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Microelectrode Recording-Based Targeting for Parkinson’s Disease Surgery

  • Charles B. MikellIII
  • Joseph S. Neimat
Chapter

Abstract

Deep brain stimulation surgery is a highly effective treatment for motor symptoms of Parkinson’s disease, but its efficacy and safety depend on precise positioning of the stimulator in subcortical structures. Microelectrode recording (MER) allows for localization of subthalamic nucleus (STN), globus pallidus interna (GPi), and surrounding structures to within fractions of a millimeter. Moreover, MER can be used to identify parts of these nuclei that represent parts of the body that are affected by PD. There are some drawbacks, including the need for multiple passes through the brain, as well as the need for specialized training and personnel, but MER remains the most common method for localization of DBS electrodes. In this chapter, we review the basics of the mapping of STN and GPi and describe some common pitfalls in recording. We also describe how to alter trajectories if recordings are suboptimal. We end by describing some future directions, including imaging-based targeting and automated detection of subcortical structures.

Keywords

Subthalamic nucleus Globus pallidus interna Microelectrode recording Multiunit activity Somatotopy Firing rate Kinesthetic 

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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Department of NeurosurgeryStony Brook University HospitalStony BrookUSA
  2. 2.Department of Neurological SurgeryUniversity of LouisvilleLouisvilleUSA

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