Electrophysiological mapping for the implantation of deep brain stimulators for Parkinson's disease and tremor
Identifieur interne : 004765 ( Main/Merge ); précédent : 004764; suivant : 004766Electrophysiological mapping for the implantation of deep brain stimulators for Parkinson's disease and tremor
Auteurs : Robert E. Gross [États-Unis] ; Paul Krack [France] ; Maria C. Rodriguez-Oroz [Espagne] ; Ali R. Rezai [États-Unis] ; Alim-Louis Benabid [France]Source :
- Movement Disorders [ 0885-3185 ] ; 2006-06.
English descriptors
- KwdEn :
- Brain (surgery), Brain Mapping (methods), Deep Brain Stimulation (methods), Electrodes, Implanted, Globus Pallidus (anatomy & histology), Globus Pallidus (physiology), Humans, Microelectrodes, Parkinson Disease (complications), Parkinson Disease (surgery), Parkinson Disease (therapy), Subthalamic Nucleus (anatomy & histology), Subthalamic Nucleus (physiology), Tremor (etiology), Tremor (therapy), Ventral Thalamic Nuclei (physiology), globus pallidus, stimulation, subthalamic nucleus, ventral intermedius.
- MESH :
- anatomy & histology : Globus Pallidus, Subthalamic Nucleus.
- complications : Parkinson Disease.
- etiology : Tremor.
- methods : Brain Mapping, Deep Brain Stimulation.
- physiology : Globus Pallidus, Subthalamic Nucleus, Ventral Thalamic Nuclei.
- surgery : Brain, Parkinson Disease.
- therapy : Parkinson Disease, Tremor.
- Electrodes, Implanted, Humans, Microelectrodes.
Abstract
The vast majority of centers use electrophysiological mapping techniques to finalize target selection during the implantation of deep brain stimulation (DBS) leads for the treatment of Parkinson's disease and tremor. This review discusses the techniques used for physiological mapping and addresses the questions of how various mapping strategies modify target selection and outcome following subthalamic nucleus (STN), globus pallidus internus (GPi), and ventralis intermedius (Vim) deep brain stimulation. Mapping strategies vary greatly across centers, but can be broadly categorized into those that use microelectrode or semimicroelectrode techniques to optimize position prior to implantation and macrostimulation through a macroelectrode or the DBS lead, and those that rely solely on macrostimulation and its threshold for clinical effects (benefits and side effects). Microelectrode criteria for implantation into the STN or GPi include length of the nucleus recorded, presence of movement‐responsive neurons, and/or distance from the borders with adjacent structures. However, the threshold for the production of clinical benefits relative to side effects is, in most centers, the final, and sometimes only, determinant of DBS electrode position. Macrostimulation techniques for mapping, the utility of microelectrode mapping is reflected in its modification of electrode position in 17% to 87% of patients undergoing STN DBS, with average target adjustments of 1 to 4 mm. Nevertheless, with the absence of class I data, and in consideration of the large number of variables that impact clinical outcome, it is not possible to conclude that one technique is superior to the other in so far as motor Unified Parkinson's Disease Rating Scale outcome is concerned. Moreover, mapping technique is only one out of many variables that determine the outcome. The increase in surgical risk of intracranial hemorrhage correlated to the number of microelectrode trajectories must be considered against the risk of suboptimal benefits related to omission of this technique. © 2006 Movement Disorder Society
Url:
- https://api.istex.fr/document/B1528809FC653EA8BF1A04C37FDAC339B94062FB/fulltext/pdf
- http://www.hal.inserm.fr/inserm-00390675
DOI: 10.1002/mds.20960
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ISTEX:B1528809FC653EA8BF1A04C37FDAC339B94062FBLe document en format XML
