S62 Can We Improve Deep Brain Stimulation Targeting with Neurophysiological Recording?

Deep Brain Stimulation (DBS) is a well established therapy mainly for some movement disorders, like Parkinson’s disease (PD). However there is not agreement about which approach for targeting the different nuclei is more appropriate. The main objective was to compare the targeting of the subthalamic nucleus (STN) in PD patients with unitary activity recording (MER) alone versus MER combined with the simultaneous recording of the local field potential (LFP) through the same microelectrode. The methods included thirty consecutive PD patