microrecordings
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OBJECTIVE: The aim of the paper was to describe the relationship of the anatomical and electrophysiological target for the subthalamic electrode implantation in Parkinson's disease patients defined as the best electrophysiological recordings from multiple paralel electrodes tracts with a target discrepancy explanation. BACKGROUND: Although microrecording is the standard in subthalamic stimulation, microelectrode monitoring prolongs surgical time and may increase the risk of haemorrhagic complications. The main purpose for the electrophysiological mapping is to overcome the discrepancy between the anatomical and electrophysiological targets. METHODS: Subthalamic electrodes were stereotactically implanted in 58 patients using microrecording by means of parallel electrodes at defined distances. The relationship of the final electrode to the anatomical trajectory, the subthalamic nucleus electrical activity length, and the relationship of right and left electrodes were analysed. RESULTS: The 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. The electrode position was symmetrical in 38.3 % of patients. The analysis of left and right electrode positions did not prove brain shift as the sole factor responsible for anatomy-functional discrepancy. Further, neither age, Parkinson's disease duration, or L-DOPA adverse effects were confirmed as responsible factors. CONCLUSIONS: The difference between the anatomical trajectory and the final electrode placement underlined the need for functional microelectrode monitoring. Brain shift is not the only causative factor for the difference (Tab. 7, Ref. 27).
- MeSH
- design vybavení MeSH
- dospělí MeSH
- hluboká mozková stimulace přístrojové vybavení MeSH
- lidé středního věku MeSH
- lidé MeSH
- monitorování fyziologických funkcí MeSH
- Parkinsonova nemoc terapie MeSH
- senioři MeSH
- thalamus MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
Both animal studies and studies using deep brain stimulation in humans have demonstrated the involvement of the subthalamic nucleus (STN) in motivational and emotional processes; however, participation of this nucleus in processing human emotion has not been investigated directly at the single-neuron level. We analyzed the relationship between the neuronal firing from intraoperative microrecordings from the STN during affective picture presentation in patients with Parkinson's disease (PD) and the affective ratings of emotional valence and arousal performed subsequently. We observed that 17% of neurons responded to emotional valence and arousal of visual stimuli according to individual ratings. The activity of some neurons was related to emotional valence, whereas different neurons responded to arousal. In addition, 14% of neurons responded to visual stimuli. Our results suggest the existence of neurons involved in processing or transmission of visual and emotional information in the human STN, and provide evidence of separate processing of the affective dimensions of valence and arousal at the level of single neurons as well.
- MeSH
- arousal * MeSH
- emoce * MeSH
- lidé MeSH
- neurony fyziologie MeSH
- nucleus subthalamicus fyziologie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
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.
- MeSH
- hluboká mozková stimulace metody MeSH
- implantované elektrody MeSH
- levodopa fyziologie MeSH
- lidé středního věku MeSH
- lidé MeSH
- mozek fyziologie MeSH
- nucleus subthalamicus patologie patofyziologie MeSH
- Parkinsonova nemoc patologie patofyziologie terapie MeSH
- pohyb fyziologie MeSH
- věkové faktory MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
Deep brain stimulation of the globus pallidus internus is an effective symptomatic treatment for pharmacoresistant dystonic syndromes, where pathophysiological mechanisms of action are not yet fully understood. The aim of this review article is to provide an overview of state-of-the-art approaches for processing microelectrode recordings in dystonia; in order to define biomarkers to identify patients who will benefit from clinical deep brain stimulation. For this purpose, the essential elements of microelectrode processing are examined. Next, we investigate a real example of spike sorting processing in this field. Herein, we describe baseline elements of microrecording processing including data collection, preprocessing phase, features computation, spike detection and sorting and finally, advanced spike train data analysis. This study will help readers acquire the necessary information about these elements and their associated techniques. Thus, this study is supposed to assist during identification and proposal of interesting clinical hypotheses in the field of single unit neuronal recordings in dystonia
The objective of our work was to find whether the subthalamic nucleus (STN) is directly involved in cognitive activities, specifically in executive functions. Ten patients with idiopathic Parkinson's disease had P3 potentials recorded by externalized deep brain electrodes that were implanted in the STN or in its immediate vicinity. Two contacts of each electrode were positioned inside the STN according to clinical effect, perioperative microrecording, and stimulation. The P3 waves were recorded following the auditory stimulus in a standard oddball paradigm. They were compared with the P3 waves elicited from a protocol modified by a dual task with an increased demand on executive functions. The P3 potentials with a steep amplitude gradient evoked by the modified protocol were detected by the contacts in 8 of the 14 available electrodes, located either inside the STN or in its immediate vicinity. The modified protocol led to an increased latency of the P3 potential in 8 of 14 electrodes. No local field potentials of the standard P3 potentials were recorded. The P3 potentials related to the increased demand on executive functions were detected by the STN contacts known to have the best effect on Parkinsonian motor signs. This could suggest that the STN takes part in the executive function processing. (c) 2007 Movement Disorder Society.
