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Microelectrode Recording for Deep Brain Stimulation of the Subthalamic Nucleus in Patients with Advanced Parkinson's
Ersoy Kocabicak1, Onur Alptekin, Dursun Aygun
1Ondokuz Mayis University, Faculty of Medicine, Department of Neurosurgery, Samsun, Turkey.
Aim:
To investigate the effect of using microelectrode recording (MER) on the length of time required to carry out a deep brain stimulation (DBS) procedure of the subthalamic nucleus in patients with Parkinson's disease (PD).
Material And Methods:
The time required to include MER in the DBS operation was calculated for the first and second sides in 24 patients with PD. The number of microelectrodes used on each trajectory for the first and second sides, and the percentage of permanent electrodes implanted on each trajectory for the first and second sides, were quantified.
Results:
The average times taken to use MER were 23.4 ± 6.2 minutes, 17.4 ± 6.5 minutes, and 41.2 ± 6.3 minutes for the first side, second side and total procedure, respectively. In 75% of patients, the permanent electrode was implanted at the planned target site for the first side, and in 61% of patients for the second side.
Conclusion:
MER extends the time required to carry out the DBS procedure. However, during surgery, it provides real-time information on the electrodes' neurophysiological locations and helps the surgical team choose an alternative target if the planned target does not produce satisfying results.
Insights
Microelectrode recording (MER) adds time to deep brain stimulation (DBS) surgery for Parkinson's disease (PD). However, MER provides crucial real-time data for accurate electrode placement, improving surgical outcomes.
Area of Science:
- Neurosurgery
- Neurology
- Medical Devices
Background:
- Deep brain stimulation (DBS) is a key treatment for Parkinson's disease (PD).
- Microelectrode recording (MER) is used to guide electrode placement during DBS surgery.
- Optimizing surgical time while ensuring accurate targeting is crucial in DBS procedures.
Purpose of the Study:
- To evaluate the impact of microelectrode recording (MER) on the duration of subthalamic nucleus deep brain stimulation (DBS) procedures in Parkinson's disease (PD) patients.
- To quantify the additional time MER adds to the DBS surgical workflow.
- To assess the accuracy of electrode implantation with and without MER guidance.
Main Methods:
- The study involved 24 patients with Parkinson's disease undergoing subthalamic nucleus DBS.
- Time required for MER integration was recorded for both the first and second surgical sides.
- The number of microelectrodes used and the percentage of permanently implanted electrodes at the target site were quantified.
Main Results:
- MER increased the total surgical time by an average of 41.2 minutes.
- The average time added by MER was 23.4 minutes for the first side and 17.4 minutes for the second side.
- Permanent electrodes were implanted at the planned target in 75% of first sides and 61% of second sides.
Conclusions:
- Microelectrode recording (MER) extends the operative time for deep brain stimulation (DBS) surgery in Parkinson's disease (PD).
- MER offers critical real-time neurophysiological information, aiding in precise electrode localization.
- This real-time feedback enables surgeons to adjust targeting if necessary, potentially improving functional outcomes.