Microelectrode recording for pallidotomy: mandatory, beneficial or dangerous?
There is an active debate regarding whether pallidotomy should be performed with microelectrode recording or macroelectrode stimulation. A meta-analysis was performed on the published reports (1992-2000) of unilateral pallidotomy for Parkinson's disease to determine if the outcome or complications of this procedure significantly differed between these two techniques. Papers were excluded if they followed a cohort of less than ten patients, had follow-up less than three months, or included previously reported patients. There were no significant differences between the two techniques in improvement of dyskinesia (p = 0.66) or UPDRS motor score (p = 0.62). Microelectrode recording had a significantly higher (p = 0.012) intracerebral hemorrhage rate (1.3 +/- 0.4%) compared to macroelectrode stimulation (0.2 +/- 0.2%).
Honey
C R
CR
Surgical Centre for Movement Disorders, University of British Columbia, Vancouver, Canada. chris.honey@telus.net
Berk
C
C
Palur
R S
RS
Schulzer
M
M
D001925:Brain Damage, Chronic / Q000209:etiology; D001931:Brain Mapping / Q000295:instrumentation / Q000379:methods*; D002543:Cerebral Hemorrhage / Q000209:etiology; D004558:Electric Stimulation / Q000009:adverse effects; D004567:Electrodes, Implanted / Q000009:adverse effects; D005500:Follow-Up Studies; D005917:Globus Pallidus / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D008839:Microelectrodes / Q000009:adverse effects; D016343:Monitoring, Intraoperative / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D009043:Motor Activity; D010300:Parkinson Disease / Q000503:physiopathology / Q000601:surgery*; D018401:Sample Size; D012720:Severity of Illness Index; D013238:Stereotaxic Techniques / Q000295:instrumentation; D016896:Treatment Outcome