Experience with microelectrode guided subthalamic nucleus deep brain stimulation

Ramin Amirnovin, Ziv M. Williams, G. Rees Cosgrove, Emad N. Eskandar

Research output: Contribution to journalArticle

61 Citations (Scopus)

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.

Original languageEnglish (US)
JournalNeurosurgery
Volume58
Issue numberSUPPL. 1
DOIs
StatePublished - Feb 1 2006
Externally publishedYes

Fingerprint

Subthalamic Nucleus
Deep Brain Stimulation
Microelectrodes
Electrodes
Parkinson Disease
Nursing Services
Infection
Magnetic Resonance Spectroscopy
Rehabilitation
Hemorrhage
Therapeutics

Keywords

  • Deep brain stimulation
  • Parkinson
  • Subthalamic nucleus

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

Cite this

Experience with microelectrode guided subthalamic nucleus deep brain stimulation. / Amirnovin, Ramin; Williams, Ziv M.; Cosgrove, G. Rees; Eskandar, Emad N.

In: Neurosurgery, Vol. 58, No. SUPPL. 1, 01.02.2006.

Research output: Contribution to journalArticle

Amirnovin, Ramin ; Williams, Ziv M. ; Cosgrove, G. Rees ; Eskandar, Emad N. / Experience with microelectrode guided subthalamic nucleus deep brain stimulation. In: Neurosurgery. 2006 ; Vol. 58, No. SUPPL. 1.
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