The Dominant-STN phenomenon in bilateral STN DBS for Parkinson's disease

  • Castrioto A
  • Meaney C
  • Hamani C
 et al. 
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Abstract

In some patients with Parkinson's disease (PD) and bilateral STN-DBS the motor benefit from one STN alone appears similar to the improvement obtained with bilateral STN-DBS. Thus, we hypothesized that some patients have a "dominant-STN," whose stimulation achieves similar results than bilateral stimulation.Twenty-two consecutive PD patients with bilateral STN-DBS were assessed in 4 randomized conditions: bilateral off-stimulation, bilateral on-stimulation, unilateral right- and unilateral left-stimulation. A hierarchical agglomerative cluster analysis of the motor UPDRS scores in these 4 conditions showed that 11 patients (50%) presented with a "dominant-STN." Interestingly, in 3 of these patients the dominant-STN was ipsilateral to the most affected side of the body. Our results support the presence of different phenotypes of response to bilateral STN stimulation. In our sample 50% of the patients presented with a dominant-STN, suggesting that a non-negligible part of PD patients might not need bilateral STN-DBS surgery. © 2010 Elsevier Inc.

Author-supplied keywords

  • Basal ganglia
  • Deep brain stimulation
  • Parkinson's disease
  • Subthalamic nucleus
  • Unilateral STN stimulation

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Authors

  • Anna Castrioto

  • Christopher Meaney

  • Clement Hamani

  • Filomena Mazzella

  • Yu Yan Poon

  • Andres M. Lozano

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