Abstract
BACKGROUND: Using electrocorticography for research (R-ECoG) during deep brain stimulation (DBS) surgery has advanced our understanding of human cortical-basal ganglia neurophysiology and mechanisms of therapeutic circuit modulation. The safety of R-ECoG has been established, but potential effects of temporary ECoG strip placement on targeting accuracy have not been reported. OBJECTIVE: To determine whether temporary subdural electrode strip placement during DBS implantation surgery affects lead implantation accuracy. METHODS: Twenty-four consecutive patients enrolled in a prospective database who underwent awake DBS surgery were identified. Ten of 24 subjects participated in R-ECoG. Lead locations were determined after fusing postoperative computed tomography scans into the surgical planning software. The effect of brain shift was quantified using Lead-DBS and analyzed in a mixed-effects model controlling for time interval to postoperative computed tomography. Targeting accuracy was reported as radial and Euclidean distance errors and compared with Mann–Whitney tests. RESULTS: Neither radial error nor Euclidean distance error differed significantly between R-ECoG participants and nonparticipants. Pneumocephalus volume did not differ between the 2 groups, but brain shift was slightly greater with R-ECoG. Pneumocephalus volume correlated with brain shift, but neither of these measures significantly correlated with Euclidean distance error. There were no complications in either group. CONCLUSION: In addition to an excellent general safety profile as has been reported previously, these results suggest that performing R-ECoG during DBS implantation surgery does not affect the accuracy of lead placement.
Original language | English |
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Pages (from-to) | 524-532 |
Number of pages | 9 |
Journal | Operative Neurosurgery |
Volume | 24 |
Issue number | 5 |
DOIs | |
State | Published - 1 May 2023 |
Externally published | Yes |
Bibliographical note
Publisher Copyright:© Congress of Neurological Surgeons 2022. All rights reserved.
Funding
This work was funded by the National Institute of Health (BRAIN Initiative), through grant U01NS117836 to Dr Richardson and K23NS099380 to Dr Herrington.
Funders | Funder number |
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National Institutes of Health | U01NS117836, K23NS099380 |
Keywords
- Deep brain stimulation
- Electrocorticography
- Microelectrode recording
- Movement disorders
- Stereotactic targeting