Department of Clinical Neurosciences and Mental Health, Faculty of Medicine University of Porto, Porto, Portugal.
Department of Clinical Neurosciences and Mental Health, Faculty of Medicine University of Porto, Porto, Portugal; Department of Neurology, Centro Hospitalar Universitário de São João, Porto, Portugal; Department of Biomedicine, Faculty of Medicine University of Porto, Porto, Portugal; i3S - Institute for Research and Innovation in Health, Porto, Portugal.
J Clin Neurosci. 2019 Nov;69:104-108. doi: 10.1016/j.jocn.2019.08.021. Epub 2019 Aug 12.
This retrospective study aims to explore the clinical utility of microelectrode recording (MER) during subthalamic deep brain stimulation (DBS) surgery in patients with Parkinson's disease (PD). We analyzed the data from 103 PD patients, who consecutively received bilateral subthalamic nucleus (STN) DBS at an experienced academic medical center. We collected demographic, clinical, and DBS related data, including intraoperative microelectrode recording data, electrode positioning, and clinical effects provided by intraoperative microstimulation. The 2 brain sides were independently analyzed and are described as first and second side (to be operated on); the first side is contralateral to motor symptoms onset. Patients were mostly men (64.1%). In both sides of the brain, percentage of agreement with the electrode final position was higher with clinical results than with intraoperative microelectrode recordings (98% vs 57% on the first implantation side, and 97% vs 58% on the second implantation side, respectively). Regarding electrode final implantation depth, 86% of electrodes were implanted between 0 mm and +2 mm in relation to anatomical target, and 95% of electrodes were implanted from -2 mm to +2 mm. Our study suggests that MER might not be necessary to achieve good clinical outcomes in PD patients undergoing STN DBS. These results support and inform the design of future prospective controlled research studies.
本回顾性研究旨在探讨微电极记录（MER）在帕金森病（PD）患者的丘脑底核（STN）脑深部电刺激（DBS）手术中的临床应用价值。我们分析了在一家经验丰富的学术医学中心连续接受双侧 STN-DBS 的 103 例 PD 患者的数据。我们收集了人口统计学、临床和 DBS 相关数据，包括术中微电极记录数据、电极定位以及术中微刺激提供的临床效果。对双侧大脑分别进行分析，并描述为第一侧和第二侧（待手术）；第一侧与运动症状起始的对侧相对。患者大多为男性（64.1%）。在大脑两侧，电极最终位置与临床结果的一致性百分比均高于与术中微电极记录的一致性百分比（第一植入侧分别为 98%比 57%，第二植入侧分别为 97%比 58%）。关于电极最终植入深度，86%的电极植入在解剖目标的 0 mm 和+2 mm 之间，95%的电极植入在-2 mm 到+2 mm 之间。我们的研究表明，MER 可能不是 PD 患者接受 STN-DBS 手术获得良好临床效果所必需的。这些结果支持并为未来前瞻性对照研究的设计提供了信息。