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Rezai</name><affiliation wicri:level="2"><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Neurosurgery, Cleveland Clinic Foundation, Cleveland, Ohio</wicri:regionArea><placeName><region type="state">Ohio</region></placeName></affiliation></author><author><name sortKey="Benabid, Alim Ouis" sort="Benabid, Alim Ouis" uniqKey="Benabid A" first="Alim-Louis" last="Benabid">Alim-Louis Benabid</name><affiliation wicri:level="1"><country xml:lang="fr">France</country><wicri:regionArea>Department of Neurosurgery, Grenoble University Joseph Fourier, Grenoble</wicri:regionArea><placeName><settlement type="city">Grenoble</settlement></placeName><placeName><settlement type="city">Grenoble</settlement><region type="region" nuts="2">Auvergne-Rhône-Alpes</region><region type="old region" nuts="2">Rhône-Alpes</region></placeName><orgName type="hospital" n="4">Centre hospitalier universitaire Grenoble Alpes</orgName></affiliation></author></analytic><monogr></monogr><series><title level="j">Movement Disorders</title><title level="j" type="sub">Official Journal of the Movement Disorder Society</title><title level="j" type="abbrev">Mov. Disord.</title><idno type="ISSN">0885-3185</idno><idno type="eISSN">1531-8257</idno><imprint><publisher>Wiley Subscription Services, Inc., A Wiley Company</publisher><pubPlace>Hoboken</pubPlace><date type="published" when="2006-06">2006-06</date><biblScope unit="vol">21</biblScope><biblScope unit="issue">S14</biblScope><biblScope unit="supplement">14</biblScope><biblScope unit="page" from="S259">S259</biblScope><biblScope unit="page" to="S283">S283</biblScope></imprint><idno type="ISSN">0885-3185</idno></series><idno type="istex">B1528809FC653EA8BF1A04C37FDAC339B94062FB</idno><idno type="DOI">10.1002/mds.20960</idno><idno type="ArticleID">MDS20960</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0885-3185</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Brain (surgery)</term><term>Brain Mapping (methods)</term><term>Deep Brain Stimulation (methods)</term><term>Electrodes, Implanted</term><term>Globus Pallidus (anatomy & histology)</term><term>Globus Pallidus (physiology)</term><term>Humans</term><term>Microelectrodes</term><term>Parkinson Disease (complications)</term><term>Parkinson Disease (surgery)</term><term>Parkinson Disease (therapy)</term><term>Subthalamic Nucleus (anatomy & histology)</term><term>Subthalamic Nucleus (physiology)</term><term>Tremor (etiology)</term><term>Tremor (therapy)</term><term>Ventral Thalamic Nuclei (physiology)</term><term>globus pallidus</term><term>stimulation</term><term>subthalamic nucleus</term><term>ventral intermedius</term></keywords><keywords scheme="MESH" qualifier="anatomy & histology" xml:lang="en"><term>Globus Pallidus</term><term>Subthalamic Nucleus</term></keywords><keywords scheme="MESH" qualifier="complications" xml:lang="en"><term>Parkinson Disease</term></keywords><keywords scheme="MESH" qualifier="etiology" xml:lang="en"><term>Tremor</term></keywords><keywords scheme="MESH" qualifier="methods" xml:lang="en"><term>Brain Mapping</term><term>Deep Brain Stimulation</term></keywords><keywords scheme="MESH" qualifier="physiology" xml:lang="en"><term>Globus Pallidus</term><term>Subthalamic Nucleus</term><term>Ventral Thalamic Nuclei</term></keywords><keywords scheme="MESH" qualifier="surgery" xml:lang="en"><term>Brain</term><term>Parkinson Disease</term></keywords><keywords scheme="MESH" qualifier="therapy" xml:lang="en"><term>Parkinson Disease</term><term>Tremor</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Electrodes, Implanted</term><term>Humans</term><term>Microelectrodes</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">The vast majority of centers use electrophysiological mapping techniques to finalize target selection during the implantation of deep brain stimulation (DBS) leads for the treatment of Parkinson's disease and tremor. This review discusses the techniques used for physiological mapping and addresses the questions of how various mapping strategies modify target selection and outcome following subthalamic nucleus (STN), globus pallidus internus (GPi), and ventralis intermedius (Vim) deep brain stimulation. Mapping strategies vary greatly across centers, but can