Electrophysiologic mapping for deep brain stimulation for movement disorders

Influence of Anesthesia and Clinical Variables on the Firing Rate, Coefficient of Variation and Multi-Unit Activity of the Subthalamic Nucleus in Patients with Parkinson’s Disease

“…The clinical outcome of the surgery largely depends on correct positioning of the stimulating electrode in the sensorimotor region of the STN [2,3]. Microelectrode recordings (MER) of single-cell and multi-unit neuronal activity are commonly used to verify the borders of the STN [4]. To obtain reliable MER, DBS surgery is traditionally performed under local anesthesia alone, as the sedative and anesthetic agents may interfere with neural activity.…”

Randomized, Double-Blind Assessment of LFP Versus SUA Guidance in STN-DBS Lead Implantation: A Pilot Study

“…Intraoperative electrophysiological recordings for the accurate localization of STN have been a vital step for DBS electrode implantation (Zonenshayn et al, 2000;Sterio et al, 2002;Amirnovin et al, 2006;Gross et al, 2006;Abosch et al, 2013;Campbell et al, 2019). SUA has been the most commonly used electrophysiological signal for targeting (Gross et al, 2006;Abosch et al, 2013;Campbell et al, 2019), which strongly relies on subjective interpretation of single unit firings (Benazzouz et al, 2002;Benabid et al, 2009;Marceglia et al, 2010;Abosch et al, 2013).…”

“…Intraoperative electrophysiological recordings for the accurate localization of STN have been a vital step for DBS electrode implantation (Zonenshayn et al, 2000;Sterio et al, 2002;Amirnovin et al, 2006;Gross et al, 2006;Abosch et al, 2013;Campbell et al, 2019). SUA has been the most commonly used electrophysiological signal for targeting (Gross et al, 2006;Abosch et al, 2013;Campbell et al, 2019), which strongly relies on subjective interpretation of single unit firings (Benazzouz et al, 2002;Benabid et al, 2009;Marceglia et al, 2010;Abosch et al, 2013). Recently, there have been reports to ameliorate this disadvantage by identifying and clustering firing types (Kaku et al, 2019(Kaku et al, , 2020 or by detecting entry and exit of the STN automatically (Wong et al, 2009;Zaidel et al, 2009;Pinzon-Morales et al, 2011;Valsky et al, 2017;Thompson et al, 2018).…”

“…Moreover, a multi-center study has reported that the sub-optimal positioning of DBS electrodes accounts for 46% of cases with inadequate clinical improvement postoperatively (Okun et al, 2005). Thus, the clinical efficacy of DBS therapy depends critically on accurate localization of the STN (Zonenshayn et al, 2000;Sterio et al, 2002;Amirnovin et al, 2006;Gross et al, 2006;Campbell et al, 2019).…”

“…Precise placement of the DBS lead can be challenging due to the small size and the anatomical variability in the human STN (Patel et al, 2008;Richardson et al, 2009). While MRI-guided asleep DBS is being performed by some centers (Aziz and Hariz, 2017;Brodsky et al, 2017;Chen et al, 2018;Ho et al, 2018;Wang et al, 2019;Liu et al, 2020), intraoperative electrophysiology remains to be an important technique for localizing the STN, despite the variations in the surgical procedure between medical centers (Zonenshayn et al, 2000;Sterio et al, 2002;Amirnovin et al, 2006;Gross et al, 2006;Abosch et al, 2013;Campbell et al, 2019). A worldwide survey involving 143 DBS centers reported that 83% of them use single unit activity (SUA) recordings for DBS lead implantation (Abosch et al, 2013).…”