Effect of Microelectrode Recording in Accurate Targeting STN with High Frequency DBS in Parkinson Disease

Abstract

Parkinson's disease (PD) is a brain disorder with distinct molecular, functional and structural features, causing tremors in elderly-matured-people, which is, differentiated by the convolution of cardinal motoric-symptoms: tremor, Bradykinesia/akinesia rigidity and postural-instability. Though clinical-diagnosis and benefits of deep-brain-stimulation (DBS) in subthalamic-nuclei (STN) have been established, albeit, how its mechanisms augment motoric-symptoms not been fully elucidated. We present a principal component (PC) based tracking method to quantify the efficacy-of-DBS predict UPDRS score objectively. Twelve PD patients were included in this study. Our hypothesis is that whether DBS and innocuous-microelectrodes save STN-neurons and restores-motor-function. In our long study, high-frequency stimulation in PD brain did not dent STN-neurons. Further, it is risk-free to stimulate-STN much prior than it was accepted far so. Intraoperative microelectrode-recording (iMER) for targeting during DBS procedures has been evaluated in 46 successive-patients with advanced idiopathic PD, who received DBS. We extrapolated MER-signals of STN-features with PCs for computing the effects of DBS in PD. The signal-parameters were transformed into a lower dimensional-feature space. In our computation, we obtained 75% variation. We find that MER gives proof of correct-positioning of microelectrode, ensures accurate-detection of STN confines and establishes its exact coordinates in a more objective way. MER boosts safety, accuracy and efficacy of DBS-electrode implementation. Thus, MER confirms the presence of abnormal-STN-neurons. Certainly tranquil MER can confirm clear position-of-electrodes and strengthen the confidence of the neurosurgeons that they are in the right-target. Availability-of-MER results in a vast data vis-á-vis functioning on neurons positioned deep in the brain may further help in untying arcane-of-brain.