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Parkinson Disease: HELP
Articles by Lisa Klingelhoefer
Based on 15 articles published since 2008
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Between 2008 and 2019, L. Klingelhoefer wrote the following 15 articles about Parkinson Disease.
 
+ Citations + Abstracts
1 Review The Gut and Nonmotor Symptoms in Parkinson's Disease. 2017

Klingelhoefer, Lisa / Reichmann, Heinz. ·Technical University Dresden, Dresden, Germany. · Technical University Dresden, Dresden, Germany. Electronic address: Heinz.Reichmann@uniklinikum-dresden.de. ·Int Rev Neurobiol · Pubmed #28805583.

ABSTRACT: Gastrointestinal (GI) symptoms are one of the most common nonmotor symptoms (NMS) in patients with Parkinson's disease (PD) involving the whole GI tract (GIT) and being evident throughout the whole course of the disease. Furthermore, constipation serves as a risk factor for PD as well as an early prodromal NMS of PD. The gut as gateway to the environment with its enteric nervous system (ENS) plays a crucial role in the neurodegenerative process that leads to PD. Alpha-synucleinopathy as the pathological hallmark of PD could be found within the whole GIT in a rostrocaudal gradient interacting with the ENS, the gut microbiome, and enteric glial cells. Bidirectional interactions between the ENS and the central nervous system (CNS) via a brain-gut-enteric microbiota axis have been reported. As well as there is evidence out of animal, autopsy, and epidemiological studies that α-synuclein spreads via rostrocranial transmission by transsynaptic cell-to-cell transfer via the sympathetic and parasympathetic nervous system to the CNS causing the typical neuropathological changes of PD. Recognition of GI NMS as prodromal markers of PD as well as a better understanding of the brain-gut connection offers new insights in the pathophysiology of PD and might provide the opportunity of PD diagnosis before CNS involvement. Hereby the opportunity for development of neuroprotective and disease-modifying therapeutics, respectively, seem to be promising. This chapter covers the variety of GI NMS and its consequences in PD as well as the important role of the gut as part of the pathological process in PD.

2 Review Non-Motor Symptoms Assessed by Non-Motor Symptoms Questionnaire and Non-Motor Symptoms Scale in Parkinson's Disease in Selected Asian Populations. 2017

Sauerbier, Anna / Jitkritsadakul, Onanong / Titova, Nataliya / Klingelhoefer, Lisa / Tsuboi, Yoshio / Carr, Harry / Kumar, Hrishikesh / Banerjee, Rebecca / Erro, Roberto / Bhidayasiri, Roongroj / Schrag, Anette / Zis, Panagiotis / Lim, Shen-Yang / Al-Hashel, J Y / Kamel, Walaa A / Martinez-Martin, Pablo / Ray Chaudhuri, K. ·Neurology, King's College Hospital, London, UK. ·Neuroepidemiology · Pubmed #28803229.

ABSTRACT: BACKGROUND: Ethnic variations have been described in medical conditions, such as hypertension, diabetes, and multiple sclerosis. Whether ethnicity plays a role in Parkinson's disease (PD), particularly with regard to non-motor symptoms (NMS), remains unclear. Existing literature is diverse, controversial, and inadequately documented. This review aims to analyse and report the currently available literature on NMS, specifically in Asian PD patients. SUMMARY: We conducted a literature review using PubMed, searching for articles and currently available publications that reference and assess NMS in PD patients living in Asia using the validated NMS Questionnaire (NMS Quest) and NMS Scale (NMSS). In total, 24 articles were included: 12 using the NMS Quest and 12 using the NMSS. Symptoms of constipation, memory impairment, and nocturia were the most frequently self-reported symptoms (NMS Quest) in selected Asian populations, while symptoms within the domains sleep/fatigue, attention/memory, and mood/apathy were most prevalent when applying the health-professional completed NMSS. Key Messages: NMS are generally prevalent and highly burdensome within selected Asian PD populations living in countries included in this review. Our review suggests that NMS-driven phenotypic heterogeneity is present in Asian patients, and compared to Western PD populations there might be variations in assessed NMS.

3 Review Objective Measurement and Monitoring of Nonmotor Symptoms in Parkinson's Disease. 2017

Klingelhoefer, Lisa / Jitkritsadakul, Onanong / Bhidayasiri, Roongroj. ·Technical University Dresden, Dresden, Germany. · Chulalongkorn Center of Excellence for Parkinson's Disease & Related Disorders, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand. · Chulalongkorn Center of Excellence for Parkinson's Disease & Related Disorders, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand; Juntendo University, Tokyo, Japan. Electronic address: rbh@chulapd.org. ·Int Rev Neurobiol · Pubmed #28802925.

