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Lateralized Subthalamic Stimulation for Axial Dysfunction in Parkinson's Disease: Exploratory Outcomes and Open-Label Extension.
Lizarraga, Karlo J; Gnanamanogaran, Bhairavei; Al-Ozzi, Tameem M; Cohn, Melanie; Tomlinson, George; Boutet, Alexandre; Elias, Gavin J B; Germann, Jürgen; Soh, Derrick; Kalia, Suneil K; Hodaie, Mojgan; Munhoz, Renato P; Marras, Connie; Hutchison, William D; Lozano, Andres M; Lang, Anthony E; Fasano, Alfonso.
Affiliation
  • Lizarraga KJ; The Edmond J. Safra Program in Parkinson's Disease and the Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, University Hospital Network and Division of Neurology, Department of Medicine, University of Toronto, Toronto, ON, Canada.
  • Gnanamanogaran B; Motor Physiology and Neuromodulation Program, Division of Movement Disorders, Department of Neurology, University of Rochester, Rochester, NY, USA.
  • Al-Ozzi TM; The Edmond J. Safra Program in Parkinson's Disease and the Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, University Hospital Network and Division of Neurology, Department of Medicine, University of Toronto, Toronto, ON, Canada.
  • Cohn M; University of Toronto, Toronto, ON, Canada.
  • Tomlinson G; University of Toronto, Toronto, ON, Canada.
  • Boutet A; Krembil Research Institute, Toronto, ON, Canada.
  • Elias GJB; Departments of Surgery and Physiology, Toronto Western Hospital and University of Toronto, Toronto, ON, Canada.
  • Germann J; Graduate Training Center of Neuroscience, Universitätsklinikum Tübingen, Tübingen, Germany.
  • Soh D; Krembil Research Institute, Toronto, ON, Canada.
  • Kalia SK; Department of Psychology, University of Toronto, Toronto, ON, Canada.
  • Hodaie M; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada.
  • Munhoz RP; University Health Network, Toronto, ON, Canada.
  • Marras C; Department of Psychology, University of Toronto, Toronto, ON, Canada.
  • Hutchison WD; Joint Department of Medical Imaging, University of Toronto, Toronto, ON, Canada.
  • Lozano AM; Division of Neurosurgery, Department of Surgery, University Health Network and University of Toronto, Toronto, ON, Canada.
  • Lang AE; University Health Network, Toronto, ON, Canada.
  • Fasano A; Division of Neurosurgery, Department of Surgery, University Health Network and University of Toronto, Toronto, ON, Canada.
Mov Disord Clin Pract ; 2024 Aug 13.
Article in En | MEDLINE | ID: mdl-39136363
ABSTRACT

BACKGROUND:

A randomized trial suggested that reducing left-sided subthalamic stimulation amplitude could improve axial dysfunction.

OBJECTIVES:

To explore open-label tolerability and associations between trial outcomes and asymmetry data.

METHODS:

We collected adverse events in trial participants treated with open-label lateralized settings for ≥3 months. We explored associations between trial outcomes, location of stimulation and motor asymmetry.

RESULTS:

14/17 participants tolerated unilateral amplitude reduction (left-sided = 10, right-sided = 4). Two hundred eighty-four left-sided and 1113 right-sided stimulated voxels were associated with faster gait velocity, 81 left-sided and 22 right-sided stimulated voxels were associated with slower gait velocity. Amplitude reduction contralateral to shorter step length was associated with 2.4-point reduction in axial MDS-UPDRS. Reduction contralateral to longer step length was associated with 10-point increase in MDS-UPDRS.

CONCLUSIONS:

Left-sided amplitude reduction is potentially more tolerable than right-sided amplitude reduction. Right-sided more than left-sided stimulation could be associated with faster gait velocity. Shortened step length might reflect contralateral overstimulation.
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Full text: 1 Collection: 01-internacional Database: MEDLINE Language: En Journal: Mov Disord Clin Pract / Mov. disord. clin. pract / Movement disorders clinical practice Year: 2024 Document type: Article Affiliation country: Canadá Country of publication: Estados Unidos
Fulltext
Add to My VHL
Print
XML
PubMed Links
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Full text: 1 Collection: 01-internacional Database: MEDLINE Language: En Journal: Mov Disord Clin Pract / Mov. disord. clin. pract / Movement disorders clinical practice Year: 2024 Document type: Article Affiliation country: Canadá Country of publication: Estados Unidos