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Microelectrode Guided Implantation of Electrodes into the Subthalamic Nucleus of Rats for Long-term Deep Brain Stimulation
Published on: October 2, 2015
Microelectrode recording-determined subthalamic nucleus length not predictive of stimulation-induced side effects
Shearwood McClelland1, Brian Kim, Linda M Winfield
1Department of Neurological Surgery, Columbia University College of Physicians and Surgeons, New York, New York, USA.
Neurosurgical Focus
|January 10, 2006
Summary
Microelectrode recording (MER) during deep brain stimulation (DBS) surgery for Parkinson disease does not reliably predict postoperative side effects based on subthalamic nucleus (STN) length. Shorter STN lengths did not correlate with increased stimulation-induced side effects.
Area of Science:
- Neurosurgery
- Neurology
- Medical Devices
Background:
- Deep brain stimulation (DBS) of the subthalamic nucleus (STN) is a key treatment for Parkinson disease.
- Microelectrode recording (MER) is often used to optimize electrode placement during DBS surgery.
- Postoperative stimulation-induced side effects may indicate electrode proximity to STN boundaries.
Purpose of the Study:
- To investigate the relationship between STN mapping using MER and postoperative stimulation-induced side effects.
- To determine if STN length identified by MER predicts the occurrence of side effects.
Main Methods:
- Retrospective analysis of 82 electrodes implanted in 75 patients undergoing STN DBS.
- Evaluation of STN length defined by MER and the incidence/threshold of stimulation-induced side effects.
- Statistical comparison of side effects between electrodes with STN lengths < 4.5 mm and >= 4.5 mm.
Main Results:
- No significant difference in the number or threshold of stimulation-induced side effects was found between electrodes with shorter (< 4.5 mm) and longer (>= 4.5 mm) MER-defined STN lengths.
- The mean threshold for paresthesias, the most common side effect, was not significantly different between the groups.
- MER-based target adjustments were generally within 2 mm of the image-planned target, with minimal differences in anterior-posterior adjustments between STN length groups.
Conclusions:
- Subthalamic nucleus length determined by microelectrode recording alone is not a reliable predictor of postoperative stimulation-induced side effects in DBS surgery.
- Further research may be needed to identify other factors influencing the relationship between MER-guided placement and stimulation-induced side effects.
