Stereotactic and Functional Neurosurgery最新文献

{"title":"Comparative study evaluating a new dose optimization software for Gamma Knife treatment planning - comparison of 80 challenging treatment plans.","authors":"Lucie Hamáčková, Josef Novotný, Markéta Farníková, Roman Liščák, Gabriela Šimonová, Dušan Urgošík, Michal Schmitt","doi":"10.1159/000546214","DOIUrl":"https://doi.org/10.1159/000546214","url":null,"abstract":"<p><p>Introduction In 2020, Elekta Instrument AB, Stockholm, released a new dose optimizer for Leksell GammaPlan, which includes the possibility of inverse planning. This study aimed to compare the new software with the previous manual version of treatment planning for stereotactic neurosurgery and evaluate its performance. Materials and Methods Four types of diagnoses - vestibular schwannomas, pituitary adenomas, meningiomas, and single brain metastasis - along with 80 clinically approved challenging cases, were selected for testing the new software. Key parameters, including coverage, selectivity, target volume, and doses to critical structures, were collected and statistically analyzed using a t-test. These parameters were compared based on the Leksell Gamma Knife Society standardization document for stereotactic radiosurgery, both for each diagnosis and for the entire dataset. Results The new software showed a clear advantage, particularly in sparing critical structures while maintaining or improving treatment plan conformity. Doses to critical structures such as the optic nerve, brainstem, cochlea, and pituitary gland decreased by an average of 13% (0.76 Gy), 7% (0.52 Gy), 7% (0.2 Gy), and 14% (1.04 Gy), respectively, reducing toxicity. Other plan parameters also showed significant improvements, except for the gradient index. Selectivity improved by 11% (0.03), the Shaw Conformity Index improved by 10% (0.1), and coverage improved by 0.01. Additionally, treatment time was reduced by 10% enhancing patient comfort. Conclusion Overall, Leksell Gamma Knife Lightning is faster and produces treatment plans with superior parameters compared to manual planning.</p>","PeriodicalId":22078,"journal":{"name":"Stereotactic and Functional Neurosurgery","volume":" ","pages":"1-21"},"PeriodicalIF":1.9,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144175039","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Battery Longevity in Deep Brain Stimulation for Parkinson's Disease.","authors":"Forough Yazdanian, Alejandro Enriquez-Marulanda, Nima Dehmamy, Ali Mortezaei, Taimur Hassan, Jay L Shils, Ron L Alterman","doi":"10.1159/000544714","DOIUrl":"https://doi.org/10.1159/000544714","url":null,"abstract":"<p><strong>Introduction: </strong>In patients receiving deep brain stimulation (DBS) therapy, the longevity of the implanted pulse generator (IPG) is influenced by multiple factors, including patient diagnosis, therapeutic target, neurostimulator type, number of implanted leads, and stimulation settings. Recent advancements in DBS technology include longer-lived batteries, both standard and rechargeable. This study assesses the estimated IPG longevity of Medtronic, inc. Percept™ PC neurostimulator in Parkinson's Disease (PD) and explores factors associated with IPG lifespan.</p><p><strong>Methods: </strong>Retrospective analysis of Percept™ devices in 31 PD patients who underwent bilateral DBS targeting either the internal globus pallidus or the subthalamic nucleus. The analysis included demographics, clinical information, stimulation settings, lead locations, and Total Effective Energy Delivered (TEED).</p><p><strong>Results: </strong>The median IPG longevity was 75.9 months (51.6-92.3). Among stimulation parameters, frequency demonstrated the strongest inverse correlation with longevity (r=-0.49, p < 0.01), followed by pulse width (r=-0.39, p < 0.01), TEED (r=-0.35, p = p < 0.01), current amplitude (r=-0.33, p < 0.01) and voltage (r=-0.25, p = 0.04), regardless of laterality. In STN-targeted patients, a significant association was observed between the Z-coordinate of the right lead and the presence of side effects (p = 0.04). Monopolar stimulation on the dominant side showed significantly longer IPG longevity compared to bipolar stimulation (80.6 vs 49.6 months, p = 0.01).</p><p><strong>Conclusion: </strong>Significant negative correlations were observed between longevity and various stimulation parameters regardless of laterality. Monopolar stimulation on the dominant side was associated with increased longevity.