Intra-Operative Electrophysiology:

Deep Brain Stimulators for Parkinson's Disease:

Intra-Operative Electrophysiology:

Deep Brain Stimulators for Parkinson's Disease
Mini Presentation (ppt) - Dr Emad Eskandar, MD

Subthalamic StimulationFor Parkinson’s Disease

• The subthalamic nucleus (STN) is overactive in Parkinson’s Disease.
• Placement of deep brain stimulators causes inactivation of subthalamic nucleus.
• Deep brain stimulators are adjustable allowing for maximum benefit and minimal side-effects.
• Early results are very promising.
• STN is a small nucleus requiring advanced imaging and neurophysiologic techniques for optimal localization.
  

Localization of STN

• Patients first undergo stereotactic localization using MRI and CT imaging to optimize localization.
• The optimal location is confirmed by recording the activity of single neurons using an array of micro-electrodes.
• Electrodes are advanced using a specialized microdrive.
• Signal is displayed on a computer monitor and, as and audio signal.
• Analysis of electrode recordings allows for high degree of precision in stimulator placement.
  

Deep Brain Stimulation at MGH

• No significant complications.
• Early results are promising.
• Future potential applications include treatment of dystonia, chronic pain, and depression.
• Future improvements will involve correlating physiologic data with intra-operative CT and MRI.