Movement Disorders and Neurostimulation, Biomedical Statistics and Multimodal Signal Processing Unit, Department of Neurology, Johannes Gutenberg University, Mainz, Germany.
Department of Neurosurgery, Johannes-Gutenberg-University, Mainz, Germany.
Sci Rep. 2020 Nov 6;10(1):19241. doi: 10.1038/s41598-020-74196-5.
Alongside stereotactic magnetic resonance imaging, microelectrode recording (MER) is frequently used during the deep brain stimulation (DBS) surgery for optimal target localization. The aim of this study is to optimize subthalamic nucleus (STN) mapping using MER analytical patterns. 16 patients underwent bilateral STN-DBS. MER was performed simultaneously for 5 microelectrodes in a setting of Ben's-gun pattern in awake patients. Using spikes and background activity several different parameters and their spectral estimates in various frequency bands including low frequency (2-7 Hz), Alpha (8-12 Hz), Beta (sub-divided as Low_Beta (13-20 Hz) and High_Beta (21-30 Hz)) and Gamma (31 to 49 Hz) were computed. The optimal STN lead placement with the most optimal clinical effect/side-effect ratio accorded to the maximum spike rate in 85% of the implantation. Mean amplitude of background activity in the low beta frequency range was corresponding to right depth in 85% and right location in 94% of the implantation respectively. MER can be used for STN mapping and intraoperative decisions for the implantation of DBS electrode leads with a high accuracy. Spiking and background activity in the beta range are the most promising independent parameters for the delimitation of the proper anatomical site.
在立体定向磁共振成像的基础上，微电极记录（MER）在深部脑刺激（DBS）手术中经常用于优化目标定位。本研究旨在通过 MER 分析模式优化丘脑底核（STN）的映射。16 名患者接受了双侧 STN-DBS。在清醒患者的 Ben's-gun 模式下，同时对 5 个微电极进行 MER 操作。使用峰和背景活动，在各种频带（包括低频（2-7 Hz）、Alpha（8-12 Hz）、Beta（分为低 Beta（13-20 Hz）和高 Beta（21-30 Hz））和 Gamma（31 至 49 Hz））中计算了几个不同的参数及其谱估计值。根据 85%的植入物中最大尖峰率，最佳 STN 导联位置具有最佳的临床效果/副作用比。低β频带背景活动的平均幅度在 85%的植入物中对应于右侧深度，在 94%的植入物中对应于右侧位置。MER 可用于 STN 映射和 DBS 电极植入的术中决策，具有很高的准确性。β频带中的尖峰和背景活动是划定适当解剖部位的最有前途的独立参数。