be broadly categorized into those that use microelectrode or semimicroelectrode techniques to optimize position prior to implantation and macrostimulation through a macroelectrode or the DBS lead, and those that rely solely on macrostimulation and its threshold for clinical effects (benefits and side effects). Microelectrode criteria for implantation into the STN or GPi include length of the nucleus recorded, presence of movement‐responsive neurons, and/or distance from the borders with adjacent structures. However, the threshold for the production of clinical benefits relative to side effects is, in most centers, the final, and sometimes only, determinant of DBS electrode position. Macrostimulation techniques for mapping, the utility of microelectrode mapping is reflected in its modification of electrode position in 17% to 87% of patients undergoing STN DBS, with average target adjustments of 1 to 4 mm. Nevertheless, with the absence of class I data, and in consideration of the large number of variables that impact clinical outcome, it is not possible to conclude that one technique is superior to the other in so far as motor Unified Parkinson's Disease Rating Scale outcome is concerned. Moreover, mapping technique is only one out of many variables that determine the outcome. The increase in surgical risk of intracranial hemorrhage correlated to the number of microelectrode trajectories must be considered against the risk of suboptimal benefits related to omission of this technique. © 2006 Movement Disorder Society</div></front></TEI><double doi="10.1002/mds.20960"><HAL><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Electrophysiological mapping for the implantation of deep brain stimulators for Parkinson's disease and tremor.</title><author><name sortKey="Gross, Robert" sort="Gross, Robert" uniqKey="Gross R" first="Robert" last="Gross">Robert Gross</name><affiliation wicri:level="1"><hal:affiliation type="laboratory" xml:id="struct-95818" status="INCOMING"><orgName>Department of Neurosurgery</orgName><desc><address><addrLine>Atlanta, Georgia</addrLine><country key="US"></country></address></desc><listRelation><relation active="#struct-322617" type="direct"></relation></listRelation><tutelles><tutelle active="#struct-322617" type="direct"><org type="institution" xml:id="struct-322617" status="INCOMING"><orgName>Emory University School of Medicine</orgName><desc><address><country key="FR"></country></address></desc></org></tutelle></tutelles></hal:affiliation><country>États-Unis</country></affiliation></author><author><name sortKey="Krack, Paul" sort="Krack, Paul" uniqKey="Krack P" first="Paul" last="Krack">Paul Krack</name><affiliation wicri:level="1"><hal:affiliation type="laboratory" xml:id="struct-14242" status="VALID"><orgName>Département de neurologie</orgName><desc><address><addrLine>Grenoble</addrLine><country key="FR"></country></address></desc><listRelation><relation active="#struct-51016" type="direct"></relation><relation active="#struct-300071" type="direct"></relation></listRelation><tutelles><tutelle active="#struct-51016" type="direct"><org type="institution" xml:id="struct-51016" status="VALID"><orgName>Université Joseph Fourier</orgName><orgName type="acronym">UJF</orgName><desc><address><addrLine>BP 53 - 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38041 Grenoble Cedex 9</addrLine><country key="FR"></country></address><ref type="url">http://www.ujf-grenoble.fr/</ref></desc></org></tutelle><tutelle active="#struct-300071" type="direct"><org type="institution" xml:id="struct-300071" status="VALID"><orgName>CHU Grenoble</orgName><desc><address><country key="FR"></country></address></desc></org></tutelle></tutelles></hal:affiliation><country>France</country><placeName><settlement type="city">Grenoble</settlement><region type="region" nuts="2">Auvergne-Rhône-Alpes</region><region type="old region" nuts="2">Rhône-Alpes</region></placeName><orgName type="university">Université Joseph Fourier</orgName><orgName type="institution" wicri:auto="newGroup">Université de