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Experience with microelectrode guided subthalamic nucleus deep brain stimulation.
Neurosurgery. 2006 Feb; 58(1 Suppl):ONS96-102; discussion ONS96-102.N

Abstract

OBJECTIVE

Subthalamic deep brain stimulation (DBS) has rapidly become the standard surgical therapy for medically refractory Parkinson disease. However, in spite of its wide acceptance, there is considerable variability in the technical approach. This study details our technique and experience in performing microelectrode recording (MER) guided subthalamic nucleus (STN) DBS in the treatment of Parkinson disease.

METHODS

Forty patients underwent surgery for the implantation of 70 STN DBS electrodes. Stereotactic localization was performed using a combination of magnetic resonance and computed tomographic imaging. We used an array of three microelectrodes, separated by 2 mm, for physiological localization of the STN. The final location was selected based on MER and macrostimulation through the DBS electrode.

RESULTS

The trajectory selected for the DBS electrode had an average pass through the STN of 5.6 +/- 0.4 mm on the left and 5.7 +/- 0.4 mm on the right. The predicted location was used in 42% of the cases but was modified by MER in the remaining 58%. Patients were typically discharged on the second postoperative day. Eighty-five percent of patients were sent home, 13% required short-term rehabilitation, and one patient required long-term nursing services. Seven complications occurred over 4 years. Four patients suffered small hemorrhages, one patient experienced a lead migration, one developed an infection of the pulse generator, and one patient suffered from a superficial cranial infection.

CONCLUSION

Simultaneous bilateral MER-guided subthalamic DBS is a relatively safe and well-tolerated procedure. MER plays an important role in optimal localization of the DBS electrodes.

Authors+Show Affiliations

Department of Neurosurgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Comparative Study
Journal Article

Language

eng

PubMed ID

16543878

Citation

Amirnovin, Ramin, et al. "Experience With Microelectrode Guided Subthalamic Nucleus Deep Brain Stimulation." Neurosurgery, vol. 58, no. 1 Suppl, 2006, pp. ONS96-102; discussion ONS96-102.
Amirnovin R, Williams ZM, Cosgrove GR, et al. Experience with microelectrode guided subthalamic nucleus deep brain stimulation. Neurosurgery. 2006;58(1 Suppl):ONS96-102; discussion ONS96-102.
Amirnovin, R., Williams, Z. M., Cosgrove, G. R., & Eskandar, E. N. (2006). Experience with microelectrode guided subthalamic nucleus deep brain stimulation. Neurosurgery, 58(1 Suppl), ONS96-102; discussion ONS96-102.
Amirnovin R, et al. Experience With Microelectrode Guided Subthalamic Nucleus Deep Brain Stimulation. Neurosurgery. 2006;58(1 Suppl):ONS96-102; discussion ONS96-102. PubMed PMID: 16543878.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Experience with microelectrode guided subthalamic nucleus deep brain stimulation. AU - Amirnovin,Ramin, AU - Williams,Ziv M, AU - Cosgrove,G Rees, AU - Eskandar,Emad N, PY - 2006/3/18/pubmed PY - 2006/6/1/medline PY - 2006/3/18/entrez SP - ONS96-102; discussion ONS96-102 JF - Neurosurgery JO - Neurosurgery VL - 58 IS - 1 Suppl N2 - OBJECTIVE: Subthalamic deep brain stimulation (DBS) has rapidly become the standard surgical therapy for medically refractory Parkinson disease. However, in spite of its wide acceptance, there is considerable variability in the technical approach. This study details our technique and experience in performing microelectrode recording (MER) guided subthalamic nucleus (STN) DBS in the treatment of Parkinson disease. METHODS: Forty patients underwent surgery for the implantation of 70 STN DBS electrodes. Stereotactic localization was performed using a combination of magnetic resonance and computed tomographic imaging. We used an array of three microelectrodes, separated by 2 mm, for physiological localization of the STN. The final location was selected based on MER and macrostimulation through the DBS electrode. RESULTS: The trajectory selected for the DBS electrode had an average pass through the STN of 5.6 +/- 0.4 mm on the left and 5.7 +/- 0.4 mm on the right. The predicted location was used in 42% of the cases but was modified by MER in the remaining 58%. Patients were typically discharged on the second postoperative day. Eighty-five percent of patients were sent home, 13% required short-term rehabilitation, and one patient required long-term nursing services. Seven complications occurred over 4 years. Four patients suffered small hemorrhages, one patient experienced a lead migration, one developed an infection of the pulse generator, and one patient suffered from a superficial cranial infection. CONCLUSION: Simultaneous bilateral MER-guided subthalamic DBS is a relatively safe and well-tolerated procedure. MER plays an important role in optimal localization of the DBS electrodes. SN - 1524-4040 UR - https://www.unboundmedicine.com/medline/citation/16543878/Experience_with_microelectrode_guided_subthalamic_nucleus_deep_brain_stimulation_ L2 - https://academic.oup.com/neurosurgery/article-lookup/doi/10.1227/01.NEU.0000192690.45680.C2 DB - PRIME DP - Unbound Medicine ER -