Accuracy of Subthalamic Nucleus Electrode Implantation in Deep Brain Stimulation Surgery for Parkinson's Disease Treatment and Affecting Factors: Outcomes at Two Centers in Vietnam

Abstract

Deep brain stimulation (DBS) surgery for Parkinson's Disease (PD) has become more and more popular in Vietnam. However, the accuracy of implantation and affecting factors are under investigation. The objective of this study is to evaluate the accuracy of the subthalamic nucleus (STN)-DBS electrode implantation technique for treatment PD at Nguyen Tri Phuong Hospital and University Medical Center. To investigate factors related to accuracy. We carried out a retrospective analysis of 58 patients with advanced PD who underwent STN-DBS surgery at Nguyen Tri Phuong Hospital and University Medical Center in Ho Chi Minh City, Viet Nam between June 2014 and July 2021 (115 leads total). All patients underwent the procedure with standard frame-based techniques under local anesthesia with microelectrode recording and macrostimuation test. Twenty-six female (44.8%) and thirty-two male (55.2%) patients with a mean age of 60.4 ± 8.3 years old (40-76 years) were included. Of total of 115 electrodes implanted, the mean target error (ΔT), radial error (ΔR), angle error (Δθ) were 1.94 ± 0.73 mm; 1.16 ± 0.69 mm; 2.22 ± 4.24 degrees, respectively. Vector error on each coordinate axis ΔX, ΔY, ΔZ were-0.35 ± 1.02 mm,+0.99 ± 0.82 mm,+0.73 ± 0.99 mm, respectively. There was a statistically significant correlation between subdural air volume, cortical shift, intracranial electrode bending, and accuracy. The current STN-DBS electrode implantation technique applied in our centers was quite accurate with acceptable error. More clinical trials are necessary to directly compare affecting factors to the accuracy of electrode implantation.