title: Intraoperative microelectrode recording for the delineation of subthalamic nucleus topography in Parkinson's disease.
abstract: BACKGROUND
  The subthalamic nucleus (STN) as an effective target for deep brain stimulation (DBS) in advanced Parkinson's disease is functionally divided into the dorsolateral sensorimotor and the ventromedial limbic and associative parts. To implant electrodes for DBS close to the sensorimotor region is considered crucial for optimal motor benefit and for avoidance of potential cognitive and behavioral side effects.
  
  
  OBJECTIVE
  The aim of this study was to determine whether the functional segregation of the STN is associated with distinct and region-specific neuronal activity patterns and action potential properties obtained by intraoperative microelectrode recordings.
  
  
  METHODS
  In 12 Parkinson's disease patients, stepwise intraoperative microelectrode recordings were performed using five concentrically configured electrodes starting 10 mm above the calculated target point until the dorsal border of the substantia nigra.
  
  
  RESULTS
  Based on autocorrelogram analysis of a total of 329 single units, we found a higher occurrence of oscillatory (P < 0.01) and bursty (P = 0.058) spike pattern in the dorsal versus the ventral STN. In contrast the ventral region was characterized by irregular firing neurons (P < 0.01). There were no significant differences in firing frequency, coefficient of variance, asymmetry index as well as spike form, duration, and amplitude.
  
  
  CONCLUSIONS
  Among all parameters analyzed in the study, spike pattern is the only convenient electrophysiologic parameter for the differentiation of STN subregions in patients with Parkinson's disease. The autocorrelogram-based analysis of spike activity seems to be of certain value for the delineation of the dorsolateral STN and might therefore facilitate the precise electrode implantation for DBS.
authors.affiliation: Department of Neurology, Johann Wolfgang Goethe-University, Frankfurt am Main, Germany. Electronic address: C.Seifried@em.uni-frankfurt.de.
authors.forename: Carola
authors.initials: C
authors.lastname: Seifried
authors.affiliation: Department of Neurosurgery, Johann Wolfgang Goethe-University, Frankfurt am Main, Germany.
authors.forename: Lutz
authors.initials: L
authors.lastname: Weise
authors.affiliation: Institute of Neurophysiology, Johann Wolfgang Goethe-University, Frankfurt am Main, Germany.
authors.forename: Rainer
authors.initials: R
authors.lastname: Hartmann
authors.affiliation: Department of Neurosurgery, Johann Wolfgang Goethe-University, Frankfurt am Main, Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Gasser
authors.affiliation: Department of Neurology, Johann Wolfgang Goethe-University, Frankfurt am Main, Germany.
authors.forename: Simon
authors.initials: S
authors.lastname: Baudrexel
authors.affiliation: Department of Neurosurgery, Johann Wolfgang Goethe-University, Frankfurt am Main, Germany.
authors.forename: Andrea
authors.initials: A
authors.lastname: Szelényi
authors.affiliation: Department of Neurology, Johann Wolfgang Goethe-University, Frankfurt am Main, Germany.
authors.forename: Simone
authors.initials: S
authors.lastname: van de Loo
authors.affiliation: Department of Neurology, Johann Wolfgang Goethe-University, Frankfurt am Main, Germany.
authors.forename: Helmuth
authors.initials: H
authors.lastname: Steinmetz
authors.affiliation: Department of Neurosurgery, Johann Wolfgang Goethe-University, Frankfurt am Main, Germany.
authors.forename: Volker
authors.initials: V
authors.lastname: Seifert
authors.affiliation: Institute of Neurophysiology, Johann Wolfgang Goethe-University, Frankfurt am Main, Germany.
authors.forename: Jochen
authors.initials: J
authors.lastname: Roeper
authors.affiliation: Department of Neurology, Johann Wolfgang Goethe-University, Frankfurt am Main, Germany.
authors.forename: Rüdiger
authors.initials: R
authors.lastname: Hilker
mesh_terms: D001931:Brain Mapping / Q000379:methods*; D046690:Deep Brain Stimulation / Q000295:instrumentation*; D004867:Equipment Design; D019544:Equipment Failure Analysis; D005260:Female; D006801:Humans; D007430:Intraoperative Care / Q000379:methods; D008297:Male; D008839:Microelectrodes; D008875:Middle Aged; D010300:Parkinson Disease / Q000175:diagnosis* / Q000503:physiopathology* / Q000628:therapy; D019919:Prosthesis Implantation / Q000379:methods; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D020531:Subthalamic Nucleus / Q000503:physiopathology*