Validity of single tract microelectrode recording in subthalamic nucleus stimulation

Area of Science:

• Neurosurgery
• Neurology
• Medical Devices

Background:

• Precise subthalamic nucleus (STN) lead implantation is critical for deep brain stimulation (DBS) surgery.
• Microelectrode recording (MER) is the gold standard for STN identification.

Purpose of the Study:

• To evaluate surgical outcomes and MER findings using a single tract MER method for STN DBS.
• To verify the efficacy of the single tract MER surgical technique.

Main Methods:

• Retrospective analysis of 440 STN DBS sides in 221 patients.
• Examination of single tract MER trajectories and final lead placement.
• Analysis of trajectory adjustments and their directions.

Main Results:

• Bilateral STN DBS significantly improved motor scores, dyskinesia/fluctuation, and reduced dopaminergic medication.
• 79.0% of procedures required only one MER trajectory.
• Posterior trajectory adjustments were most common (73.9%) to compensate for brain shift.

Conclusions:

• Single tract MER, with proper targeting and interpretation, enables precise STN lead placement with minimal trajectories.
• Prioritizing anterior-posterior trajectory adjustments is recommended when STN activity is insufficient.