title: Usefulness of an intraoperative electrophysiological navigator system for subthalamic nucleus surgery in Parkinson's disease.
abstract: OBJECTIVE
  The characteristics and benefits are presented of an intraoperative neurophysiological navigator computerized system developed in our center (Columbus-Track 1.0) that helps the surgical team in neuronal identification and in strategy processes in subthalamic nucleus surgery for Parkinson's disease (PD).
  
  
  METHODS
  The navigator consists of three assembled parts: (1) neuronal identification, based on wavelet processing, filtering and gaussian characteristics of the signal; (2) track identification, based on anatomical coincidence, somatomotor response and microstimulation quotient, and (3) strategy, coordinating correction for the next track. A retrospective comparative study was performed with 15 consecutive PD patients (30 targets) operated without the system and the next 15 consecutive patients operated with the aid of the system. With the aid of the computerized navigation system, a significant reduction in the number of tracks was observed (t = -2.503, p = 0.0015), with a mean difference of 1.2 tracks per hemisphere. A non-significant reduction in the total intervention time was also observed, with a mean difference of 20 min per hemisphere (t = -1.418, p = 0.161).
  
  
  CONCLUSIONS
  The intraoperative computerized navigation system can aid the surgical team in better identifying the neuronal signal and in defining the optimal track to achieve the target.
authors.affiliation: Department of Neurology, Hospital de la Santa Creu i Sant Pau, Autonomous University of Barcelona, Barcelona, Spain. agironell@santpau.es
authors.forename: Alexandre
authors.initials: A
authors.lastname: Gironell
authors.forename: Gerard
authors.initials: G
authors.lastname: Amirian
authors.forename: Jaume
authors.initials: J
authors.lastname: Kulisevsky
authors.forename: Joan
authors.initials: J
authors.lastname: Molet
mesh_terms: D006801:Humans; D016343:Monitoring, Intraoperative; D009474:Neurons / Q000473:pathology / Q000502:physiology; D010300:Parkinson Disease / Q000601:surgery*; D012189:Retrospective Studies; D013238:Stereotaxic Techniques; D020531:Subthalamic Nucleus / Q000601:surgery*