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@article{1159270,
author = {Chrastina, Jan and Novák, Zdeněk and Baláž, Marek and Říha, Ivo and Bočková, Martina and Rektor, Ivan},
article_location = {LONDON},
article_number = {5},
doi = {http://dx.doi.org/10.3109/02688697.2013.771726},
keywords = {brain shift; microelectrode recording; subthalamic stimulation; stereotaxy},
language = {eng},
issn = {0268-8697},
journal = {BRITISH JOURNAL OF NEUROSURGERY},
title = {The role of brain shift, patient age, and Parkinson's disease duration in the difference between anatomical and electrophysiological targets for subthalamic stimulation},
url = {http://informahealthcare.com/doi/abs/10.3109/02688697.2013.771726},
volume = {27},
year = {2013}
}
TY - JOUR
ID - 1159270
AU - Chrastina, Jan - Novák, Zdeněk - Baláž, Marek - Říha, Ivo - Bočková, Martina - Rektor, Ivan
PY - 2013
TI - The role of brain shift, patient age, and Parkinson's disease duration in the difference between anatomical and electrophysiological targets for subthalamic stimulation
JF - BRITISH JOURNAL OF NEUROSURGERY
VL - 27
IS - 5
SP - 676-682
EP - 676-682
PB - INFORMA HEALTHCARE
SN - 02688697
KW - brain shift
KW - microelectrode recording
KW - subthalamic stimulation
KW - stereotaxy
UR - http://informahealthcare.com/doi/abs/10.3109/02688697.2013.771726
L2 - http://informahealthcare.com/doi/abs/10.3109/02688697.2013.771726
N2 - Introduction. Although microrecording is common in subthalamic stimulation, microelectrode monitoring prolongs surgical time and may increase the risk of haemorrhagic complications. The main reason for electrophysiological mapping is the discrepancy between the calculated anatomical and final electrophysiological targets. The aim of this paper is to describe the relationship between anatomical and electrophysiological targets defined as the best electrophysiological recordings from multiple parallel electrode tracts, explaining the target discrepancy with attention paid to the role of brain shift and patient-and disease-related factors. Materials and methods. Subthalamic electrodes were stereotactically implanted in 58 patients using microrecording by means of parallel electrodes at defined distances. The relationship between the final electrode placement to its anatomical trajectory and the relationship between the definitive electrodes implanted on the right and left sides were analysed, as was the influence of patient age, Parkinson's disease duration, and late motor complications duration. Results. Final electrode placement matched the anatomical trajectory in 53.4% of patients on the right side and 43.1% of patients on the left side. Electrode positions were symmetrical in 38.3% of patients. The analysis of left and right electrode positions does not prove a statistically significant prevalence of lateral and posterior final electrode trajectories as could be expected from lateral and posterior movements of the brain caused by brain shift, although there was some tendency for a larger percentage of lateral electrodes on the left side. Age, Parkinson's disease duration, and L-DOPA effect duration were not confirmed as responsible factors. Conclusions. The difference between anatomical trajectory and final electrode placement supports the use of functional microelectrode monitoring in subthalamic deep brain stimulation. Brain shift is not the only causative factor of the difference. The possible roles of age, Parkinson's disease duration, and late motor complications duration were also not confirmed by study results.
ER -
CHRASTINA, Jan, Zdeněk NOVÁK, Marek BALÁŽ, Ivo ŘÍHA, Martina BOČKOVÁ and Ivan REKTOR. The role of brain shift, patient age, and Parkinson's disease duration in the difference between anatomical and electrophysiological targets for subthalamic stimulation. \textit{BRITISH JOURNAL OF NEUROSURGERY}. LONDON: INFORMA HEALTHCARE, 2013, vol.~27, No~5, p.~676-682. ISSN~0268-8697. Available from: https://dx.doi.org/10.3109/02688697.2013.771726.
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