caa a22 4500 606215646 CHVBK 20210128101059.0 cr unu---uuuuu 210128e20150401xx s 000 0 eng 10.1007/s00701-015-2361-4 doi (NATIONALLICENCE)springer-10.1007/s00701-015-2361-4 Surgical implantation of STN-DBS leads using intraoperative MRI guidance: technique, accuracy, and clinical benefit at 1-year follow-up [Elektronische Daten] [Stephan Chabardes, Stephanie Isnard, Anna Castrioto, Manuella Oddoux, Valerie Fraix, Lore Carlucci, Jean Payen, Alexandre Krainik, Paul Krack, Paul Larson, Jean Le Bas] Background: Improvement of surgical accuracy during DBS-lead implantation has been described recently, leading to "frameless” or "MRI-verified" techniques. However, combining a high-quality definition of the STN using intraoperative 1.5 MRI with the possibility to reduce errors due to co-registration and to monitor lead progression during surgical insertion while checking the absence of surgical complication is an appealing method. We report here surgical methodology, safety, application accuracy, and clinical benefit of STN-lead implantation under MRI guidance. Methods: Two patients with a severe PD state were treated by bilateral STN-DBS. Leads were implanted under general anesthesia using intraoperative MRI guidance (ClearPoint system). Lead implantation accuracy was measured on T1 axial images at the level of the target. Clinical improvement was measured on the pre- and post-UPDRS 3 scale at 1-year follow-up. Results: Surgery was safe and uneventful in both cases. Radial error was 0.36 (right) and 0.86mm (left) in case 1, and 0.41 (right) and 0.14mm (left) in case 2. No edema or hemorrhage were noticed. Conclusions: Intraoperative MRI guidance allows DBS lead implantation with high accuracy and with great clinical efficacy. A larger cohort of patients is needed to confirm these initial results. Springer-Verlag Wien, 2015 DBS nationallicence Subthalamic nucleus nationallicence MRI nationallicence Parkinson disease nationallicence Chabardes Stephan Clinique de Neurochirurgie, Pole Tête, Cou et Chirurgie Réparatrice, CHU Michallon, Grenoble, France aut Isnard Stephanie Clinique de Neurochirurgie, Pole Tête, Cou et Chirurgie Réparatrice, CHU Michallon, Grenoble, France aut Castrioto Anna Clinique de Neurologie, Pole Neurologie et Psychiatrie, CHU Michallon, Grenoble, France aut Oddoux Manuella Departement d'anesthésie Reanimation, CHU Michallon, Grenoble, France aut Fraix Valerie Clinique de Neurologie, Pole Neurologie et Psychiatrie, CHU Michallon, Grenoble, France aut Carlucci Lore Neurochirurgie, AP-HP Hôpital Beaujon, Clichy, France aut Payen Jean Departement d'anesthésie Reanimation, CHU Michallon, Grenoble, France aut Krainik Alexandre Clinique de Neuroradiologie, CHU Michallon, Grenoble, France aut Krack Paul Clinique de Neurologie, Pole Neurologie et Psychiatrie, CHU Michallon, Grenoble, France aut Larson Paul Department of Neurological Surgery, University of California, San Francisco, CA, USA aut Le Bas Jean Clinique de Neuroradiologie, CHU Michallon, Grenoble, France aut Acta Neurochirurgica Springer Vienna 157/4(2015-04-01), 729-737 0001-6268 157:4<729 2015 157 701 https://doi.org/10.1007/s00701-015-2361-4 text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s00701-015-2361-4 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Chabardes Stephan Clinique de Neurochirurgie, Pole Tête, Cou et Chirurgie Réparatrice, CHU Michallon, Grenoble, France aut NATIONALLICENCE 700 1- Isnard Stephanie Clinique de Neurochirurgie, Pole Tête, Cou et Chirurgie Réparatrice, CHU Michallon, Grenoble, France aut NATIONALLICENCE 700 1- Castrioto Anna Clinique de Neurologie, Pole Neurologie et Psychiatrie, CHU Michallon, Grenoble, France aut NATIONALLICENCE 700 1- Oddoux Manuella Departement d'anesthésie Reanimation, CHU Michallon, Grenoble, France aut NATIONALLICENCE 700 1- Fraix Valerie Clinique de Neurologie, Pole Neurologie et Psychiatrie, CHU Michallon, Grenoble, France aut NATIONALLICENCE 700 1- Carlucci Lore Neurochirurgie, AP-HP Hôpital Beaujon, Clichy, France aut NATIONALLICENCE 700 1- Payen Jean Departement d'anesthésie Reanimation, CHU Michallon, Grenoble, France aut NATIONALLICENCE 700 1- Krainik Alexandre Clinique de Neuroradiologie, CHU Michallon, Grenoble, France aut NATIONALLICENCE 700 1- Krack Paul Clinique de Neurologie, Pole Neurologie et Psychiatrie, CHU Michallon, Grenoble, France aut NATIONALLICENCE 700 1- Larson Paul Department of Neurological Surgery, University of California, San Francisco, CA, USA aut NATIONALLICENCE 700 1- Le Bas Jean Clinique de Neuroradiologie, CHU Michallon, Grenoble, France aut NATIONALLICENCE 773 0- Acta Neurochirurgica Springer Vienna 157/4(2015-04-01), 729-737 0001-6268 157:4<729 2015 157 701