Abstract Details

Title Neuro-Anatomical Volumetric Changes in Deep Brain Stimulation of Parkinson’s Disease Patients

Topic Movement Disorders

Presentation(s) P1 - Poster Session 1 (12:00 PM-1:00 PM)

Poster/Presentation
Number 3-005

Objective To perform volumetric analysis of MRI scans of several brain structures in patients undergoing staged bilateral STN DBS.

Background

PD is associated with brain atrophy of cortical and subcortical structures. Atrophy of several of these structures have been linked to predicting effects of DBS. Recently, case reports raise suspicion that DBS may hasten brain atrophy. However, to the best of our knowledge, there has not been a large cohort of patients analyzed to evaluate these findings. Staging of implanted DBS electrodes especially if separated by months to years allows for direct comparison of operated to non-operated sides of the brain within a single patient to better determine the potential effects of DBS on brain structures.

Design/Methods A retrospective analysis was performed on PD patients undergoing STN-DBS at the University of Colorado. For each patient, two MRI scans were performed and analyzed; both scans were non-contrast 3D T1 volumetric scans. Intracranial volumes were obtained using the Computational Anatomical Toolbox. Subcortical volumetric assessments were made with the FIRST FSL tool. To determine whether implantation of the DBS lead affected subcortical volumes we compared both the subcortical volumes ipsilateral of the first implanted side for both the first and second side surgeries as well as the subcortical volumes contralateral to the first implanted side.

Results 32 patients (11 women) were included in this study. DBS resulted in reduced volumes of structures ipsilateral to the implanted side, volumetric reductions in the caudate (12%), putamen (14%), pallidum (25%), and thalamus (7%) (p-value < 0.05). Likewise, ipsilateral compared to contralateral regions to the side of DBS implantation were significantly reduced in volume the caudate (11%), putamen (9%), pallidum (24%), and thalamus (4%) (p-value < 0.05)

Conclusions Despite the well known beneficial effects of STN DBS, structural changes within the basal ganglia-thalamocortical circuits are evident.

Authors/Disclosures
Drew S. Kern, MD, FAAN (University of Colorado) PRESENTER	Dr. Kern has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Medtronic. The institution of Dr. Kern has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Boston Scientific. The institution of Dr. Kern has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Abbvie. Dr. Kern has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Abbott. The institution of Dr. Kern has received research support from Boston Scientific. The institution of Dr. Kern has received research support from AbbVie Pharmaceticals. Dr. Kern has received research support from Medtronic.
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