Deviation of DBS Recording Microelectrodes during Insertion Assessed by Intraoperative CT

Area of Science:

• Neurosurgery
• Medical Imaging
• Neuromodulation

Background:

• Intraoperative microelectrode recording using the Ben Gun microdrive system is crucial for Deep Brain Stimulation (DBS) surgery.
• Accurate microelectrode localization is essential for effective DBS and interpretation of microelectrode recordings (MER).

Purpose of the Study:

• To investigate the imprecision of microelectrode implantation using the Ben Gun microdrive system during DBS surgery.
• To quantify the deviation of microelectrodes from their theoretical positions.

Main Methods:

• Analysis of the stereotactic position of 135 microelectrodes in 16 Parkinson's disease patients undergoing DBS surgery.
• Utilizing intracranial CT (iCT) integrated with a stereotactic planning system to determine microelectrode coordinates.
• Comparing simultaneous microelectrode positions to assess 3D Euclidean deviation, 2D probe's eye view deviation, and deviation from the theoretical inter-electrode distance.

Main Results:

• Median deviation was 0.64 mm in 3D and 0.58 mm in 2D.
• A significant percentage of satellite electrodes deviated substantially from the theoretical 2 mm distance from the central electrode.
• Imprecision was similar across axes (X, Y) but less in the Z-axis; bilateral implantations did not increase deviation risk.

Conclusions:

• A notable percentage of microelectrodes deviate significantly from their intended targets in DBS procedures.
• Intraoperative CT imaging can be used to estimate microelectrode deviation and enhance MER interpretation during surgery.