Spatial distance between anatomically- and physiologically-identified targets in subthalamic nucleus deep brain stimulation in Parkinson’s disease
Parvaresh-Rizi، Mansour نويسنده Department of Neurosurgery, School of Medicine AND Rasoul-E-Akram Hospital, Iran University of Medical Sciences, Tehran, Iran Parvaresh-Rizi, Mansour , Tabibkhoei، Alireza نويسنده Department of Neurosurgery, School of Medicine AND Rasoul-E-Akram Hospital, Iran University of Medical Sciences, Tehran, Iran Tabibkhoei, Alireza , Shahidi، Gholamali نويسنده Assistant Professor of Neurology, Division of Movement Disorder, Department of Neurology, Rasool-e Akram Hospital Shahidi, Gholamali , Vaidyanathan، Janardan نويسنده Medtronic, Mumbai, India Vaidyanathan, Janardan , Tabibkhoei، Amirreza نويسنده Department of Neurosurgery, School of Medicine AND Rasoul-E-Akram Hospital, Iran University of Medical Sciences, Tehran, Iran Tabibkhoei, Amirreza , Rohani، Mohammad نويسنده Department of Neurology, Iran University of Medical Sciences, Tehran, Iran ,
Background: Subthalamic nucleus (STN) stimulation is the reatment of choice for carefully chosen patients with idiopathic Parkinsonʹs disease (PD) and refractory motor fluctuations. We evaluated the value of intraoperative electrophysiology during STN deep brain stimulation (DBS) procedures in refining the anatomically-defined target.
Methods: We determined the spatial distance between the anatomical and physiological targets along x, y and z axes in 50 patients with PD who underwent bilateral subthalamic nucleus DBS surgery.
Results: The mean spatial distance between anatomical and functional targets was 1.84 ± 0.88 mm and the least distances in different methods were 0.66 mm [standard error (SE): 0.07], 1.07 mm (SE: 0.08) and 1.01 mm (SE: 0.08) on x, y and z axes, respectively, for the combined method.
Conclusion: The most physiologically-accurate anatomical targeting was achieved via a combination of multiple independent methods. There was a statistically significant difference between the anatomical and functional targets in all methods (even the combined) on the y coordinate, emphasizing the need for intra- operative electrophysiological monitoring to refine the anatomico-radiologically-defined target.