Effects of Goreisan in the Perioperative Period of Subthalamic Deep Brain Stimulation in Parkinson's Disease
ABSTRACT Introduction Patients with Parkinson's disease (PD) may benefit from deep brain stimulation (DBS). Perifocal brain edema sometimes occurs after DBS surgery, but it is transient and does not affect the final prognosis. Transient deterioration of cognitive function has been reported in p...
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Wiley
2024-10-01
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| Series: | Brain and Behavior |
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| Online Access: | https://doi.org/10.1002/brb3.70069 |
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| author | Hiroyuki Kajikawa Keita Matsuura Yuichiro Ii Ken‐ichi Tabei Naoko Nakamura Hidehiro Ishikawa Yamato Nishiguchi Kana Matsuda Ken Kagawa Naoki Ichikawa Tomohiro Araki Akihiro Shindo |
| author_facet | Hiroyuki Kajikawa Keita Matsuura Yuichiro Ii Ken‐ichi Tabei Naoko Nakamura Hidehiro Ishikawa Yamato Nishiguchi Kana Matsuda Ken Kagawa Naoki Ichikawa Tomohiro Araki Akihiro Shindo |
| author_sort | Hiroyuki Kajikawa |
| collection | DOAJ |
| description | ABSTRACT Introduction Patients with Parkinson's disease (PD) may benefit from deep brain stimulation (DBS). Perifocal brain edema sometimes occurs after DBS surgery, but it is transient and does not affect the final prognosis. Transient deterioration of cognitive function has been reported in patients with frontal edema in the first postoperative week. This study aimed to investigate the effect of Goreisan in preventing edematous changes after DBS and determine the influence of edema on cognition. Methods We included 29 patients with PD who underwent bilateral subthalamic nucleus (STN) DBS and who were divided into 2 groups: those using (11 patients) and those not using Goreisan (18 patients). At 1 week postoperatively, all patients underwent magnetic resonance imaging. We measured the volume of edema either in the frontal white matter or STN on fluid‐attenuated inversion recovery (FLAIR) images. Finally, brain edema, motor function, and cognitive function were compared between the groups with and without Goreisan. Results In the FLAIR image 1 week postoperatively, the average postoperative frontal subcortical edema (FE) volume of the group with Goreisan was significantly lower than that without Goreisan (2249 ± 2186 mm3, 6261 ± 7213 mm3, respectively, p = 0.023). Multivariate analysis with age, preoperative Mini‐Mental State Examination (MMSE) score, FE, and peri‐STN edema (SE) as factors, and MMSE at 1 week postoperatively as the dependent variable showed that preoperative MMSE score and SE were significant as associated factors. Conclusions FE after DBS surgery may be alleviated using Goreisan. SE and preoperative MMSE scores were associated with MMSE scores 1 week postoperatively. Trial Registration Not applicable |
| format | Article |
| id | doaj-art-0dabd598bee645eabde09e5797195490 |
| institution | OA Journals |
| issn | 2162-3279 |
| language | English |
| publishDate | 2024-10-01 |
| publisher | Wiley |
| record_format | Article |
| series | Brain and Behavior |
| spelling | doaj-art-0dabd598bee645eabde09e57971954902025-08-20T02:12:02ZengWileyBrain and Behavior2162-32792024-10-011410n/an/a10.1002/brb3.70069Effects of Goreisan in the Perioperative Period of Subthalamic Deep Brain Stimulation in Parkinson's DiseaseHiroyuki Kajikawa0Keita Matsuura1Yuichiro Ii2Ken‐ichi Tabei3Naoko Nakamura4Hidehiro Ishikawa5Yamato Nishiguchi6Kana Matsuda7Ken Kagawa8Naoki Ichikawa9Tomohiro Araki10Akihiro Shindo11Department of Neurology, Graduate School of Medicine Mie University Mie JapanDepartment of Neurology, Graduate School of Medicine Mie University Mie JapanDepartment of Neuroimaging and Pathophysiology Mie University School of Medicine Mie JapanSchool of Industrial Technology, Advanced Institute of Industrial Technology Tokyo Metropolitan Public University Corporation Tokyo JapanDepartment of Neurology, Graduate School of Medicine Mie University Mie JapanDepartment of Neurology, Graduate School of Medicine Mie University Mie JapanDepartment of Neurology, Graduate School of Medicine Mie University Mie JapanDepartment of Dementia Prevention and Therapeutics Mie University Graduate School of Medicine Mie JapanDepartment of Neurorolgy Suzukakaisei Hospital Mie JapanDepartment of Neurosurgery Suzukakaisei Hospital Mie JapanDepartment of Neurosurgery Suzukakaisei Hospital Mie JapanDepartment of Neurology, Graduate School of Medicine Mie University Mie JapanABSTRACT Introduction Patients with Parkinson's disease (PD) may benefit from deep brain stimulation (DBS). Perifocal brain edema sometimes occurs after DBS surgery, but it is transient and does not affect the final prognosis. Transient deterioration of cognitive function has been reported in patients with frontal edema in the first postoperative week. This study aimed to investigate the effect of Goreisan in preventing edematous changes after DBS and determine the influence of edema on cognition. Methods We included 29 patients with PD who underwent bilateral subthalamic nucleus (STN) DBS and who were divided into 2 groups: those using (11 patients) and those not using Goreisan (18 patients). At 1 week postoperatively, all patients underwent magnetic resonance imaging. We measured the volume of edema either in the frontal white matter or STN on fluid‐attenuated inversion recovery (FLAIR) images. Finally, brain edema, motor function, and cognitive function were compared between the groups with and without Goreisan. Results In the FLAIR image 1 week postoperatively, the average postoperative frontal subcortical edema (FE) volume of the group with Goreisan was significantly lower than that without Goreisan (2249 ± 2186 mm3, 6261 ± 7213 mm3, respectively, p = 0.023). Multivariate analysis with age, preoperative Mini‐Mental State Examination (MMSE) score, FE, and peri‐STN edema (SE) as factors, and MMSE at 1 week postoperatively as the dependent variable showed that preoperative MMSE score and SE were significant as associated factors. Conclusions FE after DBS surgery may be alleviated using Goreisan. SE and preoperative MMSE scores were associated with MMSE scores 1 week postoperatively. Trial Registration Not applicablehttps://doi.org/10.1002/brb3.70069brain edemadeep brain stimulationGoreisanParkinson's disease |
| spellingShingle | Hiroyuki Kajikawa Keita Matsuura Yuichiro Ii Ken‐ichi Tabei Naoko Nakamura Hidehiro Ishikawa Yamato Nishiguchi Kana Matsuda Ken Kagawa Naoki Ichikawa Tomohiro Araki Akihiro Shindo Effects of Goreisan in the Perioperative Period of Subthalamic Deep Brain Stimulation in Parkinson's Disease Brain and Behavior brain edema deep brain stimulation Goreisan Parkinson's disease |
| title | Effects of Goreisan in the Perioperative Period of Subthalamic Deep Brain Stimulation in Parkinson's Disease |
| title_full | Effects of Goreisan in the Perioperative Period of Subthalamic Deep Brain Stimulation in Parkinson's Disease |
| title_fullStr | Effects of Goreisan in the Perioperative Period of Subthalamic Deep Brain Stimulation in Parkinson's Disease |
| title_full_unstemmed | Effects of Goreisan in the Perioperative Period of Subthalamic Deep Brain Stimulation in Parkinson's Disease |
| title_short | Effects of Goreisan in the Perioperative Period of Subthalamic Deep Brain Stimulation in Parkinson's Disease |
| title_sort | effects of goreisan in the perioperative period of subthalamic deep brain stimulation in parkinson s disease |
| topic | brain edema deep brain stimulation Goreisan Parkinson's disease |
| url | https://doi.org/10.1002/brb3.70069 |
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