Summary
When microelectrode recording of single cell activity is employed for targeting the subthalamic nucleus (STN), multiple sampling of single cells is needed to determine whether the electrode has passed through the ventral boundaries of the STN. In contrast, stepwise recording of multiple cell activities by a semimicroelectrode reveals robust changes in such activities at the dorsal and ventral boundaries. We attempted to quantify changes in multiple cell activities by computing multiple-cell spike density (MSD). We analyzed MSD in 60 sides of 30 patients with Parkinson’s disease. Neural noise level was defined as the lowest cut-off level at which neural noise is separated from larger amplitude spikes. MSD was analyzed at cut-off levels ranging from 1.2 to 2.0-fold the neural noise level in the white matter in each trajectory. Both the dorsal and ventral boundaries were clearly identified by an increase and a decrease (p < 0.0001) in MSD, respectively, in all the 60 sides. The cut-off level of 1.2-fold showed the clearest change in MSD between the STN and the pars reticulata of substantia nigra. MSD analysis by semimicroelectrode recording represents the most practical means of identifying the boundaries of STN.
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References
Cuny E, Guehl D, Burbaud P, Gross C, Dousset V, Rougier A (2002) Lack of agreement between direct magnetic resonance imaging and statistical determination of a subthalamic target: the role of electrophysiological guidance. J Neurosurg 97: 591–597
Hamid NA, Mitchell RD, Mocroft P, Westby GW, Milner J, Pall H (2005) Targeting the subthalamic nucleus for deep brain stimulation: technical approach and fusion of pre-and postoperative MR images to define accuracy of lead placement. J Neurol Neurosurg Psychiatry 76: 409–414
Hutchison WD, Allan RJ, Opitz H, Levy R, Dostrovsky JO, Lang AE, Lozano AM (1998) Neurophysiological identification of the subthalamic nucleus in surgery for Parkinson’s disease. Ann Neurol 44: 622–628
Katayama Y, Kasai M, Oshima H, Fukaya C, Yamamoto T, Ogawa K, Mizutani T (2001) Subthalamic nucleus stimulation for Parkinson disease: benefits observed in levodopa-intolerant patients. J Neurosurg 95: 213–221
Krack P, Batir A, Van Blercom N, Chabardes S, Fraix V, Ardouin C, Koudsie A, Limousin PD, Benazzouz A, LeBas JF, Benabid AL, Pollak P (2003) Five-year follow-up of bilateral stimulation of the subthalamic nucleus in advanced Parkinson’s disease. N Engl J Med 349: 1925–1934
Lanotte MM, Rizzone M, Bergamasco B, Faccani G, Melcarne A, Lopiano L (2002) Deep brain stimulation of the subthalamic nucleus: anatomical, neurophysiological, and outcome correlations with the effects of stimulation. J Neurol Neurosurg Psychiatry 72: 53–58
Limousin P, Krack P, Pollak P, Benazzouz A, Ardouin C, Hoffmann D, Benabid AL (1998) Electrical stimulation of the subthalamic nucleus in advanced Parkinson’s disease. N Engl J Med 339: 1105–1111
Priori A, Egidi M, Pesenti A, Rohr M, Rampini P, Locatelli M, Tamma F, Caputo E, Chiesa V, Barbieri S (2003) Do intraoperative microrecordings improve subthalamic nucleus targeting in stereotactic neurosurgery for Parkinson’s disease? J Neurosurg Sci 47: 56–60
Starr PA, Christine CW, Theodosopoulos PV, Lindsey N, Byrd D, Mosley A, Marks WJ Jr (2002) Implantation of deep brain stimulators into the subthalamic nucleus: technical approach and magnetic resonance imaging-verified lead locations. J Neurosurg 97: 370–387
Starr PA, Vitek JL, DeLong M, Bakay RA (1999) Magnetic resonance image-based stereotactic localization on the globus pallidus and subthalamic nucleus. Neurosurgery 44: 303–313
Yamamoto T, Katayama Y, Fukaya C, Oshima H, Kasai M, Kobayashi K (2001) New method of deep brain stimulation therapy with two electrodes implanted in parallel and side by side. J Neurosurg 95: 1075–1078
Yamamoto T, Katayama Y, Kano T, Kobayashi K, Oshima H, Fukaya C (2004) Deep brain stimulation for the treatment of Parkinsonian, essential, and post-stroke tremor: a suitable stimulation method and changes in effective stimulation intensity. J Neurosurg 101: 201–209
Yamamoto T, Katayama Y, Kobayashi K, Oshima H, Fukaya C (2003) Dual-floor burr hole adjusted to burr-hole ring and cap for implantation of stimulation electrodes. J Neurosurg 99: 783–784
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© 2006 Springer-Verlag
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Kano, T. et al. (2006). Detection of boundaries of subthalamic nucleus by multiple-cell spike density analysis in deep brain stimulation for Parkinson’s disease. In: Chang, J.W., Katayama, Y., Yamamoto, T. (eds) Advances in Functional and Reparative Neurosurgery. Acta Neurochirurgica Supplementum, vol 99. Springer, Vienna. https://doi.org/10.1007/978-3-211-35205-2_6
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DOI: https://doi.org/10.1007/978-3-211-35205-2_6
Publisher Name: Springer, Vienna
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