Turkish Neurosurgery 2016 , Vol 26 , Num 6
Final Electrode Position in Subthalamic Nucleus Deep Brain Stimulation Surgery: A Comparison of Indirect and Direct Targeting Methods
Mehmet TONGE1,2,3, Ersoy KOCABICAK1,2,5, Linda ACKERMANS1, Mark KUIJF4, Yasin TEMEL1,2
1Maastricht University Medical Center, Department of Neurosurgery, Maastricht, The Netherlands
2Maastricht University Medical Center, Department of Neuroscience, Maastricht, The Netherlands
3Istanbul Medipol University, Department of Neurosurgery, Istanbul, Turkey
4Maastricht University Medical Center, Department of Neurology, Maastricht, The Netherlands
5Ondokuz Mayis University, School of Medicine, Department of Neurosurgery, Samsun, Turkey
DOI : 10.5137/1019-5149.JTN.13739-14.1 AIM: High frequency stimulation of the subthalamic nucleus (STN) is nowadays a widely performed surgery for patients with Parkinson’s disease (PD). The field has witnessed a shift from indirect targeting to direct targeting. The question arises whether this change has influenced the final electrode position in STN deep brain stimulation surgery. To address this question, we compared the final electrode positions in atlas-based and magnetic resonance-based targeting methods in our series.

MATERIAL and METHODS: We performed a database review of the surgeries performed in three affiliated centers.

RESULTS: We have found that with the shift to direct imaging, three key changes have taken place. The first is that the number of microelectrode recording trajectories has decreased by approximately 1 microelectrode. Secondly, the central trajectory has been chosen as the final position in more patients, and the third change is that direct targeting has improved the laterality of the targeting significantly.

CONCLUSION: Direct targeting has changed routine clinical practice, thereby further refining the surgical approach. Keywords : Direct targeting, Final lead, Indirect targeting, Parkinson’s disease, Subthalamic nucleus

Corresponding author : Yasin Temel, Mehmet Tonge, y.temel@maastrichtuniversity.nl, tonge_m@yahoo.com