Article
Deep brain stimulation: Detection of brain shift using multiple track microelectrode recordings
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Published: | April 28, 2011 |
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Outline
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Objective: The aim of our study was to investigate the direction and the amount of shift in deep brain structures during stereotactic implantations of electrodes into the subthalamic nucleus (STN).
Methods: 44 STNs in 22 patients with Parkinson's disease were investigated. 3-dimensional reconstructions of each STN were performed based on a) T2-weighted MRI images and b) on the results of microelectrode recordings (MER; iPlan 2.6, BrainLab, Heimstetten, Germany). Discrepancies along the borders of the corresponding MRI- and MER-STN were detected and compared regarding the first and the second operated side in each patient. For statistical analysis student-t-, Mann-Whitney Rank Sum and Fisher Exact tests were used.
Results: Positive MER-signals outside the MRI-STN were found significantly more frequently on the second operated side (in 10 of 22 STNs) in comparison to the side operated first (in 5 of 22 STNs; p = 0.010, Fisher Exact test). In the superior/inferior direction we found discrepancies of 0.27 mm (= mean; SD: 0.51 mm) on the first operated side and 1.51 mm (SD: 1.5mm) on the second (p = 0.010, t-test). In the medial/lateral direction the mean discrepancies were not statistically different (first side: 0.12 mm ± 0.31 mm; second side: 0.49 mm ± 0.98 mm; p = 0.302, Mann-Whithney Rank Sum test).
Conclusions: Microelectrode recordings can detect brain shift in deep brain stimulation procedures and might help to optimize positioning of the electrodes and the clinical results.