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Updated: May 13, 2025
Microelectrode Guided Implantation of Electrodes into the Subthalamic Nucleus of Rats for Long-term Deep Brain Stimulation
Published on: October 2, 2015
Lesioning Through a Directional Deep Brain Stimulation Lead in the Subthalamic Nucleus
Alfonso Enrique Martinez Nunez1, Dorian M Kusyk1, Joshua K Wong1
1Norman Fixel Institute for Neurological Disorders, Departments of Neurology and Neurosurgery, University of Florida, Gainesville, FL, US.
Clinical Vignette:
A 59-year-old woman with a previous subthalamic nucleus deep brain stimulation (DBS) implanted for Parkinson's disease developed a hardware related infection.
Clinical Dilemma:
Wound dehiscence and infection developed and necessitated removal of the DBS system. The patient experienced excellent therapeutic benefit from her DBS and expressed concern about device removal.
Clinical Solution:
The patient was offered the option of a lesioning procedure which could be performed during hardware explantation. An operative procedure was conducted where the intracranial DBS lead was connected to a radiofrequency system in a deliberate effort to create a targeted subthalamotomy through the existing DBS lead. A multilevel lesion was generated using the contacts on the directional DBS lead. Following the lesion the DBS lead and hardware were removed.
Gap In Knowledge:
Creating a lesion through a DBS lead using radiofrequency ablation is a therapeutic option for patients not interested in later re-implantation or for those with a history of multiple DBS related infections. Lesioning through segmented leads introduces more complexity into the procedure.
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