Validity of Single Tract Microelectrode Recording in Subthalamic Nucleus Stimulation
-
- UMEMURA Atsushi
- Department of Research and Therapeutics for Movement Disorders, Juntendo University School of Medicine Department of Neurosurgery, Juntendo University School of Medicine Department of Neurosurgery, Nagoya City University Graduate School of Medicine
-
- OKA Yuichi
- Department of Neurosurgery, Nagoya City University Graduate School of Medicine
-
- YAMADA Kazuo
- Department of Neurosurgery, Nagoya City University Graduate School of Medicine
-
- OYAMA Genko
- Department of Research and Therapeutics for Movement Disorders, Juntendo University School of Medicine Department of Neurology, Juntendo University School of Medicine
-
- SHIMO Yasushi
- Department of Research and Therapeutics for Movement Disorders, Juntendo University School of Medicine Department of Neurology, Juntendo University School of Medicine
-
- HATTORI Nobutaka
- Department of Neurology, Juntendo University School of Medicine
この論文をさがす
抄録
In surgery for subthalamic nucleus (STN) deep brain stimulation (DBS), precise implantation of the lead into the STN is essential. Physiological refinement with microelectrode recording (MER) is the gold standard for identifying STN. We studied single tract MER findings and surgical outcomes and verified our surgical method using single tract MER. The number of trajectories in MER and the final position of lead placement were retrospectively analyzed in 440 sides of STN DBS in 221 patients. Bilateral STN DBS yielded marked improvement in the motor score, dyskinesia/fluctuation score, and reduced requirement of dopaminergic medication in this series. The number of trajectories required to obtain sufficient activity of the STN was one in 79.0%, two in 18.2%, and three or more in 2.5% of 440 sides. In 92 sides requiring altered trajectory, the final direction of trajectory movement was posterior in 73.9%, anterior in 13.0%, lateral in 5.4%, and medial in 4.3%. In 18 patients, posterior moves were required due to significant brain shift with intracranial air caused by outflow of CSF during the second side procedure. Sufficient STN activity is obtained with minimum trajectories by proper targeting and precise interpretation of MER findings even in the single tract method. Anterior–posterior moves rather than medial–lateral moves should be attempted first in cases with insufficient recording of STN activity.
収録刊行物
-
- Neurologia medico-chirurgica
-
Neurologia medico-chirurgica 53 (11), 821-827, 2013
一般社団法人 日本脳神経外科学会
- Tweet
詳細情報 詳細情報について
-
- CRID
- 1390282680034365312
-
- NII論文ID
- 10031196794
-
- NII書誌ID
- AN00358613
-
- COI
- 1:STN:280:DC%2BC2c%2Fot1ejsw%3D%3D
-
- ISSN
- 13498029
- 04708105
-
- PubMed
- 24140767
-
- 本文言語コード
- en
-
- データソース種別
-
- JaLC
- Crossref
- PubMed
- CiNii Articles
-
- 抄録ライセンスフラグ
- 使用不可