Subthalamic electrode implantation using the MicroDrive system and the importance of microrecording data

Abstract

Abstract:Objective: The aim of the paper was to describe the relationship of the anatomical and electrophysiological target for the subthalamic electrode implantation in Parkinson's disease patients defi ned as the best electrophysiological recordings from multiple paralel electrodes tracts with a target discrepancy explanation. Background: Although microrecording is the standard in subthalamic stimulation, microelectrode monitoring prolongs surgical time and may increase the risk of haemorrhagic complications. The main purpose for the electrophysiological mapping is to overcome the discrepancy between the anatomical and electrophysiological targets. Methods: Subthalamic electrodes were stereotactically implanted in 58 patients using microrecording by means of parallel electrodes at defi ned distances. The relationship of the fi nal electrode to the anatomical trajectory, the subthalamic nucleus electrical activity length, and the relationship of right and left electrodes were analysed. Results: The fi nal electrode placement matched the anatomical trajectory in 53.4 % of patients on the right side, and 43.1 % of patients on the left side. The electrode position was symmetrical in 38.3 % of patients. The analysis of left and right electrode positions did not prove brain shift as the sole factor responsible for anatomyfunctional discrepancy. Further, neither age, Parkinson's disease duration, or L-DOPA adverse effects were confi rmed as responsible factors. Conclusions:The difference between the anatomical trajectory and the fi nal electrode placement underlined the need for functional microelectrode monitoring. Brain shift is not the only causative factor for the difference (Tab. 7, Ref. 27). Full Text in PDF www.elis.sk.

The advances of Deep Brain Stimulation (DBS) for treatment of Parkinson s disease (PD)

“…If the results are not demonstrated with the expected benefit, the electrodes can be deactivated, without any risk to the patients and with a return to the pre-operative condition 5,6 .…”