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DBS microelectrode

Sheng-Tzung Tsai, Shee-Ping Chen, Sheng-Huang Lin, Shinn-Zong Lin, Shin-Yuan Chen
Objectives: We have shown that neuronal activity in the subthalamic nucleus (STN) in patients with Parkinson's disease can be accurately recorded during deep brain stimulation (DBS) with general anesthesia (GA). However, a vigorous passive range of motion (PROM) test might exert awakening effects on patients who are lightly anesthetized. We will explore the effects of PROM on the heart rate (HR) and mean arterial pressure (MAP) during microelectrode recording (MER) and confirm whether it facilitates identifying the sensory motor portion of the STN under GA...
October 2018: Ci Ji Yi Xue za Zhi, Tzu-chi Medical Journal
Kai Rui Wan, Tomasz Maszczyk, Angela An Qi See, Justin Dauwels, Nicolas Kon Kam King
OBJECTIVE: This study seeks to systematically review the selection of features and algorithms for machine learning and automation in deep brain stimulation surgery (DBS) for Parkinson's disease. This will assist in consolidating current knowledge and accuracy levels to allow greater understanding and research to be performed in automating this process, which could lead to improved clinical outcomes. METHODS: A systematic literature review search was conducted for all studies that utilized machine learning and DBS in Parkinson's disease...
September 25, 2018: Clinical Neurophysiology: Official Journal of the International Federation of Clinical Neurophysiology
Andreas Nowacki, T A-K Nguyen, Gerd Tinkhauser, Katrin Petermann, Ines Debove, Roland Wiest, Claudio Pollo
BACKGROUND: Accurate interindividual comparability of deep brain stimulation (DBS) lead locations in relation to the surrounding anatomical structures is of eminent importance to define and understand effective stimulation areas. The objective of the current work is to compare the accuracy of the DBS lead localisation relative to the STN in native space with four recently developed three-dimensional subcortical brain atlases in the MNI template space. Accuracy is reviewed by anatomical and volumetric analysis as well as intraoperative electrophysiological data...
September 27, 2018: NeuroImage: Clinical
Mahsa Malekmohammadi, Hiro Sparks, Nicholas AuYong, Andrew Hudson, Nader Pouratian
BACKGROUND/AIMS: There are reports that microelectrode recording (MER) can be performed under certain anesthetized conditions for functional confirmation of the optimal deep brain stimulation (DBS) target. However, it is generally accepted that anesthesia affects MER. Due to a potential role of local field potentials (LFPs) in DBS functional mapping, we characterized the effect of propofol on globus pallidus interna (GPi) and externa (GPe) LFPs in Parkinson disease (PD) patients. METHODS: We collected LFPs in 12 awake and anesthetized PD patients undergoing DBS implantation...
2018: Stereotactic and Functional Neurosurgery
Volker A Coenen, Bastian Sajonz, Marco Reisert, Jan Bostroem, Bettina Bewernick, Horst Urbach, Carolin Jenkner, Peter C Reinacher, Thomas E Schlaepfer, Burkhard Mädler
Background: Deep brain stimulation (DBS) of the superolateral branch of the medial forebrain bundle (slMFB) emerges as a - yet experimental - treatment for major depressive disorder (MDD) and other treatment refractory psychiatric diseases. First experiences have been reported from two open label pilot trials in major depression (MDD) and long-term effectiveness for MDD (50 months) has been reported. Objective: To give a detailed description of the surgical technique for DBS of the superolateral branch of the medial forebrain bundle (slMFB) in MDD...
2018: NeuroImage: Clinical
Andreas Horn, Ningfei Li, Till A Dembek, Ari Kappel, Chadwick Boulay, Siobhan Ewert, Anna Tietze, Andreas Husch, Thushara Perera, Wolf-Julian Neumann, Marco Reisert, Hang Si, Robert Oostenveld, Christopher Rorden, Fang-Cheng Yeh, Qianqian Fang, Todd M Herrington, Johannes Vorwerk, Andrea A Kühn
Deep brain stimulation (DBS) is a highly efficacious treatment option for movement disorders and a growing number of other indications are investigated in clinical trials. To ensure optimal treatment outcome, exact electrode placement is required. Moreover, to analyze the relationship between electrode location and clinical results, a precise reconstruction of electrode placement is required, posing specific challenges to the field of neuroimaging. Since 2014 the open source toolbox Lead-DBS is available, which aims at facilitating this process...
September 1, 2018: NeuroImage
Sander Bus, Gian Pal, Bichun Ouyang, Pepijn van den Munckhof, Maarten Bot, Sepehr Sani, Leo Verhagen Metman
BACKGROUND/AIMS: Microelectrode recording (MER)-guided deep brain stimulation (DBS) aims to place the DBS lead in the optimal electrophysiological target. When single-track MER or test stimulation yields suboptimal results, trajectory adjustments are made. The accuracy of these trajectory adjustments is unknown. Intraoperative computed tomography can visualize the microelectrode (ME) and verify ME adjustments. We aimed to determine the accuracy of ME movements in patients undergoing MER-guided DBS...