Grenoble</orgName></affiliation></author><author><name sortKey="Rodriguez Oroz, Maria" sort="Rodriguez Oroz, Maria" uniqKey="Rodriguez Oroz M" first="Maria" last="Rodriguez-Oroz">Maria Rodriguez-Oroz</name><affiliation wicri:level="1"><hal:affiliation type="laboratory" xml:id="struct-95820" status="INCOMING"><orgName>University of Navarra</orgName><desc><address><addrLine>Pamplona</addrLine><country key="ES"></country></address></desc><listRelation><relation active="#struct-302368" type="direct"></relation></listRelation><tutelles><tutelle active="#struct-302368" type="direct"><org type="institution" xml:id="struct-302368" status="VALID"><orgName>Universidad de Navarra [Pamplona]</orgName><desc><address><addrLine>Campus Universitario, Plantas 1-5, 31080 Pamplona, Navarra</addrLine><country key="ES"></country></address><ref type="url">http://www.unav.edu/</ref></desc></org></tutelle></tutelles></hal:affiliation><country>Espagne</country></affiliation></author><author><name sortKey="Rezai, Ali" sort="Rezai, Ali" uniqKey="Rezai A" first="Ali" last="Rezai">Ali Rezai</name><affiliation wicri:level="1"><hal:affiliation type="laboratory" xml:id="struct-95821" status="INCOMING"><orgName>Department of Neurosurgery</orgName><desc><address><addrLine>Cleveland, Ohio</addrLine><country key="US"></country></address></desc><listRelation><relation active="#struct-306155" type="direct"></relation></listRelation><tutelles><tutelle active="#struct-306155" type="direct"><org type="institution" xml:id="struct-306155" status="INCOMING"><orgName>Cleveland Clinic Foundation</orgName><desc><address><country key="FR"></country></address></desc></org></tutelle></tutelles></hal:affiliation><country>États-Unis</country></affiliation></author><author><name sortKey="Benabid, Alim Louis" sort="Benabid, Alim Louis" uniqKey="Benabid A" first="Alim-Louis" last="Benabid">Alim-Louis Benabid</name><affiliation wicri:level="1"><hal:affiliation type="laboratory" xml:id="struct-92131" status="VALID"><orgName>Département de neurochirurgie</orgName><desc><address><country key="FR"></country></address></desc><listRelation><relation active="#struct-51016" type="direct"></relation><relation active="#struct-300071" type="direct"></relation></listRelation><tutelles><tutelle active="#struct-51016" type="direct"><org type="institution" xml:id="struct-51016" status="VALID"><orgName>Université Joseph Fourier</orgName><orgName type="acronym">UJF</orgName><desc><address><addrLine>BP 53 - 38041 Grenoble Cedex 9</addrLine><country key="FR"></country></address><ref type="url">http://www.ujf-grenoble.fr/</ref></desc></org></tutelle><tutelle active="#struct-300071" type="direct"><org type="institution" xml:id="struct-300071" status="VALID"><orgName>CHU Grenoble</orgName><desc><address><country key="FR"></country></address></desc></org></tutelle></tutelles></hal:affiliation><country>France</country><placeName><settlement type="city">Grenoble</settlement><region type="region" nuts="2">Auvergne-Rhône-Alpes</region><region type="old region" nuts="2">Rhône-Alpes</region></placeName><orgName type="university">Université Joseph Fourier</orgName><orgName type="institution" wicri:auto="newGroup">Université de Grenoble</orgName></affiliation></author></analytic><idno type="DOI">10.1002/mds.20960</idno><series><title level="j">Movement Disorders</title><idno type="ISSN">0885-3185</idno><imprint><date type="datePub">2006-06</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">The vast majority of centers use electrophysiological mapping techniques to finalize target selection during the implantation of deep brain stimulation (DBS) leads for the treatment of Parkinson's disease and tremor. This review discusses the techniques used for physiological mapping and addresses the questions of how various mapping strategies modify target selection and outcome following subthalamic nucleus (STN), globus pallidus internus (GPi), and ventralis intermedius (Vim) deep brain stimulation. Mapping strategies vary greatly across centers, but can be broadly categorized into