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Does the Use of Intraoperative Microelectrode Recording Influence the Final Location of Lead Implants in the Ventral Intermediate Nucleus for Deep Brain Stimulation?

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Abstract

To determine if the use of intraoperative microelectrode recording (MER) influences the final location of lead implant in deep brain stimulation (DBS) of the ventral intermediate nucleus (VIM), and to evaluate the incidence of associated complications. The usefulness of intraoperative MER in DBS is debated, some centers suggesting it increases complications without additional benefit. We conducted a retrospective chart review of all patients who underwent VIM DBS with MER at the University of Texas Health Science Center in Houston from June 1, 2009 to October 1, 2013. Initial (MRI determined) and final (intraoperative MER determined) coordinates of implant were compared. To assess incidences of hemorrhagic and infectious complications, we reviewed postoperative CT scans and follow-up notes. Forty-five lead implants on 24 patients were reviewed. The mean age at implantation was 62.42 years (range 18–83). The average duration from diagnosis to surgery was 21.5 years (range 1–52). A statistically significant mean difference was observed in the superior-inferior plane (0.52 ± 0.80 mm inferiorly, p < 0.05) and the anterior-posterior plane (0.45 ± 0.86 mm posteriorly, p < 0.05). A non-statistically significant difference was also observed in the medial-lateral plane (0.02± 0.15 mm, p > 0.05). One patient developed an infectious complication (4.2 %) that required removal of leads; two patients had minimal asymptomatic intra-ventricular bleeding (8.3 %). In our DBS center, intraoperative MER in VIM DBS implant does not seem to have a higher rate of surgical complications compared to historical series not using MER, and might also be useful in determining the final lead location.

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Authors and Affiliations

  1. University of Texas Health Science Center at Houston, Houston, TX, USA

    Sujan Reddy, Albert Fenoy, Erin Furr-Stimming, Mya Schiess & Raja Mehanna

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  1. Sujan Reddy
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  2. Albert Fenoy
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  3. Erin Furr-Stimming
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  4. Mya Schiess
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  5. Raja Mehanna
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Correspondence to Raja Mehanna.

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Disclosure related to the manuscript: the authors have no disclosures. Disclosures over the last 12 months, not related to manuscript: S. Reddy has nothing to disclose, A. Fenoy has nothing to disclose, E. Furr-Stimming is on the speakers bureau for Lundbeck and Impax, M. Schiess has nothing to disclose, and R. Mehanna received consultation fees from Merz Pharma.

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Authors do not have any potential conflicts of interest.

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Reddy, S., Fenoy, A., Furr-Stimming, E. et al. Does the Use of Intraoperative Microelectrode Recording Influence the Final Location of Lead Implants in the Ventral Intermediate Nucleus for Deep Brain Stimulation?. Cerebellum 16, 421–426 (2017). https://doi.org/10.1007/s12311-016-0816-7

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