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JOURNAL OF NEUROSURGICAL SCIENCES
Rivista di Neurochirurgia
Indexed/Abstracted in: e-psyche, EMBASE, PubMed/MEDLINE, Neuroscience Citation Index, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 1,651
ORIGINAL ARTICLES PARKINSON’S DISEASE
Journal of Neurosurgical Sciences 2003 Marzo;47(1):56-60
Do intraoperative microrecordings improve subthalamic nucleus targeting in stereotactic neurosurgery for Parkinson’s disease?
Priori A. 1, Egidi M. 1, Pesenti A. 1, Rohr M. 2, Rampini P. 1, Locatelli M. 1, Tamma F. 3, Caputo E. 3, Chiesa V. 3, Barbieri S. 1
1 Department of Neurosurgical Sciences, IRCCS, Ospedale Maggiore, Milan, Italy
2 Department of Bioengineering, Polytechnic, Milan, Italy
3 Department of Neurology, San Paolo Hospital, Milan, Italy
Aim. The clinical importance of intraoperative microrecordings for subthalamic nucleus (STN) localization in neurosurgical practice remains a matter of debate in the various groups.
Methods. To investigate their usefulness in localizing the STN, we retrospectively evaluated how intraoperative microelectrode recordings changed the targeting of the STN estimated only on intraoperative stimulation and neuroanatomic targeting procedures. For neuroradiologic targeting of the nucleus we used a TC-MRI fusion algorithm and direct visualization of the STN. Besides standard microrecordings we also analyzed the power spectral density (PSD) pattern of physiological signals along the track and its neuroanatomic and clinical correlations.
Results. In our series of 12 patients with Parkinson’s disease undergoing surgery for implantation of deep-brain stimulation (DBS) electrodes in the STN we found that in 25% (1/4) of patients, microrecordings determined the choice of the optimal track. In all the tracks analyzed the PSD peak coincided with the point selected for the final electrode implantation on the basis of the standard procedure for intraoperative monitoring based on both microstimulation and recordings.
Conclusion. Intraoperative microrecordings are of determinant importance for accurate STN localization and are essential for optimal results in neurosurgical practice. PSD analysis is a simple and quick quantitative signal descriptor that will probably provide even more precise, simple and rapid tool for intraoperative neurophysiological localization of the STN.