ABSTRACT: The comprehensive evaluation of nonmotor symptoms (NMS) in Parkinson's disease (PD) starts with the awareness of physicians, patients, and caregivers on their nature, clinical presentation, and effect on patient's daily activities and quality of life. This awareness can be better achieved if the symptoms can be visualized, measured, and monitored. As NMS are largely subjective in nature, a majority of them cannot be visualized (unlike tremor, which is easily seen), making their identification and quantification difficult. While symptoms are nonmotor, it does not mean that they are not measurable, as many NMS are integral to motor symptoms of Parkinson's, yet often neglected. In this review, we attempt to provide the most up-to-date and comprehensive literature review on the objective measurement and monitoring of NMS in PD. The aim is to make it clinically relevant by approaching NMS by domains as identified in the NMS Questionnaire. A section on the assessment of nonmotor fluctuations is also included, providing prospects for future objective monitoring. With the advances of technology, it is likely that many NMS will have objective outcomes, thus making these symptoms easily measurable and hopefully lead to future clinical trials that incorporate nonmotor outcomes. Nevertheless, it still requires a physician's judgment to determine which method, scales, objective measures, or monitoring devices or a combination of these is most appropriate to the individual patient in order to answer a particular clinical question.

4 Review Parkinson's disease as a multisystem disorder. 2017

Klingelhoefer, Lisa / Reichmann, H. ·Department of Neurology, Technical University Dresden, Fetscherstraße 74, 01307, Dresden, Germany. lisa.klingelhoefer@uniklinikum-dresden.de. · Department of Neurology, Technical University Dresden, Fetscherstraße 74, 01307, Dresden, Germany. ·J Neural Transm (Vienna) · Pubmed #28155133.

ABSTRACT: This article summarises the noteworthy contribution of Professor Jellinger to the understanding of Parkinson's disease (PD) as a disease affecting multiple body- and neurotransmitter-systems. Phosphorylated alpha-synuclein and the formation of Lewy pathology as neuropathological hallmarks of PD seem to spread from the enteric nervous system and the olfactory bulb in a rostrocranial direction to the CNS. Subsequently, a progressive degeneration of the dopaminergic-nigrostriatal system and widespread extranigral pathology affecting different anatomical structures and neurotransmitters are induced causing the various non-motor and motor symptoms of PD.

5 Review The nonmotor features of Parkinson's disease: pathophysiology and management advances. 2016

Reichmann, Heinz / Brandt, Moritz D / Klingelhoefer, Lisa. ·Department of Neurology, Technical University Dresden, Dresden, Germany. ·Curr Opin Neurol · Pubmed #27262147.

ABSTRACT: PURPOSE OF REVIEW: In recent years progress has been made in the detection and evaluation of nonmotor symptoms in Parkinson's disease. The pathophysiology is better understood and new treatment is available, which will be discussed in this review. RECENT FINDINGS: The most intriguing recent finding is the fact that Parkinson's disease may be a spreading disease. From the environment a toxin, bacteria, or virus may start in genetically susceptible patients a cascade of α-synuclein aggregation which reaches via the olfactory and the enteric system of the gut the brain where further spreading causes symptoms, such as sleep disturbances, motor impairment, and neuropsychiatric symptoms. New treatment should address the abnormal α-synuclein folding. If this would be achieved premotor signs, such as hyposmia, rapid eye movement-sleep behavior disorder, constipation, or depression may be a kind of biomarkers which allow together with other diagnostic tools, such as parenchymal sonography, iodobenzamide-scintigraphy and dopamine transporter scans the prediction whether somebody might be under way to develop the full-blown Parkinson's disease syndrome. SUMMARY: Parkinson's disease seems to be a spreading disease which causes not only a dopaminergic deficit as major cause for the movement disorder but also impairs function of many other brain centers which leads to a multitransmitter malfunction.

6 Review Pathogenesis of Parkinson disease--the gut-brain axis and environmental factors. 2015

Klingelhoefer, Lisa / Reichmann, Heinz. ·Department of Neurology, Technical University Dresden, Fetscherstrasse 74, 01307 Dresden, Germany. ·Nat Rev Neurol · Pubmed #26503923.