those that use microelectrode or semimicroelectrode techniques to optimize position prior to implantation and macrostimulation through a macroelectrode or the DBS lead, and those that rely solely on macrostimulation and its threshold for clinical effects (benefits and side effects). Microelectrode criteria for implantation into the STN or GPi include length of the nucleus recorded, presence of movement-responsive neurons, and/or distance from the borders with adjacent structures. However, the threshold for the production of clinical benefits relative to side effects is, in most centers, the final, and sometimes only, determinant of DBS electrode position. Macrostimulation techniques for mapping, the utility of microelectrode mapping is reflected in its modification of electrode position in 17% to 87% of patients undergoing STN DBS, with average target adjustments of 1 to 4 mm. Nevertheless, with the absence of class I data, and in consideration of the large number of variables that impact clinical outcome, it is not possible to conclude that one technique is superior to the other in so far as motor Unified Parkinson's Disease Rating Scale outcome is concerned. Moreover, mapping technique is only one out of many variables that determine the outcome. The increase in surgical risk of intracranial hemorrhage correlated to the number of microelectrode trajectories must be considered against the risk of suboptimal benefits related to omission of this technique.</div></front></TEI></HAL><ISTEX><TEI wicri:istexFullTextTei="biblStruct"><teiHeader><fileDesc><titleStmt><title xml:lang="en">Electrophysiological mapping for the implantation of deep brain stimulators for Parkinson's disease and tremor</title><author><name sortKey="Gross, Robert E" sort="Gross, Robert E" uniqKey="Gross R" first="Robert E." last="Gross">Robert E. Gross</name></author><author><name sortKey="Krack, Paul" sort="Krack, Paul" uniqKey="Krack P" first="Paul" last="Krack">Paul Krack</name></author><author><name sortKey="Rodriguez Roz, Maria C" sort="Rodriguez Roz, Maria C" uniqKey="Rodriguez Roz M" first="Maria C." last="Rodriguez-Oroz">Maria C. Rodriguez-Oroz</name></author><author><name sortKey="Rezai, Ali R" sort="Rezai, Ali R" uniqKey="Rezai A" first="Ali R." last="Rezai">Ali R. Rezai</name></author><author><name sortKey="Benabid, Alim Ouis" sort="Benabid, Alim Ouis" uniqKey="Benabid A" first="Alim-Louis" last="Benabid">Alim-Louis Benabid</name><affiliation><country>France</country><placeName><settlement type="city">Grenoble</settlement><region type="region" nuts="2">Auvergne-Rhône-Alpes</region><region type="old region" nuts="2">Rhône-Alpes</region></placeName><orgName type="hospital" n="4">Centre hospitalier universitaire Grenoble Alpes</orgName></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">ISTEX</idno><idno type="RBID">ISTEX:B1528809FC653EA8BF1A04C37FDAC339B94062FB</idno><date when="2006" year="2006">2006</date><idno type="doi">10.1002/mds.20960</idno><idno type="url">https://api.istex.fr/document/B1528809FC653EA8BF1A04C37FDAC339B94062FB/fulltext/pdf</idno><idno type="wicri:Area/Istex/Corpus">000164</idno><idno type="wicri:Area/Istex/Curation">000164</idno><idno type="wicri:Area/Istex/Checkpoint">001F11</idno><idno type="wicri:doubleKey">0885-3185:2006:Gross R:electrophysiological:mapping:for</idno></publicationStmt><sourceDesc><biblStruct><analytic><title level="a" type="main" xml:lang="en">Electrophysiological mapping for the implantation of deep brain stimulators for Parkinson's disease and tremor</title><author><name sortKey="Gross, Robert E" sort="Gross, Robert E" uniqKey="Gross R" first="Robert E." last="Gross">Robert E. Gross</name><affiliation wicri:level="2"><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Neurosurgery, Emory University School of Medicine, Atlanta, Georgia</wicri:regionArea><placeName><region type="state">Géorgie (États-Unis)</region></placeName></affiliation></author><author><name sortKey="Krack, Paul" sort="Krack, Paul" uniqKey="Krack P" first="Paul" last="Krack">Paul Krack</name><affiliation