2018: Stereotactic and Functional Neurosurgery
Yuval Duchin, Reuben R Shamir, Remi Patriat, Jinyoung Kim, Jerrold L Vitek, Guillermo Sapiro, Noam Harel
OBJECTIVE: Deep brain stimulation (DBS) requires accurate localization of the anatomical target structure, and the precise placement of the DBS electrode within it. Ultra-high field 7 Tesla (T) MR images can be utilized to create patient-specific anatomical 3D models of the subthalamic nuclei (STN) to enhance pre-surgical DBS targeting as well as post-surgical visualization of the DBS lead position and orientation. We validated the accuracy of the 7T imaging-based patient-specific model of the STN and measured the variability of the location and dimensions across movement disorder patients...
2018: PloS One
Ilknur Telkes, Ashwin Viswanathan, Joohi Jimenez-Shahed, Aviva Abosch, Musa Ozturk, Akshay Gupte, Joseph Jankovic, Nuri F Ince
Although motor subtypes of Parkinson's disease (PD), such as tremor dominant (TD) and postural instability and gait difficulty (PIGD), have been defined based on symptoms since the mid-1990s, no underlying neural correlates of these clinical subtypes have yet been identified. Very limited data exist regarding the electrophysiological abnormalities within the subthalamic nucleus (STN) that likely accompany the symptom severity or the phenotype of PD. Here, we show that activity in subbands of local field potentials (LFPs) recorded with multiple microelectrodes from subterritories of STN provide distinguishing neurophysiological information about the motor subtypes of PD...
September 4, 2018: Proceedings of the National Academy of Sciences of the United States of America
A R Sitnikov, Yu A Grigoryan, L P Mishnyakova
Background: The use of the anterior nucleus of thalamus (ANT) as a target for treatment of pharmacoresistant epilepsy is based on its crucial role in seizure propagation. We describe results of chronic bilateral ANT stimulation and bilateral ANT lesions in 31 patients with refractory epilepsy. Methods: ANT DBS was performed in 12 patients (group I) and bilateral stereotactic radiofrequency lesions of ANT were performed in 19 patients (group II). Targeting was based on stereotactic atlas information with correction of the final coordinates according to the location of anatomical landmarks and intraoperative microelectrode recording data...
2018: Surgical Neurology International
Martin Jakobs, Erenik Krasniqi, Manja Kloß, Jan-Oliver Neumann, Benito Campos, Andreas W Unterberg, Karl L Kiening
OBJECTIVE: Implantation of deep brain stimulation (DBS) electrodes requires stereotactic imaging. Stereotactic magnetic resonance imaging (MRI) for DBS surgery has become more popular and intraoperative MRI scanners have become more available. We report on our cohort of movement disorder patients who underwent intraoperative stereotactic MRI-only DBS electrode implantation. METHODS: A review of our DBS database for eligible patients over a study period of 8 years was performed...
August 8, 2018: World Neurosurgery
Christopher S Lozano, Manish Ranjan, Alexandre Boutet, David S Xu, Walter Kucharczyk, Alfonso Fasano, Andres M Lozano
OBJECTIVE The clinical results of deep brain stimulation (DBS) of the subthalamic nucleus (STN) are highly dependent on accurate targeting and target implantation. Several targeting tactics are in current use, including image-only and/or electrophysiologically guided approaches using microelectrode recordings (MERs). The purpose of the present study was to make an appraisal of imaging only-based versus imaging with the addition of intraoperative MER-guided STN electrode targeting. METHODS The authors evaluated 100 consecutive patients undergoing STN DBS...
August 3, 2018: Journal of Neurosurgery
G Du, P Zhuang, M Hallett, Y-Q Zhang, J-Y Li, Y-J Li
Background: The cardinal features of Parkinson's disease (PD) are bradykinesia, rigidity and rest tremor. Abnormal activity in the basal ganglia is predicted to underlie the mechanism of motor symptoms. This study aims to characterize properties of oscillatory activity in the basal ganglia and motor thalamus in patients with PD. Methods: Twenty-nine patients with PD who underwent bilateral or unilateral electrode implantation for subthalamic nucleus (STN) DBS ( n  = 11), unilateral pallidotomy ( n  = 9) and unilateral thalamotomy (n = 9) were studied...