</p>","PeriodicalId":22078,"journal":{"name":"Stereotactic and Functional Neurosurgery","volume":" ","pages":"1-18"},"PeriodicalIF":1.9,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144102741","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lack of Therapeutic Benefit of Vim Thalamotomy for Tremor-like Myoclonus in Two Cases of Benign Adult Familial Myoclonus Epilepsy.","authors":"Taku Nonaka, Takashi Asahi, Shiro Horisawa, Ichiro Takumi, Kiyonobu Ikeda, Akikazu Nakamura, Kenko Azuma, Hiroyuki Akagawa, Jiro Yamamoto, Nobutaka Yamamoto, Takaomi Taira","doi":"10.1159/000546301","DOIUrl":"https://doi.org/10.1159/000546301","url":null,"abstract":"<p><strong>Introduction: </strong>Benign adult familial myoclonus epilepsy (BAFME) is an autosomal dominant disorder characterized by adult-onset cortical tremor and infrequent generalized seizures. Treatment options for managing involuntary movements in BAFME remain limited.</p><p><strong>Case presentation: </strong>Here, we present two cases involving individuals with BAFME who underwent Vim thalamotomy for tremor-like myoclonus. Despite the intervention, neither patient experienced any improvement in their symptoms.</p><p><strong>Conclusion: </strong>These findings suggest that the Vim nucleus may not contribute to the pathophysiology of tremor-like myoclonus in BAFME, despite the established efficacy of Vim thalamotomy in the treatment of essential tremor.</p>","PeriodicalId":22078,"journal":{"name":"Stereotactic and Functional Neurosurgery","volume":" ","pages":"1-11"},"PeriodicalIF":1.9,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143999989","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Focused Ultrasound in the Treatment of Epilepsy: Current Applications and Future Directions.","authors":"Benjamin Sterling Succop, Andreas Seas, Joshua Woo, Kevin Jesus Bode Padron, Alyssa M Bartlett, Bhavya Shah, Shruti Agashe, Stephen Harward Ii","doi":"10.1159/000545716","DOIUrl":"10.1159/000545716","url":null,"abstract":"<p><strong>Introduction: </strong>Epilepsy is the fourth most common neurological disorder, affecting nearly 1% of the global population. Despite recent advancements in medical therapies, approximately one-third of patients remain refractory to treatment, necessitating consideration of surgical intervention. Historically, epilepsy surgery has been invasive and maximalist in nature, involving extensive brain resections with significant risk for morbidity. However, emerging approaches offer promising, less-invasive alternatives. One such technique is focused ultrasound (FUS), a rapidly evolving, incisionless, image-guided therapy that allows physicians to precisely target specific brain regions with ultrasonic energy to achieve a range of therapeutic effects.</p><p><strong>Methods: </strong>Systematic methods were implemented to define the scope of preclinical and clinical applications of FUS to treat epilepsy. Inclusion criteria included preclinical experiment, case study, case series, cohort studies, and clinical trials involving therapeutic application of FUS for treatment of epilepsy of any etiology. The primary exclusion criterion was FUS for indications other than treatment of epilepsy.</p><p><strong>Results: </strong>Forty-six published articles and 9 ongoing clinical trials were included for a total of 55 studies. For ablative therapies, 10 studies were identified, of which 2 were preclinical studies, 1 was a clinical proof-of-concept study, 3 were clinical case reports, 1 was a completed clinical pilot study, and 3 were ongoing Phase I-Phase II clinical trials. For neuromodulatory FUS, 30 studies were identified, of which 19 were preclinical studies, 1 was a clinical case report, 4 were clinical pilot studies, and 6 were ongoing Phase I-Phase II clinical trials. Lastly, with respect to FUS-mediated blood-brain barrier (BBB) opening studies, 15 were identified, all of which were preclinical studies.</p><p><strong>Discussion: </strong>Currently, FUS has been clinically applied for targeted brain ablation (high intensity [HIFU]) and neuromodulation (low intensity [LIFU]), with recent basic science applications of sonogenetics and targeted drug delivery through the BBB (Precise Intracerebral Noninvasive Guided, or PING, Surgery) offering new opportunities for clinical translation. This review summarizes preclinical and clinical applications of FUS for epilepsy treatment, addresses challenges to implementation, and explores key areas for future research.</p>","PeriodicalId":22078,"journal":{"name":"Stereotactic and Functional Neurosurgery","volume":" ","pages":"1-23"},"PeriodicalIF":1.9,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144018321","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative feasibility and complication analyses of extra-operative (bedside) removal of stereo-electroencephalography (SEEG) electrodes.","authors":"Jiahao J Chen, Thandar Aung, Theodora Constantine, Jorge Alvaro Gonzalez-Martinez","doi":"10.1159/000545984","DOIUrl":"https://doi.org/10.1159/000545984","url":null,"abstract":"<p><strong>Introduction: </strong>Stereotactic electroencephalography (SEEG) involves the implantation of intracortical electrodes for the precise localization of the epileptogenic zone (EZ) and is well-established in terms of its safety and efficacy during implantation-however, there is a notable lack of research comparing different electrode removal techniques, specifically regarding complications and feasibility of these approaches. This study evaluates the feasibility and clinical utility of intraoperative versus extraoperative (bedside) removal of stereotactic-electroencephalography (SEEG) electrodes.