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Intra-Operative Behavioral Tasks in Awake Humans Undergoing Deep Brain Stimulation Surgery
Published on: January 6, 2011
Brain shift during deep brain stimulation surgery for Parkinson's disease.
Casey H Halpern1, Shabbar F Danish, Gordon H Baltuch
1Department of Neurosurgery, University of Pennsylvania, Philadelphia, PA 19107, USA.
Stereotactic and Functional Neurosurgery
|September 21, 2007
Summary
Brain shift during deep brain stimulation (DBS) surgery can alter subcortical structure positions. This study found posterior shifts correlate with displacement, potentially impacting target accuracy and necessitating microelectrode adjustments.
Area of Science:
- Neurosurgery
- Neurology
- Medical Imaging
Background:
- Brain shift can occur during deep brain stimulation (DBS) surgery.
- This shift may compromise the precise localization of subcortical targets.
Purpose of the Study:
- To investigate the extent and characteristics of brain shift during DBS surgery.
- To determine the impact of brain shift on subcortical structure positioning and target localization.
Main Methods:
- Retrospective analysis of pre- and postoperative MRI in 50 Parkinson's disease patients undergoing DBS.
- Patients categorized by cortical displacement (<2 mm vs. >=2 mm).
- Comparison of anterior commissure (AC), posterior commissure (PC), and red nucleus (RN) coordinates.
Main Results:
- Posterior displacement of AC correlated with cortical shift and was greater in patients with significant displacement.
- Posterior shift of AC and RN center showed a strong positive correlation.
- Brain shift impacted the number of microelectrode tracks needed for STN targeting.
Conclusions:
- Subcortical structures shift posteriorly during DBS, likely due to gravity in the supine position.
- Posterior RN shift suggests potential STN displacement, compromising target accuracy.
- These findings indirectly support the necessity of microelectrode recordings for accurate DBS targeting.
