Localization of the subthalamic nucleus in Parkinson disease using multiunit activity.
Localization of the subthalamic nucleus in Parkinson disease using multiunit activity.
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DOI：
10.1016/j.jns.2011.07.027
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发表时间：
2011-11-15
影响因子：
4.4
通讯作者：
Pilitsis, Julie G.
中科院分区：
文献类型：
--
作者：
Novak, Peter;Przybyszewski, Andrzej W.;Barborica, Andrei;Ravin, Paula;Margolin, Lee;Pilitsis, Julie G.
关键词：
在帕金森病（PD）的脑深部电刺激（DBS）手术期间，常规使用术中微电极记录（MER）对丘脑底核（DBS）坐标进行细化。电生理学定位小脑扁桃体的常用标准是定性的。本研究的目的是在前瞻性环境中验证从多单位活动中得出的定量重复检测算法（QD）。10例PD患者接受了DBS手术。通过小波方法去除微电极附近的大尖峰，并在功率谱密度中积分500-2000 Hz频带，获得MUA。采用Bland-Altman和Pearson相关性分析比较了MER（IOM）与QD的术中定性标测。在所有受试者中证实了临床疗效。背侧/腹侧边缘的IOM和QD之间的平均差异为0.31±0.84/0.44±0.47 mm。使用Bland-Altman统计，仅2/36（5.6%）差异（1个背侧边缘，1个腹侧边缘）超出±2 sd测量差异线。通过IOM和QD获得的背侧边界/腹侧边界位置之间的相关性为0.79，p<0.0001/0.91，p<0.0001。这两种方法是在合理的协议，并强烈相关。QD以高精度提供了东地中海边界的客观坐标，可能比IOM更准确。有必要进行前瞻性盲法比较研究，其中DBS电极导线将使用QD或IOM置入。
Refinement of the subthalamic nucleus (STN) coordinates using intraoperative microelectrode recordings (MER) is routinely performed during deep brain stimulation (DBS) surgeries in Parkinson disease (PD). The commonly used criteria for electrophysiological localization of the STN are qualitative. The goal of this study was to validate quantitative STN detection algorithm (QD) derived from the multi-unit activity in a prospective setting. Ten PD patients underwent STN DBS surgery. The MUA was obtained by removing large spikes close to microelectrode using wavelet method and integrating the 500-2000 Hz band in the power spectral density. The qualitative intraoperative mapping of the STN using MER (IOM) versus QD was compared using Bland-Altman and Pearson’s correlation analysis. The clinical efficacy was confirmed in all subjects. The mean difference between IOM and QD of the dorsal/ventral border was 0.31±0.84/0.44±0.47 mm. Using Bland-Altman statistic, only 2/36 (5.6%) differences (one for the dorsal border and one for the ventral border) were out of ±2 sd line of measurement differences. Correlation between dorsal border/ventral borders positions obtained by IOM and QD was 0.79, p<0.0001/0.91, p<0.0001. Both methods are in reasonable agreement and are strongly correlated. The QD gives objective coordinates of the STN borders at high precision and may be more accurate than IOM. Prospective blinded comparative studies where the DBS leads will be placed using either QD or IOM are warranted.
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