</p><p><strong>Methods: </strong>The early feasibility study retrospectively reviewed 117 consecutive SEEG patients at our institution, comparing 101 intraoperative cases with 16 extra-operative cases. A total of 1,624 SEEG electrodes were evaluated. Results related to demographics, feasibility of bedside removal, and occurrence of complications were analyzed and statistically compared between groups.</p><p><strong>Results: </strong>Our findings reveal comparable patient demographics across both groups and demonstrate low complication rates of 1.98% for intraoperative and 0.00% for extra-operative removals, with a combined rate of 1.71%. Importantly, zero cases of infection were observed in both settings. In addition to the low rates of complication in both the intraoperative and extraoperative explant groups, the study indicates a statistically significantly reduced use of sedation in the extra-operative group, which may enhance patient comfort and eliminate the need for additional sedatives during their ongoing treatment. The extraoperative bedside approach also offers practical benefits, such as removing the need for operating room (OR) resources and staffing, which can prevent OR delays and contribute to shorter hospital stays.</p><p><strong>Conclusion: </strong>With the appropriate indications, the extraoperative removal of SEEG electrodes appears to be a feasible and safe alternative to the intraoperative method. It presents potential advantages in optimizing patient flow within epilepsy monitoring units, improving operational efficiency, and potentially reducing healthcare costs while promoting patient comfort. Future research is essential to validate these findings further and refine the bedside technique for broader clinical application.</p>","PeriodicalId":22078,"journal":{"name":"Stereotactic and Functional Neurosurgery","volume":" ","pages":"1-23"},"PeriodicalIF":1.9,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143995503","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of robots in epilepsy surgery.","authors":"Matthias Tomschik, Sarina Noelle Somer, Christian Dorfer","doi":"10.1159/000545985","DOIUrl":"https://doi.org/10.1159/000545985","url":null,"abstract":"<p><strong>Background: </strong>Epilepsy is a prevalent chronic neurological disease affecting millions. Many patients respond to medical therapies, but a third of patients does not and potentially requires neurosurgical procedures. These can be used to localize the onset of seizures and subsequently treat patients. Robotic technologies have emerged over the last decades to increase the efficacy and safety of epilepsy surgery. We therefore wanted to describe the role that robotics in epilepsy surgery have taken since their introduction more than 30 years ago.</p><p><strong>Summary: </strong>Robotic assistance in epilepsy surgery has evolved for more than 30 years. Its earliest use in stereotactic EEG (SEEG) implantations has now also become its most widely used application. Multiple studies have demonstrated that robotic guidance increases the accuracy while also making the implantation of electrodes faster. Beyond diagnostics, robotics have also gained widespread acceptance in ablative neurosurgical procedures where robotic systems improve the placement and can even aid in the finetuning of laser fibers for laser interstitial thermotherapy (LITT). Additionally, robotics have been employed in the placement of electrodes for intracranial neuromodulation therapies in epilepsy such as deep brain stimulation (DBS) and responsive neurostimulation (RNS). Ongoing innovations are further expanding the uses of robotic technologies in epilepsy surgery from aiding in endoscopic procedures to automated craniotomies.</p><p><strong>Key messages: </strong>Robotics in epilepsy surgery have come a long way and have already taken a central role in procedure intended for diagnostic and therapeutic purposes. This narrative review details its many benefits and provides an outlook for future developments.</p>","PeriodicalId":22078,"journal":{"name":"Stereotactic and Functional Neurosurgery","volume":" ","pages":"1-15"},"PeriodicalIF":1.9,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144047785","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gamma Knife Radiosurgery for Glossopharyngeal Neuralgia: A Retrospective Study.","authors":"Andrea Franzini, Piero Picozzi, Zefferino Rossini, Maria Pia Tropeano, Beatrice Claudia Bono, Ali Baram, Pierina Navarria, Federico Pessina","doi":"10.1159/000545986","DOIUrl":"https://doi.org/10.1159/000545986","url":null,"abstract":"<p><strong>Background: </strong>The treatment of patients with glossopharyngeal neuralgia (GN) refractory to medical therapies is challenging. Gamma Knife Radiosurgery (GKRS) has emerged as an incisionless treatment option with outcomes reported in a limited number of studies.