Microelectrode recording for deep brain stimulation of the subthalamic nucleus in patients with advanced parkinson’s disease: advantage or loss of time?

Abstract

AIM: To investigate the effect of using microelectrode recording (MER) on the length of time required to carry out a deep brain stimulation (DBS) procedure of the subthalamic nucleus in patients with Parkinson's disease (PD). MATERIAL and METHODS: The time required to include MER in the DBS operation was calculated for the first and second sides in 24 patients with PD. The number of microelectrodes used on each trajectory for the first and second sides, and the percentage of permanent electrodes implanted on each trajectory for the first and second sides, were quantified. RESULTS: The average times taken to use MER were 23.4 ± 6.2 minutes, 17.4 ± 6.5 minutes, and 41.2 ± 6.3 minutes for the first side, second side and total procedure, respectively. In 75% of patients, the permanent electrode was implanted at the planned target site for the first side, and in 61% of patients for the second side. CONCLUSION: MER extends the time required to carry out the DBS procedure. However, during surgery, it provides real-time information on the electrodes' neurophysiological locations and helps the surgical team choose an alternative target if the planned target does not produce satisfying results.

Past, Present, and Future of Deep Brain Stimulation: Hardware, Software, Imaging, Physiology and Novel Approaches

“…MER will likely continue to be an important technique in places that do not yet have access to more advanced imaging techniques ( 39 , 40 ). Although the use of MER does extend the length of the DBS procedure ( 41 ), MER frequently provides important physiologic information that results in lead adjustments up to 20–40% of the time, which can be especially important in instances when there is significant brain shift following preoperative imaging ( 42 , 43 ).…”

Effects of deep brain stimulation of the subthalamic nucleus on the postoperative levodopa response: one year follow up

“…Today, advanced magnetic resonance technologies allow for direct targeting of STN. However, MER prolongs the surgical procedure to a certain extent (12). While some studies indicated that the latter increases the ICH rates, there are others reporting otherwise (3,9,27).…”

Complications After Deep Brain Stimulation: A 21-Year Experience in 426 Patients

“…This includes advances in the skills of the neurosurgeon, such as skin incision, drilling, and suture, and the rapid assessment of microelectrode recording when inserting intracranial electrodes. In addition, fast and accurate reading of the microelectrode recording is important for the proper placement of the intracranial electrode ( Kocabicak et al, 2019 ; Soares et al, 2019 ; Reddy et al, 2020 ). We consider that the accumulation of experience and the technological advances in DBS surgery could shorten the operation time and reduce the complications and infections rates.…”