Accuracy of Microelectrode Trajectory Adjustments during DBS Assessed by Intraoperative CT
Accuracy of Microelectrode Trajectory Adjustments during DBS Assessed by Intraoperative CT
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DOI：
10.1159/000489945
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发表时间：
2018-01-01
影响因子：
1.7
通讯作者：
Metman, Leo Verhagen
中科院分区：
文献类型：
--
作者：
Bus, Sander;Pal, Gian;Metman, Leo Verhagen
背景/目标：微电极记录（MER）引导的脑深部电刺激（DBS）旨在将DBS电极导线置于最佳电生理靶点。当单轨MER或测试刺激产生次优结果时，进行轨迹调整。这些轨迹调整的准确性是未知的。术中计算机断层扫描可以可视化微电极（ME）并验证ME调整。我们旨在确定接受MER引导DBS的患者ME运动的准确性。研究方法：比较了以下三种调整方法的坐标：（1）ME保持器默认“+”配置内的坐标;（2）涉及将默认“+”旋转到“x”配置的坐标;以及（3）涉及头台调整的坐标。确定了坐标之间的径向误差和绝对差。结果：分析了59例患者的87个ME运动。中位（IQR）径向误差为0.59（0.64）mm。中位（IQR）绝对x和y坐标误差分别为0.29（0.52）和0.38（0.44）mm。将多电极保持器旋转至其“x”形设置后，误差最大。结论：可以准确地进行ME轨迹调整。在相当多的情况下，发现误差超过1 mm。从“+”设置到“x”设置的调整最容易出现不准确。(C)2018作者（S）由S发布。Karger AG，巴塞尔
Background/Aims: Microelectrode recording (MER)-guided deep brain stimulation (DBS) aims to place the DBS lead in the optimal electrophysiological target. When single-track MER or test stimulation yields suboptimal results, trajectory adjustments are made. The accuracy of these trajectory adjustments is unknown. Intraoperative computed tomography can visualize the microelectrode (ME) and verify ME adjustments. We aimed to determine the accuracy of ME movements in patients undergoing MER-guided DBS. Methods: Coordinates following three methods of adjustment were compared: (1) those within the default "+" configuration of the ME holder; (2) those involving rotation of the default "+" to the "x" configuration; and (3) those involving head stage adjustments. Radial error and absolute differences between coordinates were determined. Results: 87 ME movements in 59 patients were analyzed. Median (IQR) radial error was 0.59 (0.64) mm. Median (IQR) absolute x and y coordinate errors were 0.29 (0.52) and 0.38 (0.44) mm, respectively. Errors were largest after rotating the multielectrode holder to its "x" shaped setup. Conclusion: ME trajectory adjustments can be made accurately. In a considerable number of cases, errors exceeding 1 mm were found. Adjustments from the "+" setup to the "x" setup are most prone to inaccuracies. (C) 2018 The Author(s) Published by S. Karger AG, Basel