Objective: To find whether microelectrode recording (MER) is mandatory for deep brain stimulation (DBS) in Parkinson’s disease.

Background: DBS is traditionally done using MER guidance. This can increase the precision, but at the cost of multiple electrodes traversing the brain, which in turn increases the chances of hemorrhage, operative duration, and cost.

Method: Subthalamic nucleus (STN) DBS done without MER were analyzed with the retrospective data of DBS done with MER. Primary outcome assessed was preoperative and postoperative UPDRS scores. Secondary outcomes were the subjective improvement for tremor, rigidity, bradykinesia, dyskinesia, postural instability, and gait. Complications and need for revision surgery were also noted.

Results: Thirty-nine patients underwent MER and 29 without MER. There were significant improvement in UPDRS (I-IV) scores from 60.75±15.66 to 33.04±10.45 (P=0.001) in ON-stage, and 26.68±10.65 to 20.76±1.45 (P<0.001) in OFF-stage with no intergroup difference. Percentage reduction after surgery in either groups for tremors was 82.67 and 82.65 (P=0.99), rigidity 78.24 and 74.76 (P=0.57), bradykinesia 73.53 and 64.52 (P=0.08), dyskinesia 91.47 and 89.29 (P=0.67), postural instability 64 and 68.33 (P=0.4) and improvement in gait was 64.29 and 63.53 (P=0.89). Drugs could be reduced in all patients. There was one infection in MER group (requiring replacement) and no hemorrhage/death.

Conclusion: After attaining adequate experience with stereotaxy and DBS, one can forego MER in STN-DBS. It can save valuable operative time, cost and reduces the risk of hemorrhage. The poster has been presented at the Biennial meeting of American society of stereotactic and functional neurosurgery in June 2018 at Denver, USA.

« Back to 2019 International Congress

MDS Abstracts - https://www.mdsabstracts.org/abstract/is-microelectrode-recording-mandatory-for-deep-brain-stimulation-in-parkinsons-disease/