Accurate Deep Brain Stimulation Lead Placement Concurrent With Research Electrocorticography

Zachary Kons, Amir Hadanny, Alan Bush, Pranav Nanda, Todd M. Herrington, R. Mark Richardson

Research output: Contribution to journalArticlepeer-review

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 languageEnglish
Pages (from-to)524-532
Number of pages9
JournalOperative Neurosurgery
Volume24
Issue number5
DOIs
StatePublished - 1 May 2023
Externally publishedYes

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.

FundersFunder number
National Institutes of HealthU01NS117836, K23NS099380

    Keywords

    • Deep brain stimulation
    • Electrocorticography
    • Microelectrode recording
    • Movement disorders
    • Stereotactic targeting

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