Bilateral deep brain stimulation: the placement of the second electrode is not necessarily less accurate than that of the first one.

Sadeghi, Yalda; Pralong, Etienne; Knebel, Jean-François; Vingerhoets, François; Pollo, Claudio; Levivier, Marc; Bloch, Jocelyne (2015). Bilateral deep brain stimulation: the placement of the second electrode is not necessarily less accurate than that of the first one. Stereotactic and functional neurosurgery, 93(3), pp. 160-167. Karger 10.1159/000368439

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BACKGROUND Deep brain stimulation (DBS) is recognized as an effective treatment for movement disorders. We recently changed our technique, limiting the number of brain penetrations to three per side. OBJECTIVES The first aim was to evaluate the electrode precision on both sides of surgery since we implemented this surgical technique. The second aim was to analyse whether or not the electrode placement was improved with microrecording and macrostimulation. METHODS We retrospectively reviewed operation protocols and MRIs of 30 patients who underwent bilateral DBS. For microrecording and macrostimulation, we used three parallel channels of the 'Ben Gun' centred on the MRI-planned target. Pre- and post-operative MRIs were merged. The distance between the planned target and the centre of the implanted electrode artefact was measured. RESULTS There was no significant difference in targeting precision on both sides of surgery. There was more intra-operative adjustment of the second electrode positioning based on microrecording and macrostimulation, which allowed to significantly approach the MRI-planned target on the medial-lateral axis. CONCLUSION There was more electrode adjustment needed on the second side, possibly in relation with brain shift. We thus suggest performing a single central track with electrophysiological and clinical assessment, with multidirectional exploration on demand for suboptimal clinical responses.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Neurosurgery

UniBE Contributor:

Pollo, Claudio

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1011-6125

Publisher:

Karger

Language:

English

Submitter:

Nicole Söll

Date Deposited:

12 Apr 2016 11:09

Last Modified:

12 May 2016 08:22

Publisher DOI:

10.1159/000368439

PubMed ID:

25791181

BORIS DOI:

10.7892/boris.80158

URI:

https://boris.unibe.ch/id/eprint/80158

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