Although microelectrode recordings (MER) are commonly used to confirm stereotactic targets during surgery for movement disorders, there is no consensus on whether the additional risks and cost of MER are worth the benefits. This may be due, in part, to the inconsistency and inefficiency of subjective interpretation of MER data that is currently used in practice. We describe several fully automatic visualization methods for MER that efficiently and clearly indicate segments of the microelectrode trajectories with homogeneous neural activity that correspond to expected deep brain nuclei. Specifically we demonstrate that these visualization methods can help identify the subthalamic nucleus in Parkinson's disease patients. These methods have the potential to significantly improve patient outcome by helping neurosurgeons objectively identify target structures more quickly and accurately.
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http://dx.doi.org/10.1159/000093721 | DOI Listing |
Oper Neurosurg (Hagerstown)
November 2024
Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota, USA.
Background And Objectives: A typical workflow for deep brain stimulation (DBS) surgery consists of head frame placement, followed by stereotactic computed tomography (CT) or MRI before surgical implantation of the hardware. At some institutions, this workflow is prolonged when the imaging scanner is located far away from the operating room, thereby increasing workflow times by the addition of transport times. Recently, the intraoperative O-arm has been shown to provide accurate image fusion with preoperative CT or MR imaging, suggesting the possibility of obtaining an intraoperative localization scan and postoperative confirmation.
View Article and Find Full Text PDFBrain Commun
January 2025
Department of Neurological Surgery, University of Louisville, Louisville, KY 40202, USA.
The subthalamic nucleus is thought to play a crucial role in controlling impulsive actions. Networked among the basal ganglia and receiving input from several cortical areas, the subthalamic nucleus is well positioned to influence action selection when faced with competing and conflicting action outcomes. The purpose of this study was to test the dissociable roles of the dorsal and ventral aspects of the subthalamic nucleus during action conflict in patients with Parkinson's disease undergoing intraoperative neurophysiological recording and to explore a potential mechanism for this inhibitory control.
View Article and Find Full Text PDFStereotact Funct Neurosurg
January 2025
Introduction: In 2015, directional leads have been released in Europe for deep brain stimulation (DBS) and have been particularly used for subthalamic nucleus (STN) DBS for Parkinson's disease (PD). In this study we aimed to compare an omnidirectional and directional leads cohort of PD patients when it comes to clinical effectiveness and to assess the correlation with volume of tissue activated - target overlap (VTA-target).
Methods: A total of 60 consecutive patients were retrospectively included.
J Neurosurg
January 2025
1Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing.
Objective: The aim of this study was to evaluate outcomes of deep brain stimulation (DBS) for Meige syndrome, compare the efficacy of globus pallidus internus (GPi) and subthalamic nucleus (STN) as targets, and identify potential outcome predictors.
Methods: The PubMed, Embase, and Web of Science databases were systematically searched to collect individual data from patients with Meige syndrome receiving DBS. Outcomes were assessed using the Burke-Fahn-Marsden Dystonia Rating Scale motor (BFMDRS-M) and disability (BFMDRS-D) scores.
PLoS Biol
January 2025
Carney Institute for Brain Science, Department of Cognitive & Psychological Sciences, Brown University, Providence, Rhode Island, United States of America.
The basal ganglia (BG) play a key role in decision-making, preventing impulsive actions in some contexts while facilitating fast adaptations in others. The specific contributions of different BG structures to this nuanced behavior remain unclear, particularly under varying situations of noisy and conflicting information that necessitate ongoing adjustments in the balance between speed and accuracy. Theoretical accounts suggest that dynamic regulation of the amount of evidence required to commit to a decision (a dynamic "decision boundary") may be necessary to meet these competing demands.
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