Dual microelectrode technique for deep brain stereotactic surgery in humans.
OBJECTIVE
To improve functional stereotactic microelectrode localization of small deep brain structures by developing and evaluating a recording system with two closely separated independently controlled microelectrodes.


METHODS
Data were obtained from 52 patients using this dual microelectrode technique and 38 patients using the standard single microelectrode technique for subthalamic nucleus localization in patients with Parkinson's disease.


RESULTS
There was a decrease in the incidence of noncontributory trajectories, defined as a single penetration made by the pair of closely spaced parallel microelectrodes, owing to microelectrode failure (from 7.2% to <1%), an improved localization and verification of nuclear borders, and a significant decrease in the number of trajectories used to localize the subthalamic nucleus from a median of three to two per initial operative side (P < 0.001). The technique also provides the novel opportunity to examine population activity by correlating the discharge between two closely spaced simultaneously recorded neurons and can be used to monitor the electrophysiological effects of local electrical stimulation or microinjections of pharmacological agents.


CONCLUSIONS
Our experience indicates that the use of two closely spaced microelectrodes improves the utility of microelectrode localization in minimally invasive functional neurosurgery.
Levy
Ron
R
Department of Physiology, University of Toronto, Toronto, Canada.
Lozano
Andres M
AM
Hutchison
William D
WD
Dostrovsky
Jonathan O
JO
D046690:Deep Brain Stimulation / Q000295:instrumentation*; D004567:Electrodes, Implanted; D006801:Humans; D008488:Medical Illustration; D008839:Microelectrodes; D019635:Neurosurgical Procedures / Q000295:instrumentation*; D010300:Parkinson Disease / Q000601:surgery* / Q000628:therapy; D013238:Stereotaxic Techniques / Q000295:instrumentation*; D020531:Subthalamic Nucleus / Q000601:surgery*