Can We Put Aside Microelectrode Recordings in Deep Brain Stimulation Surgery?
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作者:
Pastor, Jesus
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Hosp Univ La Princesa, Clin Neurophysiol, C Diego de Leon 62, Madrid 28006, SpainHosp Univ La Princesa, Clin Neurophysiol, C Diego de Leon 62, Madrid 28006, Spain
Pastor, Jesus
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Vega-Zelaya, Lorena
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机构:Hosp Univ La Princesa, Clin Neurophysiol, C Diego de Leon 62, Madrid 28006, Spain
Vega-Zelaya, Lorena
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[1] Hosp Univ La Princesa, Clin Neurophysiol, C Diego de Leon 62, Madrid 28006, Spain
Microelectrode recording (MER) in deep brain stimulation (DBS) surgery has long been a recognized and efficient method for defining a target. However, in recent decades, imaging techniques, including DBS surgery, have experienced significant growth. There is convincing evidence that imaging-guided surgery can be helpful for targeting anatomically well-defined nuclei (e.g., subthalamic nucleus (STN) or internal globus pallidus (GPi)), and reductions in secondary effects have also been claimed. It has even been proposed that MER is not necessary to perform DBS, identifying in this way asleep surgery and imaging-guided DBS. However, there are several reasons why this is not the case. Neurophysiological techniques can efficiently and safely help to identify neural structures even in sleeping patients (e.g., different types of evoked potentials or motor stimulation). Deep nuclei are not homogeneous structures (even STN), so it is important to identify different places inside the putative target. Evidently, this is more relevant in the case of thalamic or hypothalamic surgery. Moreover, it is important to remember that the clinical and scientific knowledge acquired during DBS surgery can be important to gain further insight into pathologies and develop more effective treatments. Finally, the cost/efficiency of medical technology should be considered.
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ASST Santi Paolo & Carlo Osped, Neurol Unit, Dipartimento Area Med Internist, Milan, ItalyPolitecn Milan, Dept Elect Informat & Bioengn, Milan, Italy
Mailland, E.
Rinaldo, S.
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Fdn IRCCS Ist Neurol Carlo Besta, Movement Disorder Unit, Dept Clin Neurosci, Milan, ItalyPolitecn Milan, Dept Elect Informat & Bioengn, Milan, Italy
Rinaldo, S.
Eleopra, R.
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Fdn IRCCS Ist Neurol Carlo Besta, Movement Disorder Unit, Dept Clin Neurosci, Milan, ItalyPolitecn Milan, Dept Elect Informat & Bioengn, Milan, Italy
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Seoul Natl Univ Hosp, Dept Neurosurg, Seoul, South KoreaSeoul Natl Univ Hosp, Dept Neurosurg, Seoul, South Korea
Park, Kwang Hyon
Sun, Sukkyu
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Seoul Natl Univ, Grad Sch, Interdisciplinary Program Bioengn, Seoul, South KoreaSeoul Natl Univ Hosp, Dept Neurosurg, Seoul, South Korea
Sun, Sukkyu
Lim, Yong Hoon
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Seoul Natl Univ Hosp, Dept Neurosurg, Seoul, South KoreaSeoul Natl Univ Hosp, Dept Neurosurg, Seoul, South Korea
Lim, Yong Hoon
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Park, Hye Ran
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Lee, Jae Meen
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Park, Kawngwoo
Jeon, Beomseok
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Seoul Natl Univ Hosp, Dept Neurol, Seoul, South KoreaSeoul Natl Univ Hosp, Dept Neurosurg, Seoul, South Korea
Jeon, Beomseok
Park, Hee-Pyoung
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Seoul Natl Univ, Seoul Natl Univ Hosp, Dept Anesthesiol & Pain Med, Coll Med, Seoul, South KoreaSeoul Natl Univ Hosp, Dept Neurosurg, Seoul, South Korea
Park, Hee-Pyoung
Kim, Hee Chan
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Seoul Natl Univ, Grad Sch, Interdisciplinary Program Bioengn, Seoul, South Korea
Seoul Natl Univ, Dept Biomed Engn, Coll Med, Seoul, South Korea
Seoul Natl Univ, Inst Med & Biol Engn, Med Res Ctr, Seoul, South KoreaSeoul Natl Univ Hosp, Dept Neurosurg, Seoul, South Korea
Kim, Hee Chan
Paek, Sun Ha
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Seoul Natl Univ Hosp, Dept Neurosurg, Seoul, South Korea
Seoul Natl Univ, Ischemia Hypoxia Dis Inst, Coll Med, Seoul, South Korea
Seoul Natl Univ, Canc Res Inst, Coll Med, Seoul, South KoreaSeoul Natl Univ Hosp, Dept Neurosurg, Seoul, South Korea
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Univ British Columbia, Surg Ctr Movement Disorders, Div Neurosurg, Vancouver, BC V5Z 1M9, Canada
Univ Hosp Aachen, Dept Neurosurg, Aachen, GermanyUniv British Columbia, Surg Ctr Movement Disorders, Div Neurosurg, Vancouver, BC V5Z 1M9, Canada
Coenen, V. A.
Gielen, F. L. H.
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Bakken Res Ctr, Maastricht, NetherlandsUniv British Columbia, Surg Ctr Movement Disorders, Div Neurosurg, Vancouver, BC V5Z 1M9, Canada
Gielen, F. L. H.
Castro-Prado, F.
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Univ British Columbia, Surg Ctr Movement Disorders, Div Neurosurg, Vancouver, BC V5Z 1M9, CanadaUniv British Columbia, Surg Ctr Movement Disorders, Div Neurosurg, Vancouver, BC V5Z 1M9, Canada
Castro-Prado, F.
Rahman, A. Abdel
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Univ British Columbia, Surg Ctr Movement Disorders, Div Neurosurg, Vancouver, BC V5Z 1M9, CanadaUniv British Columbia, Surg Ctr Movement Disorders, Div Neurosurg, Vancouver, BC V5Z 1M9, Canada
Rahman, A. Abdel
Honey, C. R.
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Univ British Columbia, Surg Ctr Movement Disorders, Div Neurosurg, Vancouver, BC V5Z 1M9, CanadaUniv British Columbia, Surg Ctr Movement Disorders, Div Neurosurg, Vancouver, BC V5Z 1M9, Canada