2018: Translational Neurodegeneration
Terence D Sanger, Mark Liker, Enrique Arguelles, Ruta Deshpande, Arash Maskooki, Diana Ferman, Aprille Tongol, Aaron Robison
Deep brain stimulation (DBS) for secondary (acquired, combined) dystonia does not reach the high degree of efficacy achieved in primary (genetic, isolated) dystonia. We hypothesize that this may be due to variability in the underlying injury, so that different children may require placement of electrodes in different regions of basal ganglia and thalamus. We describe a new targeting procedure in which temporary depth electrodes are placed at multiple possible targets in basal ganglia and thalamus, and probing for efficacy is performed using test stimulation and recording while children remain for one week in an inpatient Neuromodulation Monitoring Unit (NMU)...
July 17, 2018: Brain Sciences
Silje Bjerknes, Mathias Toft, Ane E Konglund, Uyen Pham, Trine Rygvold Waage, Lena Pedersen, Mona Skjelland, Ira Haraldsen, Stein Andersson, Espen Dietrichs, Inger Marie Skogseid
Background: Subthalamic nucleus deep brain stimulation improves motor symptoms and fluctuations in advanced Parkinson's disease, but the degree of clinical improvement depends on accurate anatomical electrode placement. Methods used to localize the sensory-motor part of the nucleus vary substantially. Using microelectrode recordings, at least three inserted microelectrodes are needed to obtain a three-dimensional map. Therefore, multiple simultaneously inserted microelectrodes should provide better guidance than single sequential microelectrodes...
May 2018: Movement Disorders Clinical Practice
Barbara Carl, Miriam Bopp, Marko Gjorgjevski, Christopher Nimsky
OBJECTIVE: To investigate how frameless navigational techniques can be implemented to support standard frame-based stereotactic procedures. METHODS: In 25 patients (18 deep brain stimulation procedures, 3 stereotactic biopsies, and 4 stereoencephalography procedures), 57 trajectories were planned. A navigation reference array was attached to the stereotactic frame for automatic registration applying intraoperative computed tomography. RESULTS: User-independent automatic registration resulted in a low navigation registration error (0...
October 2018: World Neurosurgery
Witold H Polanski, K Daniel Martin, Swen Günther, Gabriele Schackert, Lisa Klingelhoefer, Mareike Fauser, Alexander Storch, Stephan B Sobottka
Background: For quality analysis, we applied the Six Sigma concept to define quality indicators and their boundaries as well as to compare treatment-dependent outcome data of deep brain stimulation (DBS) of the subthalamic nucleus (STN) in patients with Parkinson's disease (PD). Methods: The Unified Parkinson Disease Rating Scale (UPDRS) III with on medication and on stimulation, the reduction of daily levodopa equivalence doses (LED), and the stimulation amplitude 1 year after surgery were registered...
June 18, 2018: International Journal for Quality in Health Care
Gabriella Panuccio, Ilaria Colombi, Michela Chiappalone
Temporal lobe epilepsy (TLE) is the most common partial complex epileptic syndrome and the least responsive to medications. Deep brain stimulation (DBS) is a promising approach when pharmacological treatment fails or neurosurgery is not recommended. Acute brain slices coupled to microelectrode arrays (MEAs) represent a valuable tool to study neuronal network interactions and their modulation by electrical stimulation. As compared to conventional extracellular recording techniques, they provide the added advantages of a greater number of observation points and a known inter-electrode distance, which allow studying the propagation path and speed of electrophysiological signals...
May 15, 2018: Journal of Visualized Experiments: JoVE
Andrew L Ko, Philippe Magown, Alp Ozpinar, Vural Hamzaoglu, Kim J Burchiel
BACKGROUND: Asleep deep brain stimulation (aDBS) implantation replaces microelectrode recording for image-guided implantation, shortening the operative time and reducing cerebrospinal fluid egress. This may decrease pneumocephalus, thus decreasing brain shift during implantation. OBJECTIVE: To compare the incidence and volume of pneumocephalus during awake (wkDBS) and aDBS procedures. METHODS: A retrospective review of bilateral DBS cases performed at Oregon Health & Science University from 2009 to 2017 was undertaken...
2018: Stereotactic and Functional Neurosurgery
Reuben R Shamir, Yuval Duchin, Jinyoung Kim, Remi Patriat, Odeya Marmor, Hagai Bergman, Jerrold L Vitek, Guillermo Sapiro, Atira Bick, Ruth Eliahou, Renana Eitan, Zvi Israel, Noam Harel
BACKGROUND: Deep brain stimulation (DBS) of the subthalamic nucleus (STN) is a proven and effective therapy for the management of the motor symptoms of Parkinson's disease (PD). While accurate positioning of the stimulating electrode is critical for success of this therapy, precise identification of the STN based on imaging can be challenging. We developed a method to accurately visualize the STN on a standard clinical magnetic resonance imaging (MRI). The method incorporates a database of 7-Tesla (T) MRIs of PD patients together with machine-learning methods (hereafter 7 T-ML)...
May 24, 2018: Neurosurgery
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