wicri:level="1"><country xml:lang="fr">France</country><wicri:regionArea>Department of Neurology, Grenoble University, Grenoble</wicri:regionArea><placeName><settlement type="city">Grenoble</settlement></placeName></affiliation></author><author><name sortKey="Rodriguez Roz, Maria C" sort="Rodriguez Roz, Maria C" uniqKey="Rodriguez Roz M" first="Maria C." last="Rodriguez-Oroz">Maria C. Rodriguez-Oroz</name><affiliation wicri:level="1"><country xml:lang="fr">Espagne</country><wicri:regionArea>University of Navarra, Pamplona</wicri:regionArea><wicri:noRegion>Pamplona</wicri:noRegion></affiliation></author><author><name sortKey="Rezai, Ali R" sort="Rezai, Ali R" uniqKey="Rezai A" first="Ali R." last="Rezai">Ali R. Rezai</name><affiliation wicri:level="2"><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Neurosurgery, Cleveland Clinic Foundation, Cleveland, Ohio</wicri:regionArea><placeName><region type="state">Ohio</region></placeName></affiliation></author><author><name sortKey="Benabid, Alim Ouis" sort="Benabid, Alim Ouis" uniqKey="Benabid A" first="Alim-Louis" last="Benabid">Alim-Louis Benabid</name><affiliation wicri:level="1"><country xml:lang="fr">France</country><wicri:regionArea>Department of Neurosurgery, Grenoble University Joseph Fourier, Grenoble</wicri:regionArea><placeName><settlement type="city">Grenoble</settlement></placeName><placeName><settlement type="city">Grenoble</settlement><region type="region" nuts="2">Auvergne-Rhône-Alpes</region><region type="old region" nuts="2">Rhône-Alpes</region></placeName><orgName type="hospital" n="4">Centre hospitalier universitaire Grenoble Alpes</orgName></affiliation></author></analytic><monogr></monogr><series><title level="j">Movement Disorders</title><title level="j" type="sub">Official Journal of the Movement Disorder Society</title><title level="j" type="abbrev">Mov. Disord.</title><idno type="ISSN">0885-3185</idno><idno type="eISSN">1531-8257</idno><imprint><publisher>Wiley Subscription Services, Inc., A Wiley Company</publisher><pubPlace>Hoboken</pubPlace><date type="published" when="2006-06">2006-06</date><biblScope unit="vol">21</biblScope><biblScope unit="issue">S14</biblScope><biblScope unit="supplement">14</biblScope><biblScope unit="page" from="S259">S259</biblScope><biblScope unit="page" to="S283">S283</biblScope></imprint><idno type="ISSN">0885-3185</idno></series><idno type="istex">B1528809FC653EA8BF1A04C37FDAC339B94062FB</idno><idno type="DOI">10.1002/mds.20960</idno><idno type="ArticleID">MDS20960</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0885-3185</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>globus pallidus</term><term>stimulation</term><term>subthalamic nucleus</term><term>ventral intermedius</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">The vast majority of centers use electrophysiological mapping techniques to finalize target selection during the implantation of deep brain stimulation (DBS) leads for the treatment of Parkinson's disease and tremor. This review discusses the techniques used for physiological mapping and addresses the questions of how various mapping strategies modify target selection and outcome following subthalamic nucleus (STN), globus pallidus internus (GPi), and ventralis intermedius (Vim) deep brain stimulation. Mapping strategies vary greatly across centers, but can be broadly categorized into those that use microelectrode or semimicroelectrode techniques to optimize position prior to implantation and macrostimulation through a macroelectrode or the DBS lead, and those that rely solely on macrostimulation and its threshold for clinical effects (benefits and side effects). Microelectrode criteria for implantation into the STN or GPi include length of the nucleus recorded, presence of movement‐responsive neurons, and/or distance from the borders with adjacent structures. However, the threshold for the production of clinical benefits relative to side effects is, in most centers, the final, and sometimes only, determinant of DBS electrode position. Macrostimulation