ArticleNeurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology2025
Deep brain stimulation in Parkinson's disease: a comparison of accuracy and clinical outcomes of frame-based, frameless and frameless fiducial-less techniques.
Article in Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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1 citing paper in PubMed.
- What factors influence the length of stay and readmission after deep brain stimulation surgery? a tertiary centre study.Acta neurochirurgica · 2026Article
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11 authors.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundThe effectiveness of deep brain stimulation (DBS) for Parkinson's disease (PD) depends on implantation accuracy. DBS initially employed a stereotactic frame (frame-based, FB), but technological advancements led to the development of less invasive methods based on fiducial markers (F + F) or intraoperative imaging (F-F). This study compares the accuracy and efficacy of three DBS-STN implantation techniques.
methodsThis retrospective study involved 18 patients with PD who underwent bilateral STN DBS between 2018 and 2023. Patients were divided into three groups: FB (n = 6), F + F (n = 7), and F-F (n = 5). Postoperative CT and preoperative MRI fusion were used to evaluate electrode accuracy via deviations from planned targets in x, y, z axes, and calculate the radial error (RE) and vector error (VE). We analyzed Unified Parkinson's Disease Rating Scale (UPDRS) III scores in four "on/off medication-stimulation" combinations, LEDD, and disease stage before DBS, and 3 and 12 months post-DBS.
resultsNo statistically significant differences were observed between the three methods in|Δx| (FB = 1.30 ± 0.91; F + F = 1.05 ± 0.93; F-F = 1.33 ± 1.09 mm),|Δy| (FB = 0.95 ± 0.98; F + F = 1.11 ± 1.17; F-F = 1.28 ± 1.14 mm), RE (FB = 1.82 ± 0.29; F + F = 1,71 ± 0,36; F-F = 1,91 ± 1,49 mm) and VE (FB = 3,14 ± 0,35 mm; F + F = 4,92 ± 0,54 mm; F-F = 4,42 ± 1,22 mm). All groups demonstrated significant UPDRS III (> 50%) and LEDD reduction (> 40%) at 12 months, with no intergroup differences.
conclusionsThe study concludes that all three techniques provide equivalent accuracy and clinical efficacy. Centers should select DBS-STN methods based on available resources and expertise.
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