Preview

Russian journal of neurosurgery

Advanced search

Microelectrode registration of neuronal activity in treatment of Parkinson’s disease using the method of stereotactic thermal destruction of deep brain structures

Abstract

Objective: to present the functional results of stereotactic thermal destruction of basal nuclei with the usage of microelectrode analysis at such patients. Material and methods: We operated on 55 patients with lateralized forms of Parkinson’s disease at the base of в Novosibirsk Federal Neurosurgical Center within 8 months in 2013. We performed 26 ventral dorsal pallidotomies and 29 ventral intermediate thalamotomies. The sequential steps of intraoperative microelectrode registration of neuronal activity of basal nuclei and clinical testing are presented. Results: The usage of the mentioned method allowed significantly improving the life quality at patients with such pathology (PDQ-39 and UPDRS scales) by 73% in general. There were no lethal outcomes, 2 (3,6%) patients had perioperative complications: temporary dysarthria and hypertensive inctracerebral hemorrhage on the 2d day after thalamotomy. Conclusion: the usage of neurophysiological navigation system allows conducting stereotactic deconstructive operations more safely at the new submillimeter accuracy level as well as achieving maximal clinical effect and decreasing the risk of complications for each patient personally, whereas only anatomical orientation is possible during neurostimulation procedures.

About the Authors

E. G. Melidi
ФГБУ «Федеральный центр нейрохирургии»
Russian Federation


O. A. Gavronina
ФГБУ «Федеральный центр нейрохирургии»
Russian Federation


D. Ju. Rogov
ФГБУ «Федеральный центр нейрохирургии»
Russian Federation


E. A. Khabarova
ФГБУ «Федеральный центр нейрохирургии»
Russian Federation


References

1. Гамалея А.А., Томский А.А., Бриль Е.В., Шабалов В.А. Электростимуляция глубоких структур головного мозга при экстрапирамидных заболеваниях. Принципы программирования // Нервные болезни, 2012, № 4: 55-62.

2. Кандель Э.И. Функциональная и стереотаксическая нейрохирургия. М. 1981. 502 с.

3. Кичерова О.А., Рейхерт Л.И. Болезнь Паркинсона и другие экстрапирамидные заболевания. Тюмень; 2011: 311 с.

4. Томский А.А. Хирургическое лечение паркинсонизма методом хронической электростимуляции области субталамического ядра. / Дисс.. канд. мед. наук. М.; 2004: 201 с.

5. Тюрников В.М., Переседов В.В., Кадыков А.С. и др. Результаты хирургического лечения паркинсонизма. // 5 международный симпозиум «Повреждения мозга». С-Петербург, РВМА. 1999: 391-392

6. Шабалов В.А. Дифференцированные подходы к нейрохирургическому лечению больных с болезнью Паркинсона. / Автореф. дисс.. д-ра мед. наук. М.; 2003: 46 с.

7. Alkhani A., Lozano A., Pallidotomy for Parkinson disease: a review of contemporary literature //Journal of Neurosurgery, January 2001, Volume 94, Issue 1, P. 43-49.

8. Bejjani B.P., Donnat D., Pidoux B., Yetaik J., Damicr P., Amulf 1 et al. (2000) Bilateral subthalamic stimulation for Parkinson’s disease by using three-dimensional stereotactic magnetic resonance imaging and electrophysiological guidance // Journal of Neurosurgery Volume 92, P. 615-625.

9. Bell D.S. Speech functions of the thalamus inferred from the effects of thalamotomy. Brain 91: 619 - 638, 1968.

10. Benabid A.L., Koudsie A., Fraix V., Benazzouz A., Chabardes S., LeBas J.F. et al.( (2001). High-frequency stimulation of the subthalamic nucleus m advanced Parkinson’s disease: an 8-year experience // Journal of Neurosurgery Volume 94 P. 376-378.

11. Dogali M., Fazzini E., Kolodny E., Eidelberg D., Sterio D., Devinsky O., Berić A. Stereotactic ventral pallidotomy for Parkinson’s disease // Neurology. 1995 Apr; 45(4): 753-61.

12. Dormont D., Ricciardi K.G., Tande D., Parain K., Menuel C., Galanaud D. et al.(2004) Is the subthalamic nucleus hy-pointense on T2-weighted images? A correlation study using MR imaging and stereotactic atlas data. // AJNR American Journal of Neuroradiology 25: 1516-1523.

