gms | German Medical Science

62nd Annual Meeting of the German Society of Neurosurgery (DGNC)
Joint Meeting with the Polish Society of Neurosurgeons (PNCH)

German Society of Neurosurgery (DGNC)

7 - 11 May 2011, Hamburg

Deep brain stimulation: Detection of brain shift using multiple track microelectrode recordings

Meeting Abstract

  • J. Schlaier - Klinik und Poliklinik für Neurochirurgie, Universitätsklinikum Regensburg
  • C. Habermeyer - Klinik und Poliklinik für Neurochirurgie, Universitätsklinikum Regensburg
  • M. Lange - Klinik und Poliklinik für Neurochirurgie, Universitätsklinikum Regensburg
  • C. Fellner - Institut für Röntgendiagnostik, Universitätsklinikum Regensburg
  • A. Brawanski - Klinik und Poliklinik für Neurochirurgie, Universitätsklinikum Regensburg
  • J. Warnat - Klinik und Poliklinik für Neurochirurgie, Universitätsklinikum Regensburg

Deutsche Gesellschaft für Neurochirurgie. Polnische Gesellschaft für Neurochirurgen. 62. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Polnischen Gesellschaft für Neurochirurgen (PNCH). Hamburg, 07.-11.05.2011. Düsseldorf: German Medical Science GMS Publishing House; 2011. DocP 097

DOI: 10.3205/11dgnc318, URN: urn:nbn:de:0183-11dgnc3184

Published: April 28, 2011

© 2011 Schlaier et al.
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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.