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The Impact of Multichannel Microelectrode Recording (MER) in Deep Brain Stimulation of the Basal Ganglia

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Stereotactic and Functional Neurosurgery

Part of the book series: Acta Neurochirurgica Supplement ((NEUROCHIRURGICA,volume 117))

Abstract

Deep brain stimulation (DBS) of the basal ganglia (Ncl. subthalamicus, Ncl. ventralis intermedius thalami, globus pallidus internus) has become an evidence-based and well-established treatment option in otherwise refractory movement disorders. The Ncl. subthalamicus (STN) is the target of choice in Parkinson’s disease.

However, a considerable discussion is currently ongoing with regard to the necessity for micro-electrode recording (MER) in DBS surgery.

The present review provides an overview on deep brain stimulation and (MER) of the STN in patients with Parkinson’s disease. Detailed description is given concerning the multichannel MER systems nowadays available for DBS of the basal ganglia, especially of the STN, as a useful tool for target refinement. Furthermore, an overview is given of the historical aspects, spatial mapping of the STN by MER, and its impact for accuracy and precision in current functional stereotactic neurosurgery.

The pros concerning target refinement by MER means on the one hand, and cons including increased bleeding risk, increased operation time, local or general anesthesia, and single versus multichannel microelectrode recording are discussed in detail. Finally, the authors favor the use of MER with intraoperative testing combined with imaging to achieve a more precise electrode placement, aiming to ameliorate clinical outcome in therapy-resistant movement disorders.

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Conflict of Interest

Thomas M. Kinfe has received DBS training grant from Medtronic Inc. and training support from St. Jude Medical, Inc. Jan Vesper has been supported for travel and conference presentations from Medtronic Inc. and from St. Jude Medical, Inc.

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Authors and Affiliations

  1. Center of Neuromodulation, Department of Neurosurgery, Heinrich-Heine University Hospital, Moorenstrasse 5, Düsseldorf, 40225, Germany

    Thomas M. Kinfe MD & Jan Vesper MD, PhD

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  1. Thomas M. Kinfe MD
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  2. Jan Vesper MD, PhD
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Correspondence to Thomas M. Kinfe MD .

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Editors and Affiliations

  1. , Neurosurgical Clinic, University Hospital Erlangen, Schwabachanlage 6, Erlangen, 91054, Germany

    Guido Nikkhah

  2. Department of Neurosurgery, Division of Stereotactic and Functional, University Medical Center Freiburg, Breisacher Straße 64, Freiburg, 79106, Germany

    Marcus Pinsker

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Kinfe, T.M., Vesper, J. (2013). The Impact of Multichannel Microelectrode Recording (MER) in Deep Brain Stimulation of the Basal Ganglia. In: Nikkhah, G., Pinsker, M. (eds) Stereotactic and Functional Neurosurgery. Acta Neurochirurgica Supplement, vol 117. Springer, Vienna. https://doi.org/10.1007/978-3-7091-1482-7_5

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