Introduction: Deep brain stimulation (DBS) of the subthalamic nucleus (STN) has become standard of care for the treatment of Parkinson’s disease. Reliable interpretation of microelectrode recording (MER) data, used to guide DBS implantation surgery, requires expert electrophysiological evaluation. We have developed a software package, implemented on an electrophysiological recording system, to provide online objective estimates for entry into, and exit from, STN. In addition, the optimal electrode track for DBS implantation into STN can be determined through this software’s ability to detect changes in beta-spectrum activity.
Methods: We retrospectively collected data from 8 MER-guided STN-DBS surgeries (4 neurosurgeons; 3 sites), in which estimates for entry into and exit from STN, and optimal implant track selection, were compared between those determined by the software, and those by the implanting neurosurgeon.
Results: Comparison between software and neurosurgeon differed by 0.02 mm ± 1.90 mm (mean ± SD) for STN entry, and -0.24 mm ± 1.31 mm for STN exit, with negative indicating below target. Agreement between software and neurosurgeon for optimal track selection was 87% (7 of 8 surgeries).
Conclusions: These data demonstrate that the software can reliably and accurately estimate entry into and exit from STN, and select the optimal track for DBS implantation. A larger sample size will provide stronger validation of results.
Patient Care: By enhancing reliability of intraoperative electrophysiological validation of target for DBS surgery.
Learning Objectives: By the conclusion of this session, participants should be able to describe the importance of beta oscillatory activity in the STN.