Erasmi, Richard and Granert, Oliver and Zorenkov, Dmitry and Falk, Daniela and Wodarg, Fritz and Deuschl, Günther and Witt, Karsten (2018) White matter changes along the electrode lead in patients treated with deep brain stimulation. Frontiers in neurology, 9. p. 983. ISSN 1664-2295

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Official URL: http://dx.doi.org/10.3389/fneur.2018.00983

Abstract

Introduction: Deep brain stimulation (DBS) is an established treatment for various movement disorders. There is little data available about the potential damage to brain parenchyma through DBS treatment. The objective of this study was to investigate the occurrence of signal changes on magnetic resonance imaging (MRI) in patients treated with DBS. Methods: We retrospectively analyzed MRI scans of 30 DBS patients (21 patients with Parkinson’s disease, 3 patients with dystonia and 6 patients with tremor) that had undergone additional MRI scans after DBS surgery (ranging from 2 months to 8 years). Axial T2 sequences were analyzed by two raters using a standardized lesion mapping procedure. Results: 26 out of 30 analyzed patients showed hyperintense white matter changes surrounding the DBS lead (mean volume = 2.43ml). Lesions were prominent along the upper half of the electrode lead within the subcortical white matter, with no abnormalities along the lower lead. Their volume was significantly correlated to the time from surgery to MRI and to the number of microelectrodes used in surgery, but was independent from underlying disease (Parkinson’s disease, dystonia, tremor), target structure (STN, GPi, VIM), demographical data, or cardiovascular risk factors. Discussion: White matter changes along the electrode leads in DBS patients are a frequent finding. These changes seem to evolve with certain latency after surgery and might be radiologically classified as a gliosis. Our findings identify the number of intraoperatively usedmicroelectrodes as a risk factor in the formation of gliosis. Therefore, mechanical damage at the time of surgery and an individual tissue response might contribute to their evolution. Further studies are needed to define the exact mechanisms and their clinical impact.

Item Type: Article
Additional Information: Publiziert mit Hilfe des DFG-geförderten Open Access-Publikationsfonds der Carl von Ossietzky Universität Oldenburg.
Uncontrolled Keywords: Deep brain stimulation (DBS), electrode lead, white matter changes, MRI, Parkinson’s disease (PD)
Subjects: Technology, medicine, applied sciences > Medicine and health
Divisions: Faculty of Medicine and Health Sciences > Department of Human Medicine
Date Deposited: 13 Sep 2019 10:50
Last Modified: 18 Sep 2019 09:06
URI: https://oops.uni-oldenburg.de/id/eprint/4192
URN: urn:nbn:de:gbv:715-oops-42732
DOI: doi:10.3389/fneur.2018.00983
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