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Background: In this study we evaluated the impact of location of deep brain stimulation electrode active contact in different parts of the subthalamic nucleus on improvement of non-motor symptoms in patients with Parkinson's disease., Methods: The subthalamic nucleus was divided into two (dorsolateral/ventromedial) and three (dorsolateral, medial, ventromedial) parts. 37 deep brain stimulation electrodes were divided according to their active contact location. Correlation between change in non-motor symptoms before and one and four months after deep brain stimulation electrode implantation and the location of active contact was made., Results: In dividing the subthalamic nucleus into three parts, no electrode active contact was placed ventromedially, 28 active contacts were located in the medial part and 9 contacts were placed dorsolaterally. After one and four months, no significant difference was found between medial and dorsolateral positions. In the division of the subthalamic nucleus into two parts, 13 contacts were located in the ventromedial part and 24 contacts were placed in the dorsolateral part. After one month, significantly greater improvement in the Non-motor Symptoms Scale for Parkinson's disease (P=0.045) was found on dorsolateral left-sided stimulation, but no significant differences between the ventromedial and dorsolateral positions were found on the right side., Conclusion: This study demonstrated the relationship between improvement of non-motor symptoms and the side (hemisphere, left/right) of the deep brain stimulation electrode active contact, rather than its precise location within specific parts of the subthalamic nucleus in patients treated for advanced Parkinson's disease.

Numerous studies document significant improvement in motor symptoms in patients with Parkinson's disease (PD) after deep brain stimulation of the subthalamic nucleus (STN-DBS). However, little is known about the initial effects of STN-DBS on nonmotor domains.Our objective was to elucidate the initial effects of STN-DBS on non-motor and motor symptoms in PD patients in a 4-month follow-up.This open prospective study followed 24 patients with PD who underwent STN-DBS. The patients were examined using dedicated rating scales preoperatively and at 1 and 4 months following STN-DBS to determine initial changes in motor and nonmotor symptoms. Patients at month 1 after STN-DBS had significantly reduced the Parkinson's disease Questionnaire scores (P = .018) and Scales for Outcomes in Parkinson's disease - Autonomic scores (P = .002); these scores had increased at Month 4 after DBS-STN. Nonmotor Symptoms Scale for Parkinson's Disease had improved significantly at Month 1 (P < .001); at Month 4, it remained significantly lower than before stimulation (P = .036). There was no significant difference in The Parkinson's Disease Sleep Scaleat Month 1 and significant improvement at Month 4 (P = .026). There were no significant changes in The Female Sexual Function Index or International Index of Erectile Function. Movement Disorder Society Unified Parkinson's Disease Rating Scale, Part III scores show significant improvements at Month 1 (P < .001) and at Month 4 (P < .001).STN-DBS in patients with advanced PD clearly improves not only motor symptoms, but also several domains of nonmotor functions, namely sleep, autonomic functions and quality of life quickly following the start of stimulation.

Objective The aim of the study was to evaluate the placement accuracy of the deep brain stimulation (DBS) electrodes using the frameless navigation NexFrame© in our department. Background Methods for targeting the subthalamic nucleus (STN) in case of Parkinson disease (PD), ventral intermediate thalamic nucleus (ViM) in case of essential tremor (ET) and globus pallidus internus (GPi) in case of dystonia, differ in using direct visualization of preoperative magnetic resonance scans, in using intraoperative microelectrode recording or in anatomical target coordinates. A frame based stereotaxy or a frameless stereotactic system (NexFrame©) are used during the electrodes placement. Accurate placement of an electrode is necessary for the correct function of the deep brain stimulation. Methods Coordinates of the planned target point according to anterior and posterior commissural points are found using preoperative MRI of the brain and are usually modified intraoperatively according to microrecording and clinical examination. Coordinates of the real position of the electrode are detected using the fusion of preoperative MRI with postoperative CT. To determine the placement accuracy of the electrodes, the total error and the lateral, anteroposterior and vertical errors were calculated. Results 64 DBS electrodes were implanted using NexFrame© system to 33 patients diagnosed with PD, ET or dystonia (mean age 61.6 ± 8.7) between 2013 and 2015. The mean total error was 2.38 ± 1.24 mm, the mean lateral error was 1.21 ± 0.80 mm, the mean anteroposterior error was 1.29 ± 0.95 mm and the mean vertical error was 1.17 ± 1.08 mm. All results were compared to the results of other authors’ studies. Conclusions Results of our study show that using the frameless system NexFrame© in our department provides sufficient placement accuracy of electrodes needed for successful treatment using the DBS ( Starr et al., 2002; Schrader et al., 2002; Patwardhan et al., 2004; Holloway et al., 2005; Hamid et al., 2005; Fitzpatrick et al., 2005; Kelman et al., 2010 ). [ABSTRACT FROM AUTHOR]