Multiple Microelectrode Placements Improves Treatment With Subthalamic DBS for Parkinson Disease

Using multiple microelectrode recordings to determine optimal electrode placement in subthalamic nucleus deep brain stimulation (STN-DBS) for 12 months results in significantly greater improvements in disease burden and quality of life for patients with Parkinson disease than using single sequential microelectrodes for the surgery, according to a study published in Movement Disorders Clinical Practice.

This current randomized, controlled study sought to assess the value of using three-dimensional subthalamic nucleus mapping to determine optimal placement of multiple electrodes during DBS vs single sequential electrodes. Of the 76 patients who underwent STN-DBS between April 2009 and December 2013 at Oslo University Hospital, 60 were enrolled in the study, with 55 ultimately included in analysis (29 in the single microelectrode group, and 26 in the multiple microelectrode group).

From baseline to 12 months, the patients’ Movement Disorder Society revised Unified Parkinson Disease Rating Scale scores were 35 in the multiple microelectrode group and 26 in the single microelectrode group (P =.004), and the Parkinson Disease Questionaire-39 (PDQ-39) summary index improvement scores were 7.8 for the multiple microelectrode group and 2.9 for the single microelectrode group (P =.208). Four of the 8 PDQ-39 domains showed significant improvement for the multiple electrodes group vs 3 in the single electrode group. Bodily discomfort and activities of daily living improved significantly more for the multiple electrode group (P =.048 and P =.024). There was no difference in incidence of serious adverse events between groups, and no one experienced epileptic seizures, intracranial hemorrhages, or mortality.

Study investigators conclude that “even though MRI techniques have evolved over the last years, they will never be able to provide electrophysiological information about the target area. We consider that such information is beneficial for optimal target localization and that our findings indicate a benefit from using multiple [microelectrode recordings] introduced simultaneously during STN-DBS surgery.”

Reference

Bjerknes S, Toft M, Konglund AE, et al. Multiple microelectrode recordings in stn-dbs surgery for parkinson’s disease: a randomized study. Mov Disord Clin Pract. 2018;5(3):296-305.