13. Follett K.A., Weaver F.M., Stern M., Hur K., Harris C.L., Luo P. et al. (2010) Pallidal versus subthalamic deep-brain stimulation for Parkinson’s disease // The New England Journal of Medicine 362: 2077-2091.

14. Foltynie T., Zrinzo L., Martinez-Torres I., Tripoliti E., Petersen E., Holl E. et al. MRl-guided STN DBS in Parkinson’s disease without microelectrode recording: efficacy and safety // Journal of Neurology, Neurosurgery, and Psychiatry 2011, Volume 82: P.358-363.

15. Fox M.W., Ahlskog J.E., Kelly P.J. Stereotactic ventrolateralis thalamotomy for medically refractory tremor in post-levodopa era Parkinson’s disease patients // Journal of Neurosurgery Volume 75: 723730,1991.

16. Gprgulho A., De Salles A.A., Frighetto L., Behnke E. (2005) Incidence of hemorrhage associated with electrophysiological studies performed using macroelectrodes and microelectrodes in functional neurosurgery // Journal of Neurosurgery Volume 102: P. 888-896.

17. Guridi J., Lozano A.M. A brief history of pallidotomy // Neurosurgery Volume 41: P. 1169 - 1183, 1997.

18. Iacono R.P., Shima F., Lonser R.R. et al: The results, indications, and physiology of posteroventral pallidotomy for patients with Parkinson’s disease // Neurosurgery Volume 36: P. 1118 - 1127, 1995.

19. Kopyov O., Jacques D., Duma C., Buckwalter G., Kopyov A. et al. Microelectrode-guided posteroventral medial radiofrequency pallidotomy for Parkinson’s disease - // Journal of Neurosurgery, July 1997, Volume 87, Issue 1, P. 52-59

20. Lozano A., Hutchison W., Kiss Z. Methods for microelectrodeguided posteroventral pallidotomy. // Journal of Neurosurgery Volume 84: P. 194 - 202, 1996.

21. Maldonado L., Roujeau T., Cif L., Gonzalez V., El-Fertit H., Vasques X. et al. (2009) Magnetic resonance-based deep brain stimulation technique: a series of 478 consecutive implanted electrodes with no perioperative intracerebral hemorrhage // Neurosurgery Volume 65: P. 196-201, discussion 201-192.

22. Ojemann G.A., Ward A.A. Jr: Abnormal movement disorders, in Youmans J.R. (ed): Neurological Surgery, ed 2. Philadelphia: WB Saunders, 1982, Vol. 6, pp 3821 - 3857.

23. Schlaier J.R., Habermeyer C., Janzen Т., Fellner С., Hochreiter А., Proescholdt V. et al. The influence of intraoperative microelectrode recordings and clinical testing on the location of final stimulation sites in deep brain stimulation for Parkinson’s disease // Acta Neurochirurgica Volume 155: 357-366, 2013

24. Starr P.A., Martin A.J., Ostrem J.L., Talkc P., Levesque N., Larson P.S. Subthalamic nucleus deep brain stimulator placement using high-field interventional magnetic resonance imaging and a skull-mounted aiming device: technique and application accuracy // Journal of Neurosurgery volume 112: P. 479-490, 2010.

25. Sutton J.P., Couldwell W., Lew M.F. et al. Ventroposterior medial pallidotomy in patients with advanced Parkinson’s disease // Neurosurgery volume 36: P. 1112 - 1117, 1995.

26. Tronnier V., Fogel W., Kronenbuerger M., Steinvorth S. Pallidal stimulation: an alternative to pallidotomy? // Neurosurgical Focus Vol. 2 No. 3, P. E12., 1997.

27. Vitek J., Bakay R., Hashimoto T., Kaneoke Y., Mewes K., Zhang Z. et al. Microelectrode-guided pallidotomy: technical approach and its application in medically intractable Parkinson’s disease // Journal of Neurosurgery, June 1998, Volume 88, Issue 6, P. 1027-1043


Review

For citations:


Melidi E.G., Gavronina O.A., Rogov D.J., Khabarova E.A. Microelectrode registration of neuronal activity in treatment of Parkinson’s disease using the method of stereotactic thermal destruction of deep brain structures. Russian journal of neurosurgery. 2014;(2):39-44. (In Russ.)

Views: 667


Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.


ISSN 1683-3295 (Print)
ISSN 2587-7569 (Online)
X