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Globus Pallidus Interna Deep Brain Stimulation: Practical Guide to Placement with Microelectrode Recording

  • Eric Hudgins
  • A. G. Ramayya
  • G. H. BaltuchEmail author
Chapter

Abstract

Chronic high-frequency deep brain stimulation (DBS) is a Food and Drug Administration (FDA) approved treatment for Parkinson’s disease and has been shown to be more efficacious at improving motor symptoms than medical treatment alone. This chapter will detail the effective targeting of globus pallidus interna (GPi) using a Leksell frame-based approach that relies both on anatomical guidance with magnetic resonance imaging (MRI) and physiological mapping with microelectrode recordings and stimulation. This multimodal approach to stereotactic localization can help overcome the challenges associated with safely and effectively targeting the GPi for DBS.

Keywords

Deep brain stimulation Stereotactic Leksell frame GPi Globus pallidus 

References

  1. 1.
    Alkhani A, Lozano AM. Pallidotomy for parkinson disease: a review of contemporary literature. J Neurosurg. 2001;94(1):43–9.CrossRefGoogle Scholar
  2. 2.
    Bergman H, Wichmann T, DeLong MR. Reversal of experimental parkinsonism by lesions of the subthalamic nucleus. Science. 1990;249(4975):1436–8.CrossRefGoogle Scholar
  3. 3.
    Benazzouz A, Gross C, Feger J, Boraud T, Bioulac B. Reversal of rigidity and improvement in motor performance by subthalamic high-frequency stimulation in MPTP-treated monkeys. Eur J Neurosci. 1993;5:382–9.CrossRefGoogle Scholar
  4. 4.
    Benabid AL, Pollak P, Louveau A, Henry S, de Rougemont J. Combined (thalamotomy and stimulation) stereotactic sur- gery of the VIM thalamic nucleus for bilateral Parkinson disease. Appl Neurophysiol. 1987;50(1–6):344–6.PubMedGoogle Scholar
  5. 5.
    Benabid AL. Deep brain stimulation for Parkinson’s disease. Curr Opin Neurobiol. 2003;13(6):696–706.CrossRefGoogle Scholar
  6. 6.
    Blomstedt P, Hariz GM, Hariz MI. Pallidotomy versus pallidal stimulation. Parkinsonism Relat Disord. 2006;12(5):296–301.CrossRefGoogle Scholar
  7. 7.
    Bronstein JM, DeSalles A, DeLong MR. Stereotactic pallidotomy in the treatment of Parkinson disease: an expert opinion. Arch Neurol. 1999;56(9):1064–9.CrossRefGoogle Scholar
  8. 8.
    DeLong MR. Primate models of movement disorders of basal ganglia origin. Trends Neurosci. 1990;13(7):281–5.CrossRefGoogle Scholar
  9. 9.
    Gironell A, et al. Effects of pallidotomy and bilateral subthalamic stimulation on cognitive function in Parkinson disease: a controlled comparative study. J Neurol. 2003;250(8):917–23.CrossRefGoogle Scholar
  10. 10.
    Gironell A, et al. Motor circuitry re-organization after pallidotomy in Parkinson disease: a neurophysiological study of the bereitschaftspotential, contingent negative variation, and N30. J Clin Neurophysiol. 2002;19(6):553–61.CrossRefGoogle Scholar
  11. 11.
    Guridi J, Lozano AM. A brief history of pallidotomy. Neurosurgery. 1997;41(5):1169–83.CrossRefGoogle Scholar
  12. 12.
    Gross RE, et al. Electrophysiological mapping for the implantation of deep brain stimulators for Parkinson’s disease and tremor. Mov Disord. 2006;21(14):259–83.CrossRefGoogle Scholar
  13. 13.
    Hariz MI, Bergenheim AT. A 10-year follow-up review of patients who underwent Leksell’s posteroventral pallidotomy for Parkinson disease. J Neurosurg. 2001;94(4):552–8.CrossRefGoogle Scholar
  14. 14.
