Deep brain stimulation of the subthalamic nucleus in Parkinson's disease: Surgical technique, tips, tricks and complications

Kocabıcak, Ersoy; Temel, Yasin

doi:10.1016/j.clineuro.2013.08.020

Cited by 36 publications

(29 citation statements)

References 39 publications

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“…The central-anatomical trajectory was used for the final electrode implantation in only about one third of the patients (29). When the coordinates were individually refined after T2-weighted MRI, the final electrode was implanted along the central trajectory in two thirds of the patients (11). Although in our study, the improvement in the percentage of central trajectories between Groups 1 and 2 (52% to 76% on the right side and 38% to 78% on the left side) as well as in the percentage of electrodes implanted symmetrically in central trajectories (Group 1 at 14% and Group 2 at 62%) is significant, it is important to emphasize that neuroradiological planning did not change substantially during the study period.…”

Section: █ Conclusionmentioning

confidence: 99%

Learning curve in anatomo-electrophysiological correlations in subthalamic nucleus stimulation

Hrabovský¹,

Baláž²,

Bočková³

et al. 2016

Turkish Neurosurgery

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Parkinson's disease and other movement disorders, but not limited to them (4,13). The anatomical target definition based on neuroradiological investigation can be supported by intraoperative microrecording using simultaneously or sequentially implanted intracerebral microelectrodes and intraoperative MATERIAL and METHODS:The trajectories of right (first implanted) and left electrodes were compared in the first 50 patients operated on (Group 1) and the next 50 patients (Group 2). RESULTS:In Group 1, 52% of central trajectories were on the right and 38% on the left; in Group 2, the percentage of central trajectories was 76% on the right and 78% on the left; the difference was statistically significant (p=0.021 and 0.001). The difference in the percentage of posterior trajectories reflecting brain shift between the right and left sides was statistically insignificant in Groups 1 (26% and 28%, p=0.999) and 2 (18% and 12%, p=0.549). The percentage of bilateral central electrodes was 14% and 62% in Groups 1 and 2, respectively. CONCLUSION:The correlation between anatomically planned trajectory and final electrode placement markedly improves with the number of patients. However the significant percentage of patients with final electrode trajectory differing from anatomically planned target supports the use of intraoperative monitoring.

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Section: █ Conclusionmentioning

confidence: 99%

Learning curve in anatomo-electrophysiological correlations in subthalamic nucleus stimulation

Hrabovský¹,

Baláž²,

Bočková³

et al. 2016

Turkish Neurosurgery

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show abstract

“…The details regarding patient selection and follow-up have been described before (6,21). The surgeries can be divided in two periods.…”

Section: Surgical Techniquementioning

confidence: 99%

“…The trajectories with the longest STN activity were chosen for test stimulation. The trajectory with the least side effects and highest effect on the key symptoms with the largest stimulation window (amplitude thresholds of therapeutic and side-effects) was chosen for the final placement of the final electrode (5,6). Postoperatively all patients received either a CT or MR, and the images were fused.…”

Section: Surgical Techniquementioning

confidence: 99%

“…While the atlas-based stereotactic predefined coordinates were used to localize the STN in indirect targeting era, the T2 images were used in recent direct targeting method as described in detail previously (6,16). Our multi-affiliated center retrospective investigation shows that three key changes have taken place.…”

Section: Target Coordinatesmentioning

confidence: 99%

“…The most prominent determinants of the success of this therapy are the selection of patients and the accuracy of targeting the STN. For the latter, three factors are relevant: stereotactic accuracy, imaging techniques and electrophysiological mapping of the target area (3,6,24). surgery.…”

Section: █ Introductionmentioning

confidence: 99%

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Final electrode position in subthalamic nucleus deep brain stimulation surgery: a comparison of indirect and direct targeting methods

Tönge¹,

Kocabıcak²,

Ackermans³

et al. 2015

Turkish Neurosurgery

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Stereotactic coordinates derived from stereotactic human brain atlases merged with ventriculography and/or computerized tomography (CT) in combination with microelectrode recording (MeR) were the fundamental tools of surgery in early days (indirect targeting) (11,13). Advances in imaging techniques allowed a direct visualization of the target with high-resolution magnetic resonance (MR) imaging in recent years (direct targeting) (1,16,20,23) mATERIAl and mEThODS:We performed a database review of the surgeries performed in three affiliated centers. RESUlTS:We have found that with the shift to direct imaging, three key changes have taken place. The first is that the number of microelectrode recording trajectories has decreased by approximately 1 microelectrode. Secondly, the central trajectory has been chosen as the final position in more patients, and the third change is that direct targeting has improved the laterality of the targeting significantly.CONClUSION: Direct targeting has changed routine clinical practice, thereby further refining the surgical approach.

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Impact of Protein Fouling on the Charge Injection Capacity, Impedance, and Effective Electrode Area of Platinum Electrodes for Bionic Devices

et al. 2021

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The impact of protein fouling on platinum electrodes was assessed by electrochemical methods. Protein fouling affected the electrode potential and charge transfer through the electrode-solution interface. Adsorbed proteins partially blocked the electrode, with no charge passing through blocked regions. The electrochemical theory and methodology for investigating partially blocked electrodes is fully presented, applied to protein adsorption, and the implications for bionics applications are discussed. The partially blocked electrode had a reduced admittance, and increased impedance and polarization resistance consistent with a smaller effective electrode area. The charge storage capacity and charge injection capacity decreased after protein adsorption. The effective electrode area was assessed by impedance and cyclic voltammetry. The diffusion profile towards the partially blocked electrode was mixed between linear and radial diffusion.

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Deep brain stimulation of the subthalamic nucleus in Parkinson's disease: Surgical technique, tips, tricks and complications

Cited by 36 publications

References 39 publications

Learning curve in anatomo-electrophysiological correlations in subthalamic nucleus stimulation

Learning curve in anatomo-electrophysiological correlations in subthalamic nucleus stimulation

Final electrode position in subthalamic nucleus deep brain stimulation surgery: a comparison of indirect and direct targeting methods

Impact of Protein Fouling on the Charge Injection Capacity, Impedance, and Effective Electrode Area of Platinum Electrodes for Bionic Devices

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