- MeSH
- antiparkinsonika škodlivé účinky MeSH
- evokované potenciály fyziologie MeSH
- financování organizované MeSH
- hluboká mozková stimulace přístrojové vybavení MeSH
- kognitivní poruchy diagnóza patofyziologie MeSH
- levodopa škodlivé účinky MeSH
- lidé středního věku MeSH
- lidé MeSH
- mikroelektrody MeSH
- neuropsychologické testy MeSH
- nucleus subthalamicus patofyziologie MeSH
- Parkinsonova nemoc farmakoterapie patofyziologie patofyziologie MeSH
- polékové dyskineze etiologie patofyziologie MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
Úvod: Hluboká mozková stimulace využívá k přesnému cílení jader v oblasti bazálních ganglií přímé zobrazení magnetickou rezonancí, intraoperační microrecording nebo dané anatomické koordináty. K zavedení elektrod lze využít rámový nebo bezrámový stereotaktický systém. Pro správnou funkci hluboké mozkové stimulace je zásadní co nejpřesnější uložení elektrody v daném jádru, a proto jsme provedli vyhodnocení souboru pacientů operovaných bezrámovým stereotaktickým systémem NexFrame?. Metodika: Koordináty plánovaného cílového bodu získáváme pomocí předoperační magnetické rezonance a finální pozici uložení modifikujeme na základě microrecordingu a klinického testování. Souřadnice pooperační pozice elektrod kontrolujeme na základě CT vyšetření počítačově fúzovaného s předoperační plánovací magnetickou rezonancí. K určení přesnosti uložení elektrody byla počítána celková chyba vč. chyb v laterální, vertikální a AP ose. Výsledky: Celkový počet 70 elektrod byl implantován pomocí systému NexFrame? v období červen 2013 až leden 2016 u 35 pacientů s diagnózou Parkinsonovy nemoci, dystonie nebo esenciálního třesu. Celková chyba byla 1,64 ? 0,81 mm, chyba v laterální ose byla 1,03 ? 0,79 mm, chyba v AP ose byla 1,14 ? 0,95 mm a chyba ve vertikální ose byla 1,05 ? 0,91 mm. Výsledky naší studie byly porovnány s publikovanými studiemi vč. výčtu možných chyb při implantaci při použití jak rámového, tak bezrámového systému. Výsledkem studie je závěr, že bezrámový systém NexFrame? je plně srovnatelný s rámovými systémy.
Background: Various methods are used to target nuclei of basal ganglia, including direct visualization of preoperative magnetic resonance images, intraoperative microelectrode recording and anatomical target coordinates. A frame-based stereotaxy or a frameless stereotactic system (NexFrame?) are used during electrode placement. Accurate electrode placement is necessary for correctly functioning deep brain stimulation (DBS). The objective of the study was to evaluate placement accuracy of DBS electrodes using the NexFrame? frameless navigation system in our department. Methods: Coordinates of the planned target point according to anterior and posterior commissural points are found using preoperative MRI of the brain and are usually modified intraoperatively according to microrecording and clinical examination. The coordinates of the actual position of the electrode are detected using a fusion of preoperative MRI with postoperative CT. To determine placement accuracy of the electrodes, the total error and lateral, anteroposterior, and vertical errors were calculated. Results: A total of 70 DBS electrodes were implanted using the NexFrame? system in 35 patients diagnosed with Parkinson΄s disease, essential tremor, or dystonia (mean age 62.1 ? 8.3) between June 2013 and January 2016. The mean total error was 1.64 ? 0.81 mm, the mean lateral error was 1.03 ? 0.79 mm, the mean anteroposterior error was 1.14 ? 0.95 mm, and the mean vertical error was 1.05 ? 0,91 mm. Results were compared to the results of other studies and we conclude that the frameless Nexframe? system is fully comparable to frame-based systems.
