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The Accuracy of Imaging Guided Targeting with Microelectrode Recoding in Subthalamic Nucleus for Parkinson’s Disease: A Single-Center Experience

BACKGROUND: Accurate electrode targeting was essential for the efficacy of deep brain stimulation (DBS). There is ongoing debate about the necessary of microelectrode recording (MER) in subthalamic nucleus (STN)-DBS surgery for accurate targeting. OBJECTIVE: This study aimed to analyze the accuracy...

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Autores principales: Zheng, Zhe, Zhu, Zhoule, Ying, Yuqi, Jiang, Hongjie, Wu, Hemmings, Tian, Jun, Luo, Wei, Zhu, Junming
Formato: Online Artículo Texto
Lenguaje:English
Publicado: IOS Press 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9108556/
https://www.ncbi.nlm.nih.gov/pubmed/35124576
http://dx.doi.org/10.3233/JPD-213095
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author Zheng, Zhe
Zhu, Zhoule
Ying, Yuqi
Jiang, Hongjie
Wu, Hemmings
Tian, Jun
Luo, Wei
Zhu, Junming
author_facet Zheng, Zhe
Zhu, Zhoule
Ying, Yuqi
Jiang, Hongjie
Wu, Hemmings
Tian, Jun
Luo, Wei
Zhu, Junming
author_sort Zheng, Zhe
collection PubMed
description BACKGROUND: Accurate electrode targeting was essential for the efficacy of deep brain stimulation (DBS). There is ongoing debate about the necessary of microelectrode recording (MER) in subthalamic nucleus (STN)-DBS surgery for accurate targeting. OBJECTIVE: This study aimed to analyze the accuracy of imaging-guided awake DBS with MER in STN for Parkinson’s disease in a single center. METHODS: The authors performed a retrospective analysis of 161 Parkinson’s disease patients undergoing STN-DBS at our center from March 2013 to June 2021. The implantation was performed by preoperative magnetic resonance imaging (MRI)-based direct targeting with intraoperative MER and macrostimulation testing. 285 electrode tracks with preoperative and postoperative coordinates were included to calculate the placement error in STN targeting. RESULTS: 85.9% of electrodes guided by preoperative MRI were implanted without intraoperative adjustment. 31 (10.2%) and 12 (3.9%) electrodes underwent intraoperative adjustment due to MER and intraoperative testing, respectively. We found 86.2% (245/285) of electrodes with trajectory error ≤2 mm. The MER physiological signals length < 4 mm and ≥4 mm group showed trajectory error > 2 mm in 38.0% and 8.8% of electrodes, respectively. Compared to non-adjustment electrodes, the final positioning of MER-adjusted electrodes deviated from the center of STN. CONCLUSION: The preoperative MRI guided STN targeting results in approximately 14% cases that require electrode repositioning. MER physiological signals length < 4 mm at first penetration implied deviation off planned target. MER combined with intraoperative awake testing served to rescue such deviation based on MRI alone.
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spelling pubmed-91085562022-05-18 The Accuracy of Imaging Guided Targeting with Microelectrode Recoding in Subthalamic Nucleus for Parkinson’s Disease: A Single-Center Experience Zheng, Zhe Zhu, Zhoule Ying, Yuqi Jiang, Hongjie Wu, Hemmings Tian, Jun Luo, Wei Zhu, Junming J Parkinsons Dis Research Report BACKGROUND: Accurate electrode targeting was essential for the efficacy of deep brain stimulation (DBS). There is ongoing debate about the necessary of microelectrode recording (MER) in subthalamic nucleus (STN)-DBS surgery for accurate targeting. OBJECTIVE: This study aimed to analyze the accuracy of imaging-guided awake DBS with MER in STN for Parkinson’s disease in a single center. METHODS: The authors performed a retrospective analysis of 161 Parkinson’s disease patients undergoing STN-DBS at our center from March 2013 to June 2021. The implantation was performed by preoperative magnetic resonance imaging (MRI)-based direct targeting with intraoperative MER and macrostimulation testing. 285 electrode tracks with preoperative and postoperative coordinates were included to calculate the placement error in STN targeting. RESULTS: 85.9% of electrodes guided by preoperative MRI were implanted without intraoperative adjustment. 31 (10.2%) and 12 (3.9%) electrodes underwent intraoperative adjustment due to MER and intraoperative testing, respectively. We found 86.2% (245/285) of electrodes with trajectory error ≤2 mm. The MER physiological signals length < 4 mm and ≥4 mm group showed trajectory error > 2 mm in 38.0% and 8.8% of electrodes, respectively. Compared to non-adjustment electrodes, the final positioning of MER-adjusted electrodes deviated from the center of STN. CONCLUSION: The preoperative MRI guided STN targeting results in approximately 14% cases that require electrode repositioning. MER physiological signals length < 4 mm at first penetration implied deviation off planned target. MER combined with intraoperative awake testing served to rescue such deviation based on MRI alone. IOS Press 2022-04-05 /pmc/articles/PMC9108556/ /pubmed/35124576 http://dx.doi.org/10.3233/JPD-213095 Text en © 2022 – The authors. Published by IOS Press https://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial (CC BY-NC 4.0) License (https://creativecommons.org/licenses/by-nc/4.0/) , which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Report
Zheng, Zhe
Zhu, Zhoule
Ying, Yuqi
Jiang, Hongjie
Wu, Hemmings
Tian, Jun
Luo, Wei
Zhu, Junming
The Accuracy of Imaging Guided Targeting with Microelectrode Recoding in Subthalamic Nucleus for Parkinson’s Disease: A Single-Center Experience
title The Accuracy of Imaging Guided Targeting with Microelectrode Recoding in Subthalamic Nucleus for Parkinson’s Disease: A Single-Center Experience
title_full The Accuracy of Imaging Guided Targeting with Microelectrode Recoding in Subthalamic Nucleus for Parkinson’s Disease: A Single-Center Experience
title_fullStr The Accuracy of Imaging Guided Targeting with Microelectrode Recoding in Subthalamic Nucleus for Parkinson’s Disease: A Single-Center Experience
title_full_unstemmed The Accuracy of Imaging Guided Targeting with Microelectrode Recoding in Subthalamic Nucleus for Parkinson’s Disease: A Single-Center Experience
title_short The Accuracy of Imaging Guided Targeting with Microelectrode Recoding in Subthalamic Nucleus for Parkinson’s Disease: A Single-Center Experience
title_sort accuracy of imaging guided targeting with microelectrode recoding in subthalamic nucleus for parkinson’s disease: a single-center experience
topic Research Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9108556/
https://www.ncbi.nlm.nih.gov/pubmed/35124576
http://dx.doi.org/10.3233/JPD-213095
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