ABSTRACT: Parkinson disease (PD) follows a defined clinical pattern, and a range of nonmotor symptoms precede the motor phase. The predominant early nonmotor manifestations are olfactory impairment and constipation. The pathology that accompanies these symptoms is consistent with the Braak staging system: α-synuclein in the dorsal motor nucleus of the vagus nerve, the olfactory bulb, the enteric nervous system (ENS) and the submandibular gland, each of which is a gateway to the environment. The neuropathological process that leads to PD seems to start in the ENS or the olfactory bulb and spreads via rostrocranial transmission to the substantia nigra and further into the CNS, raising the intriguing possibility that environmental substances can trigger pathogenesis. Evidence from epidemiological studies and animal models supports this hypothesis. For example, in mice, intragastric administration of the pesticide rotenone can almost completely reproduce the typical pathological and clinical features of PD. In this Review, we present clinical and pathological evidence to support the hypothesis that PD starts in the gut and spreads via trans-synaptic cell-to-cell transfer of pathology through the sympathetic and parasympathetic nervous systems to the substantia nigra and the CNS. We also consider how environmental factors might trigger pathogenesis, and the potential for therapeutically targeting the mechanisms of these initial stages.

7 Review Parkinson's Disease and Gastrointestinal Non Motor Symptoms: Diagnostic and Therapeutic Options - A Practise Guide. 2015

Klingelhoefer, Lisa / Reichmann, Heinz. · ·J Parkinsons Dis · Pubmed #26406146.

ABSTRACT: Gastrointestinal (GI) disturbances in Parkinson's disease (PD) are varied, involve the upper and lower GI tract and are evident in all stages of the disease. Recognition and re-evaluation of these non motor symptoms (NMS) due to the course of PD is important. They have a major impact on the efficacy of oral anti-parkinsonian medication and health related quality of life. Treatment needs to be tailored to the specific patient case with evaluation of PD stage, the specific GI NMS and comorbidities. This article provides an overview of the pharmacological and non-pharmacological therapeutic options for GI NMS in PD.

8 Review Therapeutic options for nocturnal problems in Parkinson's disease and atypical parkinsonian disorders. 2014

Klingelhoefer, Lisa / Sokolov, Elisaveta / Chaudhuri, K Ray. ·Department of Neurology, National Parkinson Foundation International Centre of Excellence, King's College Hospital and King's College, 9th floor Ruskin Wing, Denmark Hill, London, SE5 9RS, UK, lisa.klingelhoefer@nhs.net. ·J Neural Transm (Vienna) · Pubmed #24696217.

ABSTRACT: Sleep disturbances in Parkinson's disease and parkinsonism (such as atypical parkinsonian disorders like multiple system atrophy, progressive supranuclear palsy, dementia with Lewy bodies and corticobasal degeneration) are multifactorial and as such treatment needs to be tailored to the specific patient case and sleep dysfunction. One also has to consider drug-related effects on sleep architecture. This article provides an overview of the therapeutic options for nocturnal problems in Parkinson`s disease and atypical parkinsonian disorders.

9 Review An update of the impact of deep brain stimulation on non motor symptoms in Parkinson's disease. 2014

Klingelhoefer, Lisa / Samuel, Michael / Chaudhuri, K Ray / Ashkan, Keyoumars. ·National Parkinson Foundation International Centre of Excellence, Department of Neurology, King's College Hospital and King's College, Denmark Hill, London, UK Department of Neurology, Technical University Dresden, Dresden, Germany. · National Parkinson Foundation International Centre of Excellence, Department of Neurology, King's College Hospital, Denmark Hill, London, UK. · National Parkinson Foundation International Centre of Excellence, Department of Neurology, King's College Hospital and King's College, Denmark Hill, London, UK. · Department of Neurosurgery, King's College Hospital, Denmark Hill, London, UK. ·J Parkinsons Dis · Pubmed #24613865.

ABSTRACT: Deep brain stimulation (DBS) of the subthalamic nucleus (STN) is a well-established therapy for patients with Parkinson's disease (PD), especially those with advanced motor complications. The effect of STN DBS on non motor symptoms (NMS) of PD is less well studied. In this article, we review the pertinent literature on the impact of STN DBS on NMS when they co-exist with disabling motor symptoms in PD patients. We also present evidence that the number and the severity of most NMS decrease after STN DBS which can have a major impact on patients' quality of life.

