gms | German Medical Science

63rd Annual Meeting of the German Society of Neurosurgery (DGNC)
Joint Meeting with the Japanese Neurosurgical Society (JNS)

German Society of Neurosurgery (DGNC)

13 - 16 June 2012, Leipzig

The influence of intraoperative microelectrode recording and clinical testing on the final stimulation site in deep brain stimulation

Meeting Abstract

  • J. Schlaier - Klinik und Poliklinik für Neurochirurgie, Universitätsklinikum Regensburg
  • C. Habermeyer - Klinik und Poliklinik für Neurochirurgie, Universitätsklinikum Regensburg
  • A. Hochreiter - Klinik und Poliklinik für Neurochirurgie, Universitätsklinikum Regensburg
  • M. Proescholdt - Klinik und Poliklinik für Neurochirurgie, Universitätsklinikum Regensburg
  • A. Brawanski - Klinik und Poliklinik für Neurochirurgie, Universitätsklinikum Regensburg
  • M. Lange - Klinik und Poliklinik für Neurochirurgie, Universitätsklinikum Regensburg

Deutsche Gesellschaft für Neurochirurgie. Japanische Gesellschaft für Neurochirurgie. 63. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie (JNS). Leipzig, 13.-16.06.2012. Düsseldorf: German Medical Science GMS Publishing House; 2012. DocFR.10.03

DOI: 10.3205/12dgnc246, URN: urn:nbn:de:0183-12dgnc2467

Published: June 4, 2012

© 2012 Schlaier et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.


Outline

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Objective: The aim of our study was to evaluate the influence of microelectrode recording and intraoperative clinical testing on the final stimulation site in deep brain stimulation.

Methods: 22 patients with idiopathic Parkinson's disease, who consecutively underwent bilateral subthalamic nucleus (STN) stimulation, were investigated. We compared MRI-based and atlas-based DBS target points in relation to the adjusted targets after intraoperative, multi-track microelectrode recording (MER) and clinical testing as well as in relation to the localization of the active contact 4 weeks after the operation. Each target and stimulation site was related to one of 27 segments of a standardized, reconstructed, 3-dimensional MRI-defined subthalamic nucleus (STN) as well as to the mid-point between the anterior and posterior commissure.

Results: Atlas-based targets were positioned more superior and more medial within and even outside the MRI-STN than the MRI-based targets, which were all located in the center of the STN. The optimal stimulation sites after MER and clinical testing found during the operation were located more lateral and slightly more superior than both planned targets. Eventually, the location of the active contacts 4 weeks after the operation were the most superior and most lateral in and often outside the MRI-STN. The differences in the distributions of our 4 targets reached statistical significance (p = 0.015).

Conclusions: Intraoperative, multi-track microelectrode recording and clinical testing influence the location of the final stimulation site significantly.