Related Experiment Video
Updated: Aug 25, 2025
Targeting Neuronal Fiber Tracts for Deep Brain Stimulation Therapy Using Interactive, Patient-Specific Models
Published on: August 12, 2018
Complications of Deep Brain Stimulation for Parkinson Disease and Relationship between Micro-electrode tracks and
Neilen P Rasiah1, Romir Maheshwary2, Churl-Su Kwon3
1Department of Neurosurgery, Cumming School of Medicine, University of Calgary, Alberta, USA.
Background:
Deep brain stimulation is a common treatment for Parkinson's disease (PD). Despite strong efficacy in well-selected patients, complications can occur. Intraoperative micro-electrode recording (MER) can enhance efficacy by improving lead accuracy. However, there is controversy as to whether MER increases risk of hemorrhage.
Objectives:
To provide a comprehensive systematic review and meta-analysis reporting complication rates from deep brain stimulation in PD. We also interrogate the association between hemorrhage and MER.
Methods:
The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were implemented while querying the Pubmed, Embase, and Cochrane databases. All included studies were randomized controlled trials and prospective case series with 5 or more patients. Primary outcomes included rates of overall revision, infection, lead malposition, surgical site and wound complications, hardware-related complications, and seizure. The secondary outcome was the relationship between number of MER tracks and hemorrhage rate.
Results:
262 articles with 21,261 patients were included in the analysis. Mean follow-up was 25.8 months (range 0-133). Complication rates were: revision 4.9%, infection 4.2%, lead malposition 3.3%, surgical site complications 2.8%, hemorrhage 2.4%, hardware-related complications 2.4%, and seizure 1.9%. While hemorrhage rate did not increase with single-track MER (odds ratio, 3.49; P = 0.29), there was a significant non-linear increase with each additional track.
Conclusion:
Infection and lead malposition were the most common complications. Hemorrhage risk increases with more than one MER track. These results highlight the challenge of balancing surgical accuracy and perioperative risk.
Insights
Deep brain stimulation for Parkinson's disease has common complications. While micro-electrode recording (MER) improves accuracy, more than one MER track significantly increases hemorrhage risk, balancing accuracy and safety.
Area of Science:
- Neurosurgery
- Neurology
- Medical Technology
Background:
- Deep brain stimulation (DBS) is a standard Parkinson's disease (PD) treatment.
- Micro-electrode recording (MER) enhances DBS lead accuracy but its association with hemorrhage risk is debated.
Approach:
- Systematic review and meta-analysis of randomized controlled trials and prospective case series (PRISMA guidelines).
- Analyzed complication rates and the relationship between MER tracks and hemorrhage in 21,261 PD patients.
Key Points:
- Overall complication rates: revision 4.9%, infection 4.2%, lead malposition 3.3%, hemorrhage 2.4%.
- Infection and lead malposition were most frequent complications.
- Hemorrhage risk did not increase with single-track MER but rose non-linearly with additional tracks.
Conclusions:
- Balancing surgical precision with perioperative risks is crucial in DBS for PD.
- Increased MER tracks correlate with higher hemorrhage rates, necessitating careful procedural planning.