techniques for mapping, the utility of microelectrode mapping is reflected in its modification of electrode position in 17% to 87% of patients undergoing STN DBS, with average target adjustments of 1 to 4 mm. Nevertheless, with the absence of class I data, and in consideration of the large number of variables that impact clinical outcome, it is not possible to conclude that one technique is superior to the other in so far as motor Unified Parkinson's Disease Rating Scale outcome is concerned. Moreover, mapping technique is only one out of many variables that determine the outcome. The increase in surgical risk of intracranial hemorrhage correlated to the number of microelectrode trajectories must be considered against the risk of suboptimal benefits related to omission of this technique. © 2006 Movement Disorder Society</div></front></TEI></ISTEX><PubMed><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Electrophysiological mapping for the implantation of deep brain stimulators for Parkinson's disease and tremor.</title><author><name sortKey="Gross, Robert E" sort="Gross, Robert E" uniqKey="Gross R" first="Robert E" last="Gross">Robert E. Gross</name><affiliation wicri:level="1"><nlm:affiliation>Department of Neurosurgery, Emory University School of Medicine, Atlanta, Georgia 30322, USA. robert_gross@emory.org</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Neurosurgery, Emory University School of Medicine, Atlanta, Georgia 30322</wicri:regionArea><wicri:noRegion>Georgia 30322</wicri:noRegion></affiliation></author><author><name sortKey="Krack, Paul" sort="Krack, Paul" uniqKey="Krack P" first="Paul" last="Krack">Paul Krack</name></author><author><name sortKey="Rodriguez Oroz, Maria C" sort="Rodriguez Oroz, Maria C" uniqKey="Rodriguez Oroz M" first="Maria C" last="Rodriguez-Oroz">Maria C. Rodriguez-Oroz</name></author><author><name sortKey="Rezai, Ali R" sort="Rezai, Ali R" uniqKey="Rezai A" first="Ali R" last="Rezai">Ali R. Rezai</name></author><author><name sortKey="Benabid, Alim Louis" sort="Benabid, Alim Louis" uniqKey="Benabid A" first="Alim-Louis" last="Benabid">Alim-Louis Benabid</name></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2006">2006</date><idno type="doi">10.1002/mds.20960</idno><idno type="RBID">pubmed:16810720</idno><idno type="pmid">16810720</idno><idno type="wicri:Area/PubMed/Corpus">002B79</idno><idno type="wicri:Area/PubMed/Curation">002B79</idno><idno type="wicri:Area/PubMed/Checkpoint">002D42</idno><idno type="wicri:Area/Ncbi/Merge">001757</idno><idno type="wicri:Area/Ncbi/Curation">001757</idno><idno type="wicri:Area/Ncbi/Checkpoint">001757</idno><idno type="wicri:doubleKey">0885-3185:2006:Gross R:electrophysiological:mapping:for</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Electrophysiological mapping for the implantation of deep brain stimulators for Parkinson's disease and tremor.</title><author><name sortKey="Gross, Robert E" sort="Gross, Robert E" uniqKey="Gross R" first="Robert E" last="Gross">Robert E. Gross</name><affiliation wicri:level="1"><nlm:affiliation>Department of Neurosurgery, Emory University School of Medicine, Atlanta, Georgia 30322, USA. robert_gross@emory.org</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Neurosurgery, Emory University School of Medicine, Atlanta, Georgia 30322</wicri:regionArea><wicri:noRegion>Georgia 30322</wicri:noRegion></affiliation></author><author><name sortKey="Krack, Paul" sort="Krack, Paul" uniqKey="Krack P" first="Paul" last="Krack">Paul Krack</name></author><author><name sortKey="Rodriguez Oroz, Maria C" sort="Rodriguez Oroz, Maria C" uniqKey="Rodriguez Oroz M" first="Maria C" last="Rodriguez-Oroz">Maria C. Rodriguez-Oroz</name></author><author><name sortKey="Rezai, Ali R" sort="Rezai, Ali R" uniqKey="Rezai A" first="Ali R" last="Rezai">Ali R. Rezai</name></author><author><name sortKey="Benabid, Alim Louis" sort="Benabid, Alim Louis" uniqKey="Benabid A" first="Alim-Louis" last="Benabid">Alim-Louis Benabid</name></author></analytic><series><title level="j">Movement disorders : official journal of the Movement Disorder Society</title><idno type="ISSN">0885-3185</idno><imprint><date when="2006" type="published">2006</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Brain (surgery)</term><term>Brain Mapping (methods)</term><term>Deep Brain Stimulation (methods)</term><term>Electrodes, Implanted</term><term>Globus Pallidus (anatomy & histology)</term><term>Globus Pallidus (physiology)</term><term>Humans</term><term>Microelectrodes</term><term>Parkinson Disease (complications)</term><term>Parkinson Disease (surgery)</term><term>Parkinson Disease (therapy)</term><term>Subthalamic Nucleus (anatomy & histology)</term><term>Subthalamic Nucleus (physiology)</term><term>Tremor (etiology)</term><term>Tremor (therapy)</term><term>Ventral Thalamic Nuclei (physiology)</term></keywords><keywords scheme="MESH" qualifier="anatomy & histology" xml:lang="en"><term>Globus Pallidus</term><term>Subthalamic Nucleus</term></keywords><keywords scheme="MESH" qualifier="complications" xml:lang="en"><term>Parkinson Disease</term></keywords><keywords scheme="MESH" qualifier="etiology" xml:lang="en"><term>Tremor</term></keywords><keywords scheme="MESH" qualifier="methods" xml:lang="en"><term>Brain Mapping</term><term>Deep Brain Stimulation</term></keywords><keywords scheme="MESH" qualifier="physiology" xml:lang="en"><term>Globus Pallidus</term><term>Subthalamic Nucleus</term><term>Ventral Thalamic Nuclei</term></keywords><keywords scheme="MESH" qualifier="surgery" xml:lang="en"><term>Brain</term><term>Parkinson Disease</term></keywords><keywords scheme="MESH" qualifier="therapy" xml:lang="en"><term>Parkinson Disease</term><term>Tremor</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Electrodes, Implanted</term><term>Humans</term><term>Microelectrodes</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">The vast majority of centers use electrophysiological mapping techniques to finalize target selection during the implantation of deep brain stimulation (DBS) leads for the treatment of Parkinson's disease and tremor. This review discusses the techniques used for physiological mapping and addresses the questions of how various mapping strategies modify target selection and outcome following subthalamic nucleus (STN), globus pallidus internus (GPi), and ventralis intermedius (Vim) deep brain stimulation. Mapping strategies vary greatly across centers, but can be broadly categorized into those that use microelectrode or semimicroelectrode techniques to optimize position prior to implantation and macrostimulation through a macroelectrode or the DBS lead, and those that rely solely on macrostimulation and its threshold for clinical effects (benefits and side effects). Microelectrode criteria for implantation into the STN or GPi include length of the nucleus recorded, presence of movement-responsive neurons, and/or distance from the borders with adjacent structures. However, the threshold for the production of clinical benefits relative to side effects is, in most centers, the final, and sometimes only, determinant of DBS electrode position. Macrostimulation techniques for mapping, the utility of microelectrode mapping is reflected in its modification of electrode position in 17% to 87% of patients undergoing STN DBS, with average target adjustments of 1 to 4 mm. Nevertheless, with the absence of class I data, and in consideration of the large number of variables that impact clinical outcome, it is not possible to conclude that one technique is superior to the other in so far as motor Unified Parkinson's Disease Rating Scale outcome is concerned. Moreover, mapping technique is only one out of many variables that determine the outcome. The increase in surgical risk of intracranial hemorrhage correlated to the number of microelectrode trajectories must be considered against the risk of suboptimal benefits related to omission of this technique.</div></front></TEI></PubMed></double></record>Pour manipuler ce document sous Unix (Dilib)
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