Cargando…
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...
Autores principales: | , , , , , , , |
---|---|
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 |
_version_ | 1784708731245690880 |
---|---|
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. |
format | Online Article Text |
id | pubmed-9108556 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | IOS Press |
record_format | MEDLINE/PubMed |
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 |
work_keys_str_mv | AT zhengzhe theaccuracyofimagingguidedtargetingwithmicroelectroderecodinginsubthalamicnucleusforparkinsonsdiseaseasinglecenterexperience AT zhuzhoule theaccuracyofimagingguidedtargetingwithmicroelectroderecodinginsubthalamicnucleusforparkinsonsdiseaseasinglecenterexperience AT yingyuqi theaccuracyofimagingguidedtargetingwithmicroelectroderecodinginsubthalamicnucleusforparkinsonsdiseaseasinglecenterexperience AT jianghongjie theaccuracyofimagingguidedtargetingwithmicroelectroderecodinginsubthalamicnucleusforparkinsonsdiseaseasinglecenterexperience AT wuhemmings theaccuracyofimagingguidedtargetingwithmicroelectroderecodinginsubthalamicnucleusforparkinsonsdiseaseasinglecenterexperience AT tianjun theaccuracyofimagingguidedtargetingwithmicroelectroderecodinginsubthalamicnucleusforparkinsonsdiseaseasinglecenterexperience AT luowei theaccuracyofimagingguidedtargetingwithmicroelectroderecodinginsubthalamicnucleusforparkinsonsdiseaseasinglecenterexperience AT zhujunming theaccuracyofimagingguidedtargetingwithmicroelectroderecodinginsubthalamicnucleusforparkinsonsdiseaseasinglecenterexperience AT zhengzhe accuracyofimagingguidedtargetingwithmicroelectroderecodinginsubthalamicnucleusforparkinsonsdiseaseasinglecenterexperience AT zhuzhoule accuracyofimagingguidedtargetingwithmicroelectroderecodinginsubthalamicnucleusforparkinsonsdiseaseasinglecenterexperience AT yingyuqi accuracyofimagingguidedtargetingwithmicroelectroderecodinginsubthalamicnucleusforparkinsonsdiseaseasinglecenterexperience AT jianghongjie accuracyofimagingguidedtargetingwithmicroelectroderecodinginsubthalamicnucleusforparkinsonsdiseaseasinglecenterexperience AT wuhemmings accuracyofimagingguidedtargetingwithmicroelectroderecodinginsubthalamicnucleusforparkinsonsdiseaseasinglecenterexperience AT tianjun accuracyofimagingguidedtargetingwithmicroelectroderecodinginsubthalamicnucleusforparkinsonsdiseaseasinglecenterexperience AT luowei accuracyofimagingguidedtargetingwithmicroelectroderecodinginsubthalamicnucleusforparkinsonsdiseaseasinglecenterexperience AT zhujunming accuracyofimagingguidedtargetingwithmicroelectroderecodinginsubthalamicnucleusforparkinsonsdiseaseasinglecenterexperience |