</p><p><strong>Objectives: </strong>To report on the outcomes of GKRS in patients with GN treated at our center.</p><p><strong>Methods: </strong>We retrospectively reviewed all patients with GN who underwent GKRS at our center since 2017. Pain intensity was evaluated using the Barrow Neurological Institute (BNI) pain score modified for GN. Adverse events were recorded.</p><p><strong>Results: </strong>Six patients underwent GKRS for GN at our center between 2017 and 2024. The maximum dose delivered was 85Gy for one patient and 90 Gy for the others. After a median period of 2 weeks from GKRS, all patients experienced pain reduction (BNI I-IIIa). Pain recurred during follow-up in two patients after 9 and 3 months, respectively. Both underwent repeat GKRS, which relieved pain in one. No adverse event or neurological deficit occurred.</p><p><strong>Conclusions: </strong>GKRS is an effective, well-tolerated treatment for patients with GN. Pain may recur over time, but more durable pain relief can be achieved with repeat GKRS.</p>","PeriodicalId":22078,"journal":{"name":"Stereotactic and Functional Neurosurgery","volume":" ","pages":"1-17"},"PeriodicalIF":1.9,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143994831","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Literature Review on Lesion-Symptom Mapping and Deep Brain Stimulation for Poststroke Spasticity: Restoring a Dysfunctional Network?","authors":"Lucien Favre, David Zhang, Claudio Pollo, Andreas Nowacki","doi":"10.1159/000545888","DOIUrl":"10.1159/000545888","url":null,"abstract":"<p><strong>Introduction: </strong>The present study aimed to define a structural network of stroke-induced and spasticity-related lesions and to relate this network to target sites and reported effects of deep brain stimulation (DBS) to treat poststroke spasticity.</p><p><strong>Methods: </strong>The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed (online suppl. Table 2). We performed two separate systematic literature reviews, collecting data from previously published voxel-based lesion-symptom mapping (VLSM) studies for poststroke spasticity patients searching the Medline database on Pubmed using the keywords \"stroke,\" \"spasticity,\" and \"lesion mapping\" as well as data from previously published cohorts undergoing DBS for poststroke spasticity using the keywords \"brain stimulation\" and \"spasticity.\" Data collected from each study included patient demographic characteristics, stroke diagnosis, movement disorder, DBS target, stimulation parameters, complications, and outcomes. Data from VLSM studies were used to calculate coordinate-based activation likelihood clusters, which were then used as seeds for enhanced fiber tracking to analyze affected networks.</p><p><strong>Results: </strong>Data from five studies on voxel-based lesion-symptom mapping for stroke-induced spasticity were included in the analysis. Meta-analytical mapping of stroke-related lesions identified significant clusters located in the basal ganglia-thalamo-cortical network which were predominantly connected to the sensorimotor cortex. We identified eight studies (four retrospective case series, two prospective open-label non-randomized trials, and two prospective double-blind trials) fulfilling our inclusion and exclusion criteria on DBS for spasticity reporting on 107 patients in total. Most studies reported outcomes in patients with cerebral palsy, a condition associated with both stroke-related spasticity and hypertonia-related dystonia, which are difficult to differentiate clinically. Target sites included different parts of the cerebellum and the motor thalamus with overall mixed results.</p><p><strong>Conclusion: </strong>Because all reported effective DBS target sites are situated along the cerebello-thalamo-cortical network, we hypothesize that the therapeutic effect of DBS on spasticity might be induced by resetting a functional imbalance between the basal ganglia-thalamo-cortical and the cerebello-thalamo-cortical networks in patients with a supraspinal etiology of spasticity. However, the results need to be interpreted cautiously due to the inevitable inclusion of stroke-related dystonia.