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Controlling Parkinson's Disease With Adaptive Deep Brain Stimulation
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Electrophysiologic mapping for deep brain stimulation for movement disorders.

Brett A Campbell1, Andre G Machado2, Kenneth B Baker3

  • 1Department of Neurosciences, Cleveland Clinic, Cleveland, OH, United States.

Handbook of Clinical Neurology
|July 7, 2019
PubMed
Summary

Electrophysiologic mapping refines deep brain stimulation (DBS) lead placement for movement disorders like Parkinson's disease. Microelectrode recordings precisely guide electrode implantation in target brain regions for effective therapeutic stimulation.

Keywords:
DBSDeep brain stimulationElectrophysiologyGPiMERMicroelectrode recordingSTNVim thalamus

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Area of Science:

  • Neurosurgery
  • Neuroscience
  • Biomedical Engineering

Background:

  • Deep brain stimulation (DBS) is a key treatment for movement disorders.
  • Accurate lead placement is crucial for DBS efficacy.
  • Current targeting relies on imaging and electrophysiologic mapping.

Purpose of the Study:

  • To provide an overview of microelectrode recording in DBS surgery.
  • To explain how electrophysiologic mapping refines image-based targeting for lead placement.
  • To highlight the role of mapping in DBS for movement disorders.

Main Methods:

  • Utilizing multiple imaging modalities for initial stereotactic planning.
  • Employing microelectrode recording to analyze neuronal firing rates and patterns.
  • Using acute stimulation to assess proximity to critical brain structures.

Main Results:

  • Electrophysiologic mapping identifies specific neuronal targets within the brain.
  • Mapping data refines the trajectory and final position of DBS electrodes.
  • Functional maps guide lead placement in the subthalamic nucleus, thalamus, and globus pallidus.

Conclusions:

  • Microelectrode recording is integral to DBS surgical procedures.
  • Electrophysiologic mapping enhances the precision of DBS lead placement.
  • This technique is vital for treating Parkinson's disease, dystonia, and tremor.