com/neurobiology-of-disease

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