</p>","PeriodicalId":22078,"journal":{"name":"Stereotactic and Functional Neurosurgery","volume":" ","pages":"1-12"},"PeriodicalIF":1.9,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12083951/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144011203","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quality of Life after Deep Brain Stimulation: A Primary versus Secondary Dystonia Comparative Study.","authors":"Emily Sanrey, Marylou Grasso, Marie Brethome, Emilie Chan-Seng, Valérie Gil, Philippe Coubes, Gaëtan Poulen","doi":"10.1159/000545755","DOIUrl":"https://doi.org/10.1159/000545755","url":null,"abstract":"<p><strong>Introduction: </strong>Generalized dystonia is a motor disorder causing major limitations in daily living activities. Deep brain stimulation (DBS) is an established therapy for primary disorders, but its efficacy in secondary ones remains variable. Although quality of life (QoL) assessment is crucial in disabling conditions to understand the comprehensive impact of surgical treatment on daily life, the available questionnaires are not well adapted.</p><p><strong>Methods: </strong>Herein, QoL after DBS was evaluated using a \"homemade\" scale. The DBS-QoL scale is a new questionnaire specifically designed for generalized dystonia patients.</p><p><strong>Results: </strong>Twenty-one DYT1 patients and 40 cerebral palsy patients underwent globus pallidus internus DBS during the inclusion period. Clinical improvement was measured using the BFMDRS and compared to QoL evolution using the DBS-QoL. We identified a significant positive impact of DBS on motor and functional aspects for both groups, with superior gains in DYT1 patients. In this group, we found significant improvement in functional aspects, whereas in perinatal hypoxic patients, the opposite trend was reported, with better satisfaction in terms of wellbeing. Across both etiologies, patients expressed satisfaction with the surgical outcomes (83%).</p><p><strong>Conclusion: </strong>QoL assessment, using a dedicated scale, was shown to complement BFMDRS, enhancing the detection of subtle symptom improvements in DBS-treated patients.</p>","PeriodicalId":22078,"journal":{"name":"Stereotactic and Functional Neurosurgery","volume":" ","pages":"1-6"},"PeriodicalIF":1.9,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144048769","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of Deep Brain Stimulation and Responsive Neurostimulation Wound Complication Rates and Risk Factors: A Single-Center Retrospective Study.","authors":"Eric Bayman, Chiagoziem Anigbogu, Ashkaun Razmara, Steven G Ojemann, John A Thompson, Daniel R Kramer","doi":"10.1159/000545146","DOIUrl":"10.1159/000545146","url":null,"abstract":"<p><strong>Introduction: </strong>Deep brain stimulation (DBS) and responsive neural stimulation (RNS) are effective for patients with pharmacoresistant epilepsy. Similar outcomes and increasingly convergent indications mean the choice of device may come down to other factors. Common to implanted therapeutic devices, wound-associated adverse outcomes are among the more common complications for these two procedures. However, there have been limited studies evaluating the differences in wound complication rates between DBS and RNS, despite the procedural differences for implantation for the two devices. Our objective was to analyze the differences in wound complication rates between patients who received DBS and RNS devices at the University of Colorado Hospital between 2016 and 2023.</p><p><strong>Methods: </strong>All DBS and RNS surgeries performed from 2016 to 2023 for two surgeons at the University of Colorado Hospital were retrospectively reviewed. Wound complications included infection, hardware protrusion, or wound erosion requiring surgical washout, explant, or replacement. Risk factors evaluated included age, sex, diabetes, body mass index, and immunocompromised status. Incidence of complications and risk factors were evaluated and compared using a chi-squared and Mann-Whitney U test. The relationship between selected risk factors and the probability of wound complication was evaluated using a binomial logistic regression.</p><p><strong>Results: </strong>A total of 297 patients underwent DBS (n = 234, n = 218 for movement disorders, n = 16 for epilepsy) and RNS (n = 63) implantation. The DBS group had higher median age at the time of surgery compared to the RNS group (65 vs. 37, p < 0.001), and no other significant differences in group characteristics were noted. Wound complication incidence was greater in the RNS group compared to DBS (12.7% vs. 4.3%, p < 0.001). No other risk factors were noted to contribute to wound complication rate.</p><p><strong>Conclusion: </strong>Wound complication incidence was greater in RNS patients compared to DBS patients. Differences in age, sex, body mass index, and immunocompromised status were not associated with increased wound complication risk.</p>","PeriodicalId":22078,"journal":{"name":"Stereotactic and Functional Neurosurgery","volume":" ","pages":"1-7"},"PeriodicalIF":1.9,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143796539","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}