title: The Insertion of Electrodes in the Brain for Electrophysiological Recording or Chronic Stimulation Is Not Associated With Any Biochemically Detectable Neuronal Injury.
abstract: OBJECTIVE
  The aim of this study was to evaluate the degree of brain tissue injury that could be potentially induced by the introduction of a) microrecording electrodes, b) macrostimulation electrodes, or c) chronic stimulation electrodes. We aimed to evaluate whether the use of five simultaneous microrecording tracks is associated with any brain injury not detectable by conventional imaging such as CT or MRI.
  
  
  METHODS
  The study included 61 patients who underwent surgery for implantation of 121 DBS leads. In all cases, five simultaneous tracts were utilized for microelectrode recordings. All patients underwent measurements of serum S-100b at specific time points as follows: a) prior to the operation, and b) intraoperatively at specific stages of the procedure: 1) after opening the burr hole, 2) after the insertion of microrecording electrodes, 3) during macrostimulation, 4) at the end of the operation, and 5) on the first postoperative day.
  
  
  RESULTS
  The levels of serum S-100B protein remained within the normal range during the entire period of investigation in all patients with the exception of two cases. In both patients, the procedure was complicated by intraparenchymal hemorrhage visible in neuro-imaging. The first patient developed a small intraparenchymal hemorrhage, visible on the postoperative MRI, with no neurological deficit. The second patient experienced a focal epileptic seizure after the insertion of the right DBS chronic lead and the postoperative CT scan revealed a right frontal lobe hemorrhage.
  
  
  CONCLUSIONS
  These results strongly indicate that the insertion of either multiple recording electrodes or the implantation of chronic electrodes in DBS does not increase the risk of brain hemorrhage or of other intracranial complications, and furthermore it does not cause any biochemically detectable brain tissue damage.
authors.affiliation: Department of Neurosurgery, University of Athens Medical School, "Evangelismos" Hospital, Athens, Greece.|P. Kokkalis Hellenic Center for Neurosurgical Research, Athens, Greece.
authors.forename: Marios S
authors.initials: MS
authors.lastname: Themistocleous
authors.affiliation: Department of Neurosurgery, University of Athens Medical School, "Evangelismos" Hospital, Athens, Greece.|P. Kokkalis Hellenic Center for Neurosurgical Research, Athens, Greece.
authors.forename: Damianos E
authors.initials: DE
authors.lastname: Sakas
authors.affiliation: Department of Neurosurgery, University of Athens Medical School, "Evangelismos" Hospital, Athens, Greece.|P. Kokkalis Hellenic Center for Neurosurgical Research, Athens, Greece.
authors.forename: Efstathios
authors.initials: E
authors.lastname: Boviatsis
authors.affiliation: Department of Neurosurgery, University of Athens Medical School, "Evangelismos" Hospital, Athens, Greece.|P. Kokkalis Hellenic Center for Neurosurgical Research, Athens, Greece.
authors.forename: George
authors.initials: G
authors.lastname: Tagaris
authors.affiliation: Department of Neurosurgery, University of Athens Medical School, "Evangelismos" Hospital, Athens, Greece.
authors.forename: Andreas
authors.initials: A
authors.lastname: Kouyialis
authors.affiliation: P. Kokkalis Hellenic Center for Neurosurgical Research, Athens, Greece.
authors.forename: Christina
authors.initials: C
authors.lastname: Psachoulia
authors.affiliation: Department of Neurosurgery, University of Athens Medical School, "Evangelismos" Hospital, Athens, Greece.|P. Kokkalis Hellenic Center for Neurosurgical Research, Athens, Greece.
authors.forename: Pantelis
authors.initials: P
authors.lastname: Stathis
mesh_terms: D000328:Adult; D000368:Aged; D046690:Deep Brain Stimulation / Q000009:adverse effects / Q000295:instrumentation / Q000639:trends*; D004567:Electrodes, Implanted / Q000009:adverse effects / Q000639:trends*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008839:Microelectrodes / Q000009:adverse effects / Q000639:trends; D008875:Middle Aged; D010300:Parkinson Disease / Q000097:blood* / Q000000981:diagnostic imaging* / Q000601:surgery; D064568:S100 Calcium Binding Protein beta Subunit / Q000097:blood*; D020531:Subthalamic Nucleus / Q000737:chemistry / Q000000981:diagnostic imaging*; D014057:Tomography, X-Ray Computed / Q000379:methods
chemical_list: D064568:S100 Calcium Binding Protein beta Subunit; C579160:S100B protein, human
keywords: Brain injury; Parkinson's disease; S-100B protein; deep brain stimulation; microelectrode recordings