MicroTargeting® platform: an individual stereotaxic device in functional neurosurgery
Purchase on Springer.com
$39.95 / €34.95 / £29.95*
Rent the article at a discountRent now
* Final gross prices may vary according to local VAT.
Object: Deep brain stimulation of the Nucleus subthalamicus (DBS-STN) results in an improvement of cardinal symptoms of Parkinson disease (PD) and allows a significant reduction of medication. Because of the potential risk of inaccuracies during image acquisition, planning procedure, placement of test electrodes and final electrode insertion a microTargeting® platform, FHC Company, Germany, as an example of automation in stereotaxic neurosurgery was used.
Materials and methods: A 65-years-old male patient with PD with severe motor dysfunctions was selected for DBS-STN. Preoperatively and just before image acquisition (CT, T1w-, T2w-MRI) three WayPointTM anchors per side were implanted in the skull for further definition of entry and target points, postprocessing and for creation of an individual stereotaxic platform, which was fixed with the patient’s head intraoperatively.
Results: The “MicroTargeting” system allowed a precise detection of the STN and definition of electrode trajectories, which was confirmed intraoperatively by microelectrode recording and macrostimulation. At a frequency of 130 Hz, 1.5 mA and 60 μ s pulse width the typical motor dysfunction disappeared and no stimulation associated side effects could be registered. Adjustment and reduction of medication followed.
Conclusion: MicroTargeting® platform replaced traditional target arch and electrode positioning system in an excellent way and increased the patient’s comfort. With the individual stereotaxic platform an example for automation was found, which has the potential to increase the patient’s and neurosurgeon’s safety.
- Kupsch A, Earl C (1999) Neurosurgical intervention in the treatment of ideopathic Parkinson disease: neurostimulation and neural implantation. J Mol Med 77:178–184 CrossRef
- Limousin P, Krack P, Pollak P, et al (1998) Electrical stimulation of the subthalamic nucleus in advanced Parkinson’s disease. N Eng J Med 339:1105–1111 CrossRef
- Hariz MI, Bergenheim AT (1993) Clinical evaluation of computed tomography-guided versus ventriculography-guided thalamotomy for movement disorders. Acta Neurochir 58:53–55
- Hariz MI, Bergenheim AT (1990) A comparative study on ventriculographic and computerized tomography-guided determinations of brain targets in functional stereotaxis. J Neurosurg 73:565–571
- Alp MS, Dujovny M, Misra M, Charbel FT, Ausman JI (1998) Head registration techniques for image-guided surgery. Neurol Res 20:31–37
- Brommeland T, Hennig R (2000) A new procedure for frameless computer navigated stereotaxy. Acta Neurochir 142:443–448 CrossRef
- Buchholz RD, Ho HW, Rubin JP (1993) Variables affecting the accuracy of stereotactic localization using computerized tomography. J Neurosurg 79:667–673 CrossRef
- Cohen DS, Lustgarten JH, Miller E, Khandji AG, Goodman RR (1995) Effects of coregistration of MR to CT images on MR stereotactic accuracy. J Neurosurg 82:772–779 CrossRef
- Parasuraman R, Sheridan TB, Wickens CD (2000) A model for types and levels of human interaction with automation. IEEE Trans Syst Man Cybern A Syst Hum 30:286–297 CrossRef
- Endsley MR, Kaber DB (1999) Level of automation effects on performance, situation awareness and workload in a dynamic control task. Ergonomics 42:462–92 CrossRef
- MicroTargeting® platform: an individual stereotaxic device in functional neurosurgery
International Journal of Computer Assisted Radiology and Surgery
Volume 1, Issue 5 , pp 295-299
- Cover Date
- Print ISSN
- Online ISSN
- Additional Links
- Parkinson’s disease
- MicroTargeting system
- Industry Sectors
- Author Affiliations
- 1. Department of Neurosurgery, University of Leipzig, Liebigstrasse 20, 04103, Leipzig, Germany
- 5. ICCAS, University of Leipzig, Leipzig, Germany
- 2. Department of ENT, University of Leipzig, Leipzig, Germany
- 3. Department of Radiology, University of Leipzig, Leipzig, Germany
- 4. Department of Neurology, University of Leipzig, Leipzig, Germany