Microelectrode recording can be a good adjunct in magnetic resonance image–directed subthalamic nucleus deep brain stimulation for parkinsonism

Chen, Shin-Yuan; Lee, Chao Chin; Lin, Sheng Huang; Hsin, Yue Long; Lee, Tien Wen; Yen, Pao-Sheng; Chou, Yu-Cheng; Lee, Chi Wei; Hsieh, Wanhua Annie; Su, Chin Cheng; Lin, Shinn Zong

doi:10.1016/j.surneu.2005.06.029

Cited by 42 publications

(38 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The tentative surgical target coordinates for the tip of the permanent implantable electrode were set at the central, lowest border of the STN by direct visualization on MRI, as previously described in detail. 4 A Leksell G-frame unit (Elekta Instrument, Inc.) was used for the stereotactic procedure. The patient was resting in a straight supine position, and the head frame was secured in a Mayfield adaptor.…”

Section: Imaging and Targetingmentioning

confidence: 99%

Dorsolateral subthalamic neuronal activity enhanced by median nerve stimulation characterizes Parkinson’s disease during deep brain stimulation with general anesthesia

Tsai¹,

Chuang

Kuo

et al. 2015

JNS

Self Cite

View full text Add to dashboard Cite

S ubthalamic nucleus (STN) deep brain stimulation (DBS) has been shown to be an effective treatment for advanced Parkinson's disease (PD) and yields good long-term motor outcome. 25 Conventionally, STN-DBS is a surgical procedure conducted while the patient receives a local anesthetic and remains awake to ensure accurate electrophysiological mapping. In addition, this approach allows physicians to conduct intraoperative macrostimulation tests for motor response while minimizing potential side effects of stimulation. However, if a patient with PD is experiencing drastic off-medication symptoms, such as anxiety, painful dystonia, and respiratory distress, the patient may be precluded from this lengthy surgical procedure. 16,26 We previously reported our long-term results describing patients with PD who underwent STN-DBS under conditioned general anesthe- (PD). However, few studies are available that report whether neuronal firing can be accurately recorded during this condition. In this study the authors attempted to characterize the neuronal activity of the subthalamic nucleus (STN) and elucidate the influence of general anesthetics on neurons during DBS surgery in patients with PD. The benefit of median nerve stimulation (MNS) for localization of the dorsolateral subterritory of the STN, which is involved in sensorimotor function, was explored. methods Eight patients with PD were anesthetized with desflurane and underwent contralateral MNS at the wrist during microelectrode recording of the STN. The authors analyzed the spiking patterns and power spectral density (PSD) of the background activity along each penetration track and determined the spatial correlation to the target location, estimated using standard neurophysiological procedures. results The dorsolateral STN spiking pattern showed a more prominent bursting pattern without MNS and more oscillation with MNS. In terms of the neural oscillation of the background activity, beta-band oscillation dominated within the sensorimotor STN and showed significantly more PSD during MNS (p < 0.05). coNclusioNs Neuronal firing within the STN could be accurately identified and differentiated when patients with PD received general anesthetics. Median nerve stimulation can enhance the neural activity in beta-band oscillations, which can be used as an index to ensure optimal electrode placement via successfully tracked dorsolateral STN topography.

show abstract

Section: Imaging and Targetingmentioning

confidence: 99%

Dorsolateral subthalamic neuronal activity enhanced by median nerve stimulation characterizes Parkinson’s disease during deep brain stimulation with general anesthesia

Tsai¹,

Chuang

Kuo

et al. 2015

JNS

Self Cite

View full text Add to dashboard Cite

show abstract

“…Brain shift, imaging technique limitations, MRI image distortion, individual experience in target planning, anatomical anomalies of the target structure, interpretation of microrecording results, and technical aspects of stereotactic surgery, including surgical errors and mechanical inaccuracies of the operating system, are the most frequently mentioned (1,6,22,30).…”

Section: █ Discussionmentioning

confidence: 99%

“…stimulation (6,31). However, intraoperative monitoring prolongs surgical time and there are reports suggesting an association between the use of microelectrodes and increased incidence of hemorrhagic complications (24,32).…”

mentioning

confidence: 99%

Learning curve in anatomo-electrophysiological correlations in subthalamic nucleus stimulation

Hrabovský¹,

Baláž²,

Bočková³

et al. 2016

Turkish Neurosurgery

View full text Add to dashboard Cite

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.

show abstract

“…Most centers only use MRI for targeting while others use image fusion techniques to coregister MRI and CT scans. MRI-directed targeting for STN-DBS has proven to be a simple yet accurate method in most DBS practicing centers; it has been a standard procedure in our hospital since 2002 [42]. The advantages of MRI includes better demarcation of deep nuclei (e.g., the red and subthalamic nucleus) as references for targeting, better visualization of critical structures that can prevent inadvertent injury (e.g., lateral ventricles and vasculatures within sulci) and a clear delineation of simulating trajectory for electrode.…”

Section: Targeting Methods In Dbs: Mri Alone Versus Ct Scan Fused Witmentioning

confidence: 99%

“…Based on the above comparison, the same therapeutic effect for patients can be achieved in STN-DBS with and without MER, but MER has more surgery-related adverse events. Others have reported that the use of MER improves the outcome of STN-DBS [42]. With the advancement of MRI technology and imaging processing, MRI-guided STN-DBS without MER may be an alternative surgical method for advanced PD patients.…”

Section: The Necessity Of Microelectrode Recording In Stn-dbs Surgerymentioning

confidence: 99%

Controversial Issues in Deep Brain Stimulation in Parkinson's Disease

Chen¹,

Tsai²,

Lin³

2011

Towards New Therapies for Parkinson's Disease

Self Cite

View full text Add to dashboard Cite

Microelectrode recording can be a good adjunct in magnetic resonance image–directed subthalamic nucleus deep brain stimulation for parkinsonism

Cited by 42 publications

References 24 publications

Dorsolateral subthalamic neuronal activity enhanced by median nerve stimulation characterizes Parkinson’s disease during deep brain stimulation with general anesthesia

Dorsolateral subthalamic neuronal activity enhanced by median nerve stimulation characterizes Parkinson’s disease during deep brain stimulation with general anesthesia

Learning curve in anatomo-electrophysiological correlations in subthalamic nucleus stimulation

Controversial Issues in Deep Brain Stimulation in Parkinson's Disease

Contact Info

Product

Resources

About