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Prevalent placement error of deep brain stimulation electrode in movement disorders (technical considerations)
Bratislavske Lekarske Listy
|December 9, 2017
Summary
Deep brain stimulation electrode placement accuracy was analyzed. Electrode shifts, particularly on the left side, were observed, potentially due to anchoring device traction, necessitating calibration for optimal outcomes.
Area of Science:
- Neurosurgery
- Neurology
- Medical device technology
Background:
- Deep brain stimulation (DBS) is a well-established therapeutic technique.
- Electrode displacement from the optimal target can compromise efficacy and necessitate revision surgery.
Purpose of the Study:
- To evaluate the targeting accuracy of DBS electrode implantation in the subthalamic nucleus (STN) and globus pallidus internus (Gpi).
- To identify causes of targeting inaccuracy and prevalent electrode shift directions.
Main Methods:
- Analysis of targeting accuracy in 47 Parkinson's disease and 11 dystonia patients.
- Bilateral DBS electrode implantation between 2009 and 2016.
Main Results:
- Observed prevalent electrode shift: medial and posterior on the left, lateral on the right.
- Greater shift occurred on the left, associated with higher trajectory angulation.
- Electrode traction in the anchoring device identified as a potential cause of shift.
Conclusions:
- Targeting inaccuracy results from cumulative errors during implantation.
- Prevalent directional shifts can occur, necessitating correction.
- Calibration of stereotactic coordinates can prevent suboptimal electrode placement.
