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Introduction: Mutations in LRRK2+ gene in chromosome 12 (also called dardarin, from the Basque word dardara, meaning tremor) have been related to the appearance of Parkinson's disease in several families. One particular mutation on this gene (R1441G) is specific to subjects of a Basque inheritance, whereas others have been described in families around the world, being G2019S the most frequent one. A previous study in our unit with a small sample size suggested that R1441G carriers had a worse outcome after DBS compared to an idiopathic PD group. Objective: To determine if DBS is equally valuable and has the same outcome to patients with PD with G2019S or R1441G mutation in LRRK2+ gene as is to idiopathic PD patients. Methods: Patients with LRRK2+ anomalies who have had surgery in Cruces University Hospital (Barakaldo, Basque Country) have been included in this analysis with a minimum of one year after procedure follow-up. As a control, patients matched 2:1 have been selected being similar in age at surgery and time of evolution of disease. Clinical data included variation of UPDRS and Schwab-England at onset and one year postoperatively, as well as variation of levodopa equivalent daily dose (LEDD). Results: Seventeen patients have been found in our cohort with LRRK2+ mutations, 12 of these with the R1441G mutation and 5 with G2019S one. Mean age at surgery in the case group was 60.05 (61.8 in the control group) and patients had a mean of 12.5 years of evolution of disease in the case group (12.3 in the control group). Implementing a linear mixed model, no differences were found related to UPDRS-III reduction after one year of surgery (31.05% in the genetic group and 30.29% in the control group) (p=0.857). No differences were found in the reduction of the Schwab-England scale (18.82 point reduction in the genetic group versus 17.71 point reduction in the control group) (p=0.886). LEDD was reduced in mean 572.53 mg in the genetic group versus 530.44 mg in the control group, which also was non-significant (p=0.734). Comparing between both mutated groups, no differences have been found in any parameter. Conclusion: There is no evidence in our study that DBS outcomes may be different in the LRRK2+ mutated group including G2019S or R1441G mutations PD than in the idiopathic PD group. Therefore, contrary to our previous report, LRRK2+ mutation carrier status should not be relevant criteria to select patients to surgery. [ABSTRACT FROM AUTHOR]

The O-arm surgical imaging system® is a multidimensional platform that provides the opportunity of visualizing the electrodes in real time in deep brain stimulation surgery. The objective of this study is to investigate in our center the value of this tool, by comparing the clinical improvement of a group operated on with this technology and a control group. After one year follow-up, the results were analyzed. Material and Methods: Twenty consecutive Parkinson disease patients that received deep brain stimulation with one year follow-up were selected. Electrode placement was optimized using the O-arm imaging system. They were compared to 20 consecutive patients operated on under 2D fluoroscopy as a control group. In both groups variation of the motor part of the Unified Parkinson's Disease Rating Scale (UPDRS-III) was measured, in addition to the number of microrecording tracks and the length of the surgery. Results: A median basal off reduction of 42% was observed in the O-arm group vs. 24% in the control at one year follow-up, which was statistically significant (p < 0.005). The reduction of the length of the surgery was statistically significant, being 1 h and 10 minutes less in the O-arm group. The number of tracks needed per electrode was reduced from 2.47 to 1.99. Conclusions: The O-arm can be easily included in the workflow of deep brain stimulation surgery. It gives the opportunity of visualizing the electrodes in real time. In our center it has helped to improve our results and refine our procedure. It has helped reducing the surgical time and number of tracks, as well as improving the clinical state of our patients. Further studies are needed to establish the fusion error. [ABSTRACT FROM AUTHOR]