March 2012
Janssen
ML, Zwartjes DG, Temel Y, van Kranen-Mastenbroek V, Duits A, Bour LJ, Veltink
PH, Heida T, Visser-Vandewalle V
Background: Deep
brain stimulation of the subthalamic nucleus alleviates motor symptoms
in Parkinson's disease patients. However, some patients suffer from
cognitive and emotional changes. These side effects are most likely
caused by current spread to the cognitive and limbic territories in the
subthalamic nucleus. The aim of this study was to identify the motor
part of the subthalamic nucleus to reduce stimulation-induced behavioral
side effects, by using motor cortex stimulation.
Methods: We
describe the results of subthalamic nucleus neuronal responses to
stimulation of the hand area of the motor cortex and evaluate the safety
of this novel technique.
Results: Responses
differed between regions within the subthalamic nucleus. In the
anterior and lateral electrode at dorsal levels of the subthalamic
nucleus, an early excitation (∼5–45 ms) and subsequent inhibition
(45–105 ms) were seen. The lateral electrode also showed a late
excitation (∼125–160 ms). Focal seizures were observed following motor
cortex stimulation.
Conclusions: To
prevent seizures the current density should be lowered, so that motor
cortex stimulation-evoked responses can be safely used during deep brain
stimulation surgery.
