The development of image-guided and electrophysiological navigation for deep brain stimulation surgery

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Deep brain stimulation(DBS) of the subthalamic nucleus(STN) for the patients with Parkinson disease(PD) is performed using intraoperative microelectrode recording(MER) to define the optimal site. The correlation between microelectrode criteria and surgical outcome was respectively examined in the patients with STN DBS. The number of total STN neurons, movement-related neurons and the length of STN recorded were significantly correlated with improvement of the surgical outcome and the number of movement-related neurons was most strongly related with the surgical outcome. We developed the new image analysis technique based on non-linear transformation theory. The brain shift is evaluated according to the volume of free air in the skull X-P(front and lateral view) taken intraoperatively, resulting calculation of AC and PC displacement. Totally, we developed the electrophysiological navigation of which the single unit recording data significantly correlated to the surgical outcome is considered and the real-time electrophysiological data can be fitted to the 3Dvirtual Schaltenbland and Wahren atlas