ArticleJournal of neurology, neurosurgery, and psychiatry2023
Intraoperative physiology augments atlas-based data in awake deep brain stimulation.
Article in Journal of neurology, neurosurgery, and psychiatry, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- Remifentanil-esketamine-based General Anesthesia Strategy for Microelectrode-guided Deep-brain Stimulation for Parkinson Disease.Anesthesiology · 2026Article
- Intraoperative neural firing correlates with motor and cognitive features in Parkinson's disease.Journal of neurosurgery · 2025Article
- Parameterization of intraoperative human microelectrode recordings: Linking action potential morphology to brain anatomy.bioRxiv : the preprint server for biology · 2025Article
- Parameterization of intraoperative human microelectrode recordings: Linking action potential morphology to brain anatomy.PLoS computational biology · 2025Article
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Authors and funding
15 authors.
Funding
Abstract
backgroundDeep brain stimulation (DBS) is commonly performed with patients awake to perform intraoperative microelectrode recordings and/or macrostimulation testing to guide final electrode placement. Supplemental information from atlas-based databases derived from prior patient data and visualised as efficacy heat maps transformed and overlaid onto preoperative MRIs can be used to guide preoperative target planning and intraoperative final positioning. Our quantitative analysis of intraoperative testing and corresponding changes made to final electrode positioning aims to highlight the value of intraoperative neurophysiological testing paired with image-based data to optimise final electrode positioning in a large patient cohort.
methodsData from 451 patients with movement disorders treated with 822 individual DBS leads at a single institution from 2011 to 2021 were included. Atlas-based data was used to guide surgical targeting. Intraoperative testing data and coordinate data were retrospectively obtained from a large patient database. Medical records were reviewed to obtain active contact usage and neurologist-defined outcomes at 1 year.
resultsMicroelectrode recording firing profiles differ per track, per target and inform the locations where macrostimulation testing is performed. Macrostimulation performance correlates with the final electrode track chosen. Centroids of atlas-based efficacy heat maps per target were close in proximity to and may predict active contact usage at 1 year. Overall, patient outcomes at 1 year were improved for patients with better macrostimulation response.
conclusionsAtlas-based imaging data is beneficial for target planning and intraoperative guidance, and in conjunction with intraoperative neurophysiological testing during awake DBS can be used to individualize and optimise final electrode positioning, resulting in favourable outcomes.
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