title: Subthalamic nucleus stimulation in Parkinson's disease: correlation of active electrode contacts with intraoperative microrecordings.
abstract: OBJECTIVE
  The most effective site for subthalamic nucleus (STN) stimulation has remained unclear. The position of active contacts relative to the dorsal margin of the STN was determined.
  
  
  METHODS
  Electrodes (n = 49) were implanted following STN mapping by microrecording and microstimulation along five tracks (n = 25 patients). The stereotactic position of active contacts was determined and correlated with microrecordings using an algorithm for direct three-dimensional comparisons (n = 37).
  
  
  RESULTS
  Most active contacts were detected within +/-1.0 mm from the dorsal margin of the STN as defined by microrecording (32.4%) or farther dorsal in the subthalamic area (37.8%), and only 29.7% were localized to the STN proper. This was consistent with the average stereotactic coordinates of the active contacts in these three groups.
  
  
  CONCLUSIONS
  Our data suggest that the dorsal border area of the STN is the most effective target. Besides the dorsolateral STN (sensorimotor part) this may include projections from/to STN, the zona incerta, and pallidofugal projections in the fields of Forel.
authors.affiliation: Klinik für Neurochirurgie, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Kiel, Germany. patten@uke.uni-hamburg.de
authors.forename: W
authors.initials: W
authors.lastname: Hamel
authors.forename: U
authors.initials: U
authors.lastname: Fietzek
authors.forename: A
authors.initials: A
authors.lastname: Morsnowski
authors.forename: B
authors.initials: B
authors.lastname: Schrader
authors.forename: D
authors.initials: D
authors.lastname: Weinert
authors.forename: D
authors.initials: D
authors.lastname: Müller
authors.forename: G
authors.initials: G
authors.lastname: Deuschl
authors.forename: H M
authors.initials: HM
authors.lastname: Mehdorn
mesh_terms: D004599:Electric Stimulation Therapy; D004567:Electrodes, Implanted; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative; D010300:Parkinson Disease / Q000601:surgery* / Q000628:therapy*; D013238:Stereotaxic Techniques; D020531:Subthalamic Nucleus / Q000502:physiology* / Q000601:surgery