10 Clinical Trial Olfactory training in patients with Parkinson's disease. 2013

Haehner, Antje / Tosch, Clara / Wolz, Martin / Klingelhoefer, Lisa / Fauser, Mareike / Storch, Alexander / Reichmann, Heinz / Hummel, Thomas. ·Smell & Taste Clinic, Department of Otorhinolaryngology, University of Dresden Medical School, Dresden, Germany. antje.haehner@uniklinikum-dresden.de ·PLoS One · Pubmed #23613901.

ABSTRACT: OBJECTIVE: Decrease of olfactory function in Parkinson's disease (PD) is a well-investigated fact. Studies indicate that pharmacological treatment of PD fails to restore olfactory function in PD patients. The aim of this investigation was whether patients with PD would benefit from "training" with odors in terms of an improvement of their general olfactory function. It has been hypothesized that olfactory training should produce both an improved sensitivity towards the odors used in the training process and an overall increase of olfactory function. METHODS: We recruited 70 subjects with PD and olfactory loss into this single-center, prospective, controlled non-blinded study. Thirty-five patients were assigned to the olfactory training group and 35 subjects to the control group (no training). Olfactory training was performed over a period of 12 weeks while patients exposed themselves twice daily to four odors (phenyl ethyl alcohol: rose, eucalyptol: eucalyptus, citronellal: lemon, and eugenol: cloves). Olfactory testing was performed before and after training using the "Sniffin' Sticks" (thresholds for phenyl ethyl alcohol, tests for odor discrimination, and odor identification) in addition to threshold tests for the odors used in the training process. RESULTS: Compared to baseline, trained PD patients experienced a significant increase in their olfactory function, which was observed for the Sniffin' Sticks test score and for thresholds for the odors used in the training process. Olfactory function was unchanged in PD patients who did not perform olfactory training. CONCLUSION: The present results indicate that olfactory training may increase olfactory sensitivity in PD patients.

11 Article Application of the Six Sigma concept for quality assessment of different strategies in DBS surgery. 2018

Polanski, Witold H / Martin, K Daniel / Günther, Swen / Schackert, Gabriele / Klingelhoefer, Lisa / Fauser, Mareike / Storch, Alexander / Sobottka, Stephan B. ·Department of Neurosurgery, University Hospital Carl-Gustav-Carus, Technical University of Dresden, Fetscherstr. 74, Dresden, Germany. · Faculty of Business Administration, University of applied Science HTW Dresden, Friedrich-List-Platz 1, Dresden, Germany. · Division of Neurodegenerative Diseases, Department of Neurology, Technical University of Dresden, Fetscherstr. 74, Dresden, Germany. · Department of Neurology, University of Rostock, Rostock, Germany. ·Int J Qual Health Care · Pubmed #29917085.

ABSTRACT: Background: For quality analysis, we applied the Six Sigma concept to define quality indicators and their boundaries as well as to compare treatment-dependent outcome data of deep brain stimulation (DBS) of the subthalamic nucleus (STN) in patients with Parkinson's disease (PD). Methods: The Unified Parkinson Disease Rating Scale (UPDRS) III with on medication and on stimulation, the reduction of daily levodopa equivalence doses (LED), and the stimulation amplitude 1 year after surgery were registered. Regarding the results of the EARLYSTIM study, sigma values for applicable studies were calculated and compared. Further, the impact of perioperative conditions on patients' outcomes was analyzed. Results: Forty-one studies with 2184 patients were included. The bleeding risk was 1.36%. In median, UPDRS III on/on improved by 19.9% while the LED was reduced by 45.2%. The median stimulation amplitude was 2.84 V. With the Six Sigma principle, a comparison between different centers was possible. Microelectrode recordings (MER) did not correlate with occurrence of bleedings and did not impact patient outcome. Conclusions: The Six Sigma principle can be simply used to analyze, improve and compare complex medical processes, particularly, the DBS surgery. Based on these data, higher sigma values were reached for clinical improvement in UPDRS III on/on for patients who underwent surgery in local anesthesia with intraoperative test stimulation compared to surgery in general anesthesia. However, the difference was not statistically significant. Application of MER was found to be optional with no increased bleeding risk and no improvement on patient's outcome.