    Jacques DS, Eagle KS, Kopyov OV. Use of posteroventral pallidotomy for treatment of Parkinson’s disease: is pallidotomy still an experimental procedure? A review and commentary. Stereotact Funct Neurosurg. 1998;70(1):19–31.CrossRefGoogle Scholar
  15. 15.
    Kleiner-Fisman G, et al. Long-term effect of unilateral pallidotomy on levodopa-induced dyskinesia. Mov Disord. 2010;25(10):1496–8.CrossRefGoogle Scholar
  16. 16.
    Kramer DR, Halpern CH, Buonacore DL, McGill KR, Hurtig HI, Jaggi JL, Baltuch GH. Best surgical practices: a stepwise approach to the University of Pennsylvania deep brain stimulation protocol. Neurosurg Focus. 2010;29(2):E3.CrossRefGoogle Scholar
  17. 17.
    Krauss JK, et al. Posteroventral medial pallidotomy in levodopa-unresponsive parkinsonism. Arch Neurol. 1997;54(8):1026–9.CrossRefGoogle Scholar
  18. 18.
    Laitinen LV, Bergenheim AT, Hariz MI. Ventroposterolateral pallidotomy can abolish all parkinsonian symptoms. Stereotact Funct Neurosurg. 1992;58:14–21.CrossRefGoogle Scholar
  19. 19.
    Leksell L, et al. A new fixation device for the Leksell stereotaxic system. Technical note. J Neurosurg. 1987;66(4):626–9.CrossRefGoogle Scholar
  20. 20.
    Lozano AM, Lang AE. Pallidotomy for Parkinson’s disease. Neurosurg Clin N Am. 1998;9(2):325–36.CrossRefGoogle Scholar
  21. 21.
    Melnick ME, et al. Effect of pallidotomy on postural control and motor function in Parkinson disease. Arch Neurol. 1999;56(11):1361–5. Available at: http://www.ncbi.nlm.nih.gov/pubmed/10555656.CrossRefGoogle Scholar
  22. 22.
    Miocinovic S, Somayajula S, Chitnis S, Vitek JL. History, applications, and mechanisms of deep brain stimulation. JAMA Neurol. 2013;70(2):163–71.CrossRefGoogle Scholar
  23. 23.
    Pollak P, Benabid AL, Gross C, et al. Effets de la stimulation du noyau sous thalamique dans la maladie de Parkinson. Rev Neurol (Paris). 1993;149(3):175–6.Google Scholar
  24. 24.
    Quinn N. Progress in functional neurosurgery for Parkinson’s disease. Lancet. 1999;354(9191):1658–9.CrossRefGoogle Scholar
  25. 25.
    Siegel KL, Metman LV. Effects of bilateral posteroventral pallidotomy on gait of subjects with Parkinson disease. Arch Neurol. 2000;57(2):198–204.CrossRefGoogle Scholar
  26. 26.
    Siegfried J, Lippitz B. Bilateral chronic electrostimulation of ventroposterolateral pallidum: a new therapeutic approach for alleviating all parkinsonian symptoms. Neurosurgery. 1994;35:1126–9.CrossRefGoogle Scholar
  27. 27.
    Simon SL, et al. Error analysis of MRI and Leksell stereotactic frame target localization in deep brain stimulation surgery. Stereotact Funct Neurosurg. 2005;83(1):1–5.CrossRefGoogle Scholar
  28. 28.
    Sobstyl M, et al. Bilateral pallidotomy for the treatment of advanced Parkinson disease. Neurol Neurochir Pol. 2003;37(Suppl 5):251–62.PubMedGoogle Scholar
  29. 29.
    Soukup VM, et al. Cognitive sequelae of unilateral posteroventral pallidotomy. Arch Neurol. 1997;54(8):947–50.CrossRefGoogle Scholar
  30. 30.
    Spiegel EA, Wycis HT, Szekely EG, et al. Stimulation of Forel’s field during stereotaxic operations in the human brain. Electroencephalogr Clin Neurophysiol. 1964;16:537–48.CrossRefGoogle Scholar
  31. 31.
    Starr PA. Pallidal interventions for Parkinson’s disease. In: Winn HR, editor. Youmanns neurological surgery. 6th ed. New York: Elsevier; 2011. p. 938–43.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Department of NeurosurgeryUniversity of PennsylvaniaPhiladelphiaUSA

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