Title :

Asleep Robot-Assisted Surgery for the Implantation of Subthalamic Electrodes Provides the Same Clinical Improvement and Therapeutic Window as Awake Surgery.

Author(s) :

Lefranc, Michel [Auteur]
CHU Amiens-Picardie
Zouitina, Yassine [Auteur]
Tir, Mélissa [Auteur]
Laboratoire de Neurosciences Fonctionnelles et Pathologies - UR UPJV 4559 [LNFP]
Service de neurologie [Amiens]
Merle, Philippe [Auteur]
Self-adaptation for distributed services and large software systems [SPIRALS]
Université de Lille, Sciences et Technologies
Ouendo, Martial [Auteur]
Constans, Jean-Marc [Auteur]
Service de Radiologie [CHU Caen]
Godefroy, Olivier [Auteur]
CHU Amiens-Picardie
Laboratoire de Neurosciences Fonctionnelles et Pathologies - UR UPJV 4559 [LNFP]
Service de neurologie [Amiens]
Peltier, Johann [Auteur]
Service de neurologie [Amiens]
Krystkowiak, Pierre [Auteur]
Service de neurologie [Amiens]

Journal title :

World Neurosurgery

Pages :

602--608

Publisher :

Elsevier

Publication date :

2017

ISSN :

1878-8750

English keyword(s) :

Anesthesia
General/methods
Local/methods
Apathy/physiology
Cognition Disorders/etiology
Conscious Sedation/methods
Deep brain stimulation
Deep Brain Stimulation/*instrumentation/methods
Electrodes
Implanted
Female
Humans
Male
Middle Aged
Mood Disorders/etiology
Parkinson Disease/*therapy
Parkinson's disease
Postoperative Complications/etiology
Robot-assisted electrode placement
Robotic Surgical Procedures/adverse effects/*methods
ROSA robot
Subthalamic nucleus
Subthalamic Nucleus/surgery
Therapeutic window
Treatment Outcome
Wakefulness/physiology

HAL domain(s) :

Sciences du Vivant [q-bio]

English abstract : [en]

OBJECTIVE: To study the impact of not performing awake clinical evaluation during the robot-assisted implantation of subthalamic nucleus deep brain stimulation (STN-DBS) electrodes on the stimulation parameters and clinical ...
Show more >OBJECTIVE: To study the impact of not performing awake clinical evaluation during the robot-assisted implantation of subthalamic nucleus deep brain stimulation (STN-DBS) electrodes on the stimulation parameters and clinical outcomes in patients with Parkinson disease (PD). METHODS: A total of 23 patients with PD underwent robot-assisted surgery for the bilateral implantation of STN-DBS electrodes. Thirteen patients received general anesthesia (GA) and a limited intraoperative evaluation (side effects only), and the other 10 patients received local anesthesia (LA) and a full evaluation. The primary endpoint was the therapeutic window (TW), defined as the difference between the mean voltage threshold for motor improvement and the mean voltage threshold for side effects in the active contacts at 12 months after surgery. Motor scores were measured as well. RESULTS: The TW was similar in the LA and GA groups, with mean ± standard deviation values of 2.06 ± 0.53 V and 2.28 ± 0.99 V, respectively (P = 0.32). In the short term, the Unified Parkinson Disease Rating Scale (UPDRS) III score in the "off-drug, on-stim" condition fell to a similar extent in the LA and GA groups (by 40.3% and 49%, respectively; P = 0.336), as did the UPDRS III score in the "on-stim, on-drug" condition (by 57% and 70.7%, respectively; P = 0.36). CONCLUSIONS: Asleep, robot-assisted implantation of STN-DBS electrodes (with accurate identification of the STN and positioning of the DBS lead) produced the same motor results and TW as awake surgery.Show less >

Language :

Anglais

Peer reviewed article :

Oui

Audience :

Internationale

Popular science :

Non

Comment :

Place: United States

Collections :

• Centre de Recherche en Informatique, Signal et Automatique de Lille (CRIStAL) - UMR 9189

Source :

Harvested from HAL