12 Article Accelerated Age-Dependent Hippocampal Volume Loss in Parkinson Disease With Mild Cognitive Impairment. 2017

Schneider, Christine B / Donix, Markus / Linse, Katharina / Werner, Annett / Fauser, Mareike / Klingelhoefer, Lisa / Löhle, Matthias / von Kummer, Rüdiger / Reichmann, Heinz / Anonymous2520905 / Storch, Alexander. ·1 Division of Neurodegenerative Diseases, Department of Neurology, Technische Universität Dresden, 01307 Dresden, Germany. · 2 Department of Psychiatry and Psychotherapy, Division of Old Age Psychiatry and Cognitive Neuropsychiatry, University Hospital Carl Gustav Carus, Technische Universität Dresden, 01307 Dresden, Germany. · 3 Institute and Clinic for Diagnostic and Interventional Neuroradiology, University Hospital Carl Gustav Carus, Technische Universität Dresden, 01307 Dresden, Germany. · 5 Department of Neurology, University of Rostock, 18147 Rostock, Germany. · 4 Department of Neurology, Technische Universität Dresden, 01307 Dresden, Germany. · 6 German Centre for Neurodegenerative Diseases (DZNE), 18147 Rostock, Germany. ·Am J Alzheimers Dis Other Demen · Pubmed #28468552.

ABSTRACT: BACKGROUND: Patients with Parkinson disease are at high risk of developing dementia. During the course of the disease, a substantial number of patients will experience a cognitive decline, indicating the dynamics of the underlying neuropathology. Magnetic resonance imaging (MRI) has become increasingly useful for identifying structural characteristics in radiological brain anatomy existing prior to clinical symptoms. Whether these changes reflect pathology, whether they are aging related, or both often remains unclear. We hypothesized that aging-associated brain structural changes would be more pronounced in the hippocampal region among patients with Parkinson disease having mild cognitive deficits relative to cognitively unimpaired patients. METHODS: Using MRI, we investigated 30 cognitively healthy patients with Parkinson disease and 33 patients with nondemented Parkinson disease having mild cognitive impairment. All participants underwent structural MRI scanning and extensive clinical and neuropsychological assessments. RESULTS: Irrespective of the study participants' cognitive status, older age was associated with reduced cortical thickness in various neocortical regions. Having mild cognitive impairment was not associated with an increased rate of cortical thinning or volume loss in these regions, except in the hippocampus bilaterally. CONCLUSION: Patients with Parkinson disease having mild cognitive impairment show an accelerated age-dependent hippocampal volume loss when compared with cognitively healthy patients with Parkinson disease. This may indicate pathological processes in a key region for memory functioning in patients with Parkinson disease at risk of developing dementia. Structural MRI of the hippocampal region could potentially contribute to identifying patients who should receive early treatment aimed at delaying the clinical onset of dementia.

13 Article Night-time sleep in Parkinson's disease - the potential use of Parkinson's KinetiGraph: a prospective comparative study. 2016

Klingelhoefer, L / Rizos, A / Sauerbier, A / McGregor, S / Martinez-Martin, P / Reichmann, H / Horne, M / Chaudhuri, K R. ·Department of Neurology, Technical University Dresden, Dresden, Germany. · Biomedical Research Unit, Department of Neurology, National Parkinson Foundation International Centre of Excellence, King's College Hospital and King's College, London, UK. · Centre for Clinical Neurosciences and Neurological Research, St Vincent's Hospital Melbourne, Fitzroy, Vic., Australia. · National Centre of Epidemiology and CIBERNED, Carlos III Institute of Health, Madrid, Spain. · Florey Institute for Neuroscience and Mental Health, University of Melbourne, Parkville, Vic., Australia. ·Eur J Neurol · Pubmed #27160044.

ABSTRACT: BACKGROUND AND PURPOSE: Night-time sleep disturbances are important non-motor symptoms and key determinants of health-related quality of life (HRQoL) in patients with Parkinson's disease (PD). The Parkinson's KinetiGraph (PKG) can be used as an objective measure of different motor states and periods of immobility may reflect episodes of sleep. Our aim was to evaluate whether PKG can be used as an objective marker of disturbed night-time sleep in PD. METHODS: In this prospective comparative study, data from PKG recordings over six consecutive 24 h periods are compared with Hauser diaries and scales focusing on motor state, sleep and HRQoL in PD patients. Thirty-three 'non-sleepy' PD patients (PD-NS) were compared with 30 PD patients presenting with excessive daytime sleepiness (PD-EDS). The groups were matched for age, gender and Hoehn and Yahr state. RESULTS: In the PD-EDS group subjective sleep reports correlated with the PKG's parameters for quantity and quality night-time sleep, but not in the PD-NS group. There were no significant correlations of the night-time sleep quantity parameters of the Hauser diary with subjective sleep perception, neither in the PD-EDS nor in the PD-NS group. CONCLUSIONS: This first PKG based study of night-time sleep in PD suggests that PKG could be used to provide an easy to use and rough evaluation of aspects of night-time sleep and one that could flag patients where polysomnography may be required. In sleepy PD patients for instance, quantity and quality PKG parameters correlate with different aspects of sleep such as insomnia, parasomnia and restless legs syndrome.

14 Article Thinking about motor fluctuations: An examination of metacognitions in Parkinson's disease. 2015

Fernie, Bruce A / Spada, Marcantonio M / Ray Chaudhuri, K / Klingelhoefer, Lisa / Brown, Richard G. ·King's College London, Institute of Psychiatry, Psychology and Neuroscience, Department of Psychology, London, UK; CASCAID, South London & Maudsley NHS Foundation Trust, London, UK. Electronic address: bruce.fernie@kcl.ac.uk. · London South Bank University, London, UK. · King's College and NPF Centre of Excellence, Kings College Hospital NHS Foundation Trust, London, UK. · King's College Hospital NHS Foundation Trust, London, UK; Department of Neurology, Technical University Dresden, Fetscherstraße 74, Dresden, Germany. · King's College London, Institute of Psychiatry, Psychology and Neuroscience, Department of Psychology, London, UK. ·J Psychosom Res · Pubmed #25990617.

ABSTRACT: OBJECTIVE: Motor fluctuations (characterised by a sudden increase in symptom intensity, referred to as an 'off-period') are common side effects after treatment of Parkinson's disease (PD) with dopaminergic medication. A proportion of these people find motor fluctuations highly distressing. This study aimed to identify metacognitions associated with cognitive and attentional responses to these experiences. METHODS: Ten individuals with PD who experience motor fluctuations were interviewed for this study using an adapted metacognitive profiling schedule. Participants were asked about their metacognitions, and the cognitive processes and attentional strategies activated in response to a distressing off-period. RESULTS: Metacognitions identified were more often related to conceptual thinking about symptoms rather than symptom focus and data suggested trends for increased depressive symptoms among individuals with stronger metacognitive beliefs. CONCLUSION: Metacognitions may play a role in determining or maintaining off-period distress in PD.

15 Article Accuracy of subthalamic nucleus targeting by T2, FLAIR and SWI-3-Tesla MRI confirmed by microelectrode recordings. 2015

Polanski, Witold H / Martin, Klaus D / Engellandt, Kay / von Kummer, Rüdiger / Klingelhoefer, Lisa / Fauser, Mareike / Storch, Alexander / Schackert, Gabriele / Sobottka, Stephan B. ·Department of Neurosurgery, Medical school 'Carl Gustav Carus' of the Technical University of Dresden, Fetscherstr. 74, 01307, Dresden, Germany, witold.polanski@uniklinikum-dresden.de. ·Acta Neurochir (Wien) · Pubmed #25596640.

ABSTRACT: BACKGROUND: Successful deep brain stimulation is mostly dependent on accurate positioning of the leads at the optimal target points. We investigated whether the identification of the subthalamic nucleus in T2-weighted 3-T MRI, fluid-attenuated inversion recovery 3-T MRI and susceptibility-weighted 3-T MRI is confirmed by intraoperative neurological microelectrode recording. METHODS: We evaluated 182 microelectrode recording leads in 21 patients with bilateral deep brain stimulation, retrospectively. Consequently, 728 electrode contact positions in T2-weighted 3-T MRI, 552 electrode contact positions in fluid-attenuated inversion recovery 3-T MRI and 490 electrode contact positions in susceptibility-weighted 3-T MRI were evaluated for a positive nucleus subthalamicus signal. RESULTS: The highest sensitivity was measured for fluid-attenuated inversion recovery 3-T MRI with 82.5 %, while the highest specificity was observed for susceptibility-weighted 3-T MRI with 90.6 %. The negative predictive value was nearly equal for susceptibility-weighted MRI and fluid-attenuated inversion recovery MRI with 87.5 % vs. 87.1 %, but the positive predictive value was higher in susceptibility-weighted 3-T MRI (86.0 %) than in the other MRI sequences. CONCLUSIONS: The susceptibility-weighted 3-T MRI-based subthalamic nucleus localization shows the best accuracy compared with T2-weighted and fluid-attenuated inversion recovery 3-T MRI. Therefore, the susceptibility-weighted 3-T MRI should be preferred for surgical planning when the operation procedure is performed under general anesthesia without microelectrode recordings.