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Single electrode and multiple electrode guided electrical stimulation of the subthalamic nucleus in advanced Parkinson's Disease

(2007) NEUROSURGERY. 61(5). p.346-355
Author
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Abstract
OBJECTIVE: It is still debated to what extent intraoperative electrophysiological techniques contribute to the outcome of subthalamic nucleus (STN) deep brain stimulation QBS). Intraoperative electrophysiological recordings for identification of the STN can be made with one electrode or with multiple, simultaneously implanted electrodes. The latter provide more detailed information about the electrophysiological boundaries of the STN; however, implantation of several electrodes at one time might increase the risk of bleeding. Here we report the results of a study of patients with advanced Parkinson's disease, in which one group of patients underwent bilateral STN DBS with electrophysiological recordings from a single electrode, and the other group received STN DBS with multiple (five or fewer) simultaneously implanted electrodes. PATIENTS AND METHODS: Fifty-five patients suffering from advanced Parkinson's disease who underwent bilateral STN stimulation were included in this study. Thirty-two patients underwent STN DBS guided by a single semi-microelectrode, and 23 patients underwent STN DBS guided with simultaneously implanted multiple microelectrodes. All patients were examined preoperatively and 3 and 12 months postoperatively with regard to activities of daily living, motor functions, and neuropsychological functions. RESULTS: We found that the simultaneous implantation of multiple electrodes does not increase the risk of bleeding or any other major intracranial complication. The use of multiple electrodes resulted in better motor results when compared with patients who underwent STN DBS guided with a single recording electrode. There were significantly more improvements in patients' tremor and rigidity, and as a consequence, a better total Unified Parkinson Disease Rating Scale, Part III score was identified during the medication-off phase. Despite better motor effects, patients treated with multiple electrodes showed subtle deterioration in neuropsychological functions, particularly in memory function. CONCLUSION: STN DBS performed with multiple electrophysiological recording electrodes resulted in better motor outcome but induced specific mild declines in neuropsychological functions.

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MLA
Temel, Yasin et al. “Single Electrode and Multiple Electrode Guided Electrical Stimulation of the Subthalamic Nucleus in Advanced Parkinson’s Disease.” NEUROSURGERY 61.5 (2007): 346–355. Print.
APA
Temel, Y., Wilbrink, P., Duits, A., Boon, P., Tromp, S., Ackermans, L., Van Kranen-Mastenbroek, V., et al. (2007). Single electrode and multiple electrode guided electrical stimulation of the subthalamic nucleus in advanced Parkinson’s Disease. NEUROSURGERY, 61(5), 346–355.
Chicago author-date
Temel, Yasin, Poldi Wilbrink, Annelien Duits, Paul Boon, Selma Tromp, Linda Ackermans, Vivianne Van Kranen-Mastenbroek, Wim Weber, and Veerle Visser-Vandewalle. 2007. “Single Electrode and Multiple Electrode Guided Electrical Stimulation of the Subthalamic Nucleus in Advanced Parkinson’s Disease.” Neurosurgery 61 (5): 346–355.
Chicago author-date (all authors)
Temel, Yasin, Poldi Wilbrink, Annelien Duits, Paul Boon, Selma Tromp, Linda Ackermans, Vivianne Van Kranen-Mastenbroek, Wim Weber, and Veerle Visser-Vandewalle. 2007. “Single Electrode and Multiple Electrode Guided Electrical Stimulation of the Subthalamic Nucleus in Advanced Parkinson’s Disease.” Neurosurgery 61 (5): 346–355.
Vancouver
1.
Temel Y, Wilbrink P, Duits A, Boon P, Tromp S, Ackermans L, et al. Single electrode and multiple electrode guided electrical stimulation of the subthalamic nucleus in advanced Parkinson’s Disease. NEUROSURGERY. 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA: LIPPINCOTT WILLIAMS & WILKINS; 2007;61(5):346–55.
IEEE
[1]
Y. Temel et al., “Single electrode and multiple electrode guided electrical stimulation of the subthalamic nucleus in advanced Parkinson’s Disease,” NEUROSURGERY, vol. 61, no. 5, pp. 346–355, 2007.
@article{667982,
  abstract     = {{OBJECTIVE: It is still debated to what extent intraoperative electrophysiological techniques contribute to the outcome of subthalamic nucleus (STN) deep brain stimulation QBS). Intraoperative electrophysiological recordings for identification of the STN can be made with one electrode or with multiple, simultaneously implanted electrodes. The latter provide more detailed information about the electrophysiological boundaries of the STN; however, implantation of several electrodes at one time might increase the risk of bleeding. Here we report the results of a study of patients with advanced Parkinson's disease, in which one group of patients underwent bilateral STN DBS with electrophysiological recordings from a single electrode, and the other group received STN DBS with multiple (five or fewer) simultaneously implanted electrodes.
PATIENTS AND METHODS: Fifty-five patients suffering from advanced Parkinson's disease who underwent bilateral STN stimulation were included in this study. Thirty-two patients underwent STN DBS guided by a single semi-microelectrode, and 23 patients underwent STN DBS guided with simultaneously implanted multiple microelectrodes. All patients were examined preoperatively and 3 and 12 months postoperatively with regard to activities of daily living, motor functions, and neuropsychological functions.

RESULTS: We found that the simultaneous implantation of multiple electrodes does not increase the risk of bleeding or any other major intracranial complication. The use of multiple electrodes resulted in better motor results when compared with patients who underwent STN DBS guided with a single recording electrode. There were significantly more improvements in patients' tremor and rigidity, and as a consequence, a better total Unified Parkinson Disease Rating Scale, Part III score was identified during the medication-off phase. Despite better motor effects, patients treated with multiple electrodes showed subtle deterioration in neuropsychological functions, particularly in memory function.

CONCLUSION: STN DBS performed with multiple electrophysiological recording electrodes resulted in better motor outcome but induced specific mild declines in neuropsychological functions.}},
  author       = {{Temel, Yasin and Wilbrink, Poldi and Duits, Annelien and Boon, Paul and Tromp, Selma and Ackermans, Linda and Van Kranen-Mastenbroek, Vivianne and Weber, Wim and Visser-Vandewalle, Veerle}},
  issn         = {{0148-396X}},
  journal      = {{NEUROSURGERY}},
  language     = {{eng}},
  number       = {{5}},
  pages        = {{346--355}},
  publisher    = {{LIPPINCOTT WILLIAMS & WILKINS}},
  title        = {{Single electrode and multiple electrode guided electrical stimulation of the subthalamic nucleus in advanced Parkinson's Disease}},
  url          = {{http://dx.doi.org/10.1227/01.neu.0000303993.82149.98}},
  volume       = {{61}},
  year         = {{2007}},
}

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