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Can We Put Aside Microelectrode Recordings in Deep Brain Stimulation Surgery?

Microelectrode recording (MER) in deep brain stimulation (DBS) surgery has long been a recognized and efficient method for defining a target. However, in recent decades, imaging techniques, including DBS surgery, have experienced significant growth. There is convincing evidence that imaging-guided s...

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Autores principales: Pastor, Jesús, Vega-Zelaya, Lorena
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7564183/
https://www.ncbi.nlm.nih.gov/pubmed/32825301
http://dx.doi.org/10.3390/brainsci10090571
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author Pastor, Jesús
Vega-Zelaya, Lorena
author_facet Pastor, Jesús
Vega-Zelaya, Lorena
author_sort Pastor, Jesús
collection PubMed
description Microelectrode recording (MER) in deep brain stimulation (DBS) surgery has long been a recognized and efficient method for defining a target. However, in recent decades, imaging techniques, including DBS surgery, have experienced significant growth. There is convincing evidence that imaging-guided surgery can be helpful for targeting anatomically well-defined nuclei (e.g., subthalamic nucleus (STN) or internal globus pallidus (GPi)), and reductions in secondary effects have also been claimed. It has even been proposed that MER is not necessary to perform DBS, identifying in this way asleep surgery and imaging-guided DBS. However, there are several reasons why this is not the case. Neurophysiological techniques can efficiently and safely help to identify neural structures even in sleeping patients (e.g., different types of evoked potentials or motor stimulation). Deep nuclei are not homogeneous structures (even STN), so it is important to identify different places inside the putative target. Evidently, this is more relevant in the case of thalamic or hypothalamic surgery. Moreover, it is important to remember that the clinical and scientific knowledge acquired during DBS surgery can be important to gain further insight into pathologies and develop more effective treatments. Finally, the cost/efficiency of medical technology should be considered.
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spelling pubmed-75641832020-10-26 Can We Put Aside Microelectrode Recordings in Deep Brain Stimulation Surgery? Pastor, Jesús Vega-Zelaya, Lorena Brain Sci Editorial Microelectrode recording (MER) in deep brain stimulation (DBS) surgery has long been a recognized and efficient method for defining a target. However, in recent decades, imaging techniques, including DBS surgery, have experienced significant growth. There is convincing evidence that imaging-guided surgery can be helpful for targeting anatomically well-defined nuclei (e.g., subthalamic nucleus (STN) or internal globus pallidus (GPi)), and reductions in secondary effects have also been claimed. It has even been proposed that MER is not necessary to perform DBS, identifying in this way asleep surgery and imaging-guided DBS. However, there are several reasons why this is not the case. Neurophysiological techniques can efficiently and safely help to identify neural structures even in sleeping patients (e.g., different types of evoked potentials or motor stimulation). Deep nuclei are not homogeneous structures (even STN), so it is important to identify different places inside the putative target. Evidently, this is more relevant in the case of thalamic or hypothalamic surgery. Moreover, it is important to remember that the clinical and scientific knowledge acquired during DBS surgery can be important to gain further insight into pathologies and develop more effective treatments. Finally, the cost/efficiency of medical technology should be considered. MDPI 2020-08-20 /pmc/articles/PMC7564183/ /pubmed/32825301 http://dx.doi.org/10.3390/brainsci10090571 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Editorial
Pastor, Jesús
Vega-Zelaya, Lorena
Can We Put Aside Microelectrode Recordings in Deep Brain Stimulation Surgery?
title Can We Put Aside Microelectrode Recordings in Deep Brain Stimulation Surgery?
title_full Can We Put Aside Microelectrode Recordings in Deep Brain Stimulation Surgery?
title_fullStr Can We Put Aside Microelectrode Recordings in Deep Brain Stimulation Surgery?
title_full_unstemmed Can We Put Aside Microelectrode Recordings in Deep Brain Stimulation Surgery?
title_short Can We Put Aside Microelectrode Recordings in Deep Brain Stimulation Surgery?
title_sort can we put aside microelectrode recordings in deep brain stimulation surgery?
topic Editorial
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7564183/
https://www.ncbi.nlm.nih.gov/pubmed/32825301
http://dx.doi.org/10.3390/brainsci10090571
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