Targeting the basal ganglia for deep brain stimulation in Parkinson's disease

J. Guridi, M. C. Rodriguez-Oroz, A. M. Lozano, E. Moro, A. Albanese, B. Nuttin, J. Gybels, E. Ramos, J. A. Obeso

Research output: Contribution to journalArticlepeer-review

Abstract

The revitalization of surgery for Parkinson's disease (PD) has fueled discussion about the best methodology to define the target. Placement of electrodes for deep brain stimulation (DBS) requires the usual stereotactic technique but the argument is mainly centered on whether or not microrecording neuronal activity is necessary. We compared the accuracy of calculating the coordinates X (medio-lateral) and Y (rostro-caudal) considered by the classic stereotactic method, i.e., definition of the AC-PC intercomissural line by MRI and a digitized version of the Schaltenbrand's atlas, with final electrode placement according with microrecording and microstimulation in 21 patients. For both the globus pallidum internum (GPi) (n = 21) and the subthalamic nucleus (STN) (n = 36) there was, respectively, a 43% and 45% mismatching of more than 3 mm between the theoretic coordinates and the final site of electrode location. This applies to both the X and Y planes. Accuracy was not improved in patients (n = 11) in whom the bilateral procedure was undertaken in a single day. We conclude that proper electrode positioning of the STN and GPi requires fine electrophysiologic assessment.

Original languageEnglish
JournalNeurology
Volume55
Issue number12 SUPPL. 6
Publication statusPublished - Dec 26 2000

Keywords

  • Basal ganglia surgery
  • Microrecording
  • Stereotactic techniques
  • Stimulation
  • Targeting

ASJC Scopus subject areas

  • Neuroscience(all)

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