The role of intraoperative monitoring in target selection in deep brain stimulation: A single centre study
Introduction: Intraoperative microelectrode recording (MER) and intraoperative test stimulation may provide vital information for optimal electrode placement and clinical outcome in movement disorders patients treated with deep brain stimulation (DBS). The aims of this retrospective study were to de...
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Elsevier
2025-01-01
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| Series: | Clinical Parkinsonism & Related Disorders |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2590112525000039 |
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| author | Sandro Ibrulj Dejan Georgiev Žiga Samsa Polona Mušič Mitja Benedičič Maja Trošt |
| author_facet | Sandro Ibrulj Dejan Georgiev Žiga Samsa Polona Mušič Mitja Benedičič Maja Trošt |
| author_sort | Sandro Ibrulj |
| collection | DOAJ |
| description | Introduction: Intraoperative microelectrode recording (MER) and intraoperative test stimulation may provide vital information for optimal electrode placement and clinical outcome in movement disorders patients treated with deep brain stimulation (DBS). The aims of this retrospective study were to determine (i) how often the planned (imaging based) placements of electrodes were changed due to MER and intraoperative test stimulation in Parkinson’s disease (PD), dystonia and essential tremor (ET) patients; (ii) whether the frequency of repositioning changed over time; (iii) whether patients’ age or disease duration (in PD) influenced the frequency of repositioning. Methods: Data on the planned and the final placement of 141 electrodes in 72 consecutive DBS treated patients (52 PD, 11 dystonia, 9 ET) was collected over the first 8 years of DBS implementation in a single center. An association between the rate of electrode repositioning and the patients’ age, disease duration and the time/year of implementation was explored. Results: Analysis of all targets showed a change in final electrode placement in 39.7 % (56/141); 39.8 % (41/103) in PD, 40.9 % (9/22) in dystonia and 37.5 % (6/16) in ET. Annual analysis showed a decrease in rate of repositioning between the centre’s first and eighth year (p = 0.013) of implementation. No correlation was found between electrode repositioning rate and patient age (p = 0.42) nor disease duration (p = 0.09) in PD. Conclusion: This retrospective analysis confirms the benefit of MER and intraoperative test stimulation during DBS surgery in determining the final electrode position during the early / initial period of implementing the procedure. Our findings show a learning curve in successful preoperative planning in our centre achieved through experience. |
| format | Article |
| id | doaj-art-d590c0fa4e45431599ae56d5536c3d14 |
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| issn | 2590-1125 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Elsevier |
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| series | Clinical Parkinsonism & Related Disorders |
| spelling | doaj-art-d590c0fa4e45431599ae56d5536c3d142025-08-20T02:36:34ZengElsevierClinical Parkinsonism & Related Disorders2590-11252025-01-011210029910.1016/j.prdoa.2025.100299The role of intraoperative monitoring in target selection in deep brain stimulation: A single centre studySandro Ibrulj0Dejan Georgiev1Žiga Samsa2Polona Mušič3Mitja Benedičič4Maja Trošt5Department of Neurology, University Medical Centre Ljubljana, 1000 Ljubljana, Slovenia; Corresponding author at: Department of Neurology, University Medical Centre Ljubljana, Zaloška cesta 7, 1000 Ljubljana, Slovenia.Department of Neurology, University Medical Centre Ljubljana, 1000 Ljubljana, Slovenia; Faculty of Computer Science and Informatics, University of Ljubljana, 1000 Ljubljana, SloveniaDepartment of Neurosurgery, General Hospital Celje, 3000 Celje, SloveniaDepartment of Anaesthesiology, University Medical Centre Ljubljana, 1000 Ljubljana, SloveniaDepartment of Neurosurgery, University Medical Centre Ljubljana, 1000 Ljubljana, SloveniaDepartment of Neurology, University Medical Centre Ljubljana, 1000 Ljubljana, Slovenia; Medical Faculty, University of Ljubljana, 1000 Ljubljana, SloveniaIntroduction: Intraoperative microelectrode recording (MER) and intraoperative test stimulation may provide vital information for optimal electrode placement and clinical outcome in movement disorders patients treated with deep brain stimulation (DBS). The aims of this retrospective study were to determine (i) how often the planned (imaging based) placements of electrodes were changed due to MER and intraoperative test stimulation in Parkinson’s disease (PD), dystonia and essential tremor (ET) patients; (ii) whether the frequency of repositioning changed over time; (iii) whether patients’ age or disease duration (in PD) influenced the frequency of repositioning. Methods: Data on the planned and the final placement of 141 electrodes in 72 consecutive DBS treated patients (52 PD, 11 dystonia, 9 ET) was collected over the first 8 years of DBS implementation in a single center. An association between the rate of electrode repositioning and the patients’ age, disease duration and the time/year of implementation was explored. Results: Analysis of all targets showed a change in final electrode placement in 39.7 % (56/141); 39.8 % (41/103) in PD, 40.9 % (9/22) in dystonia and 37.5 % (6/16) in ET. Annual analysis showed a decrease in rate of repositioning between the centre’s first and eighth year (p = 0.013) of implementation. No correlation was found between electrode repositioning rate and patient age (p = 0.42) nor disease duration (p = 0.09) in PD. Conclusion: This retrospective analysis confirms the benefit of MER and intraoperative test stimulation during DBS surgery in determining the final electrode position during the early / initial period of implementing the procedure. Our findings show a learning curve in successful preoperative planning in our centre achieved through experience.http://www.sciencedirect.com/science/article/pii/S2590112525000039Deep brain stimulationIntraoperative monitoringasleep DBS |
| spellingShingle | Sandro Ibrulj Dejan Georgiev Žiga Samsa Polona Mušič Mitja Benedičič Maja Trošt The role of intraoperative monitoring in target selection in deep brain stimulation: A single centre study Clinical Parkinsonism & Related Disorders Deep brain stimulation Intraoperative monitoring asleep DBS |
| title | The role of intraoperative monitoring in target selection in deep brain stimulation: A single centre study |
| title_full | The role of intraoperative monitoring in target selection in deep brain stimulation: A single centre study |
| title_fullStr | The role of intraoperative monitoring in target selection in deep brain stimulation: A single centre study |
| title_full_unstemmed | The role of intraoperative monitoring in target selection in deep brain stimulation: A single centre study |
| title_short | The role of intraoperative monitoring in target selection in deep brain stimulation: A single centre study |
| title_sort | role of intraoperative monitoring in target selection in deep brain stimulation a single centre study |
| topic | Deep brain stimulation Intraoperative monitoring asleep DBS |
| url | http://www.sciencedirect.com/science/article/pii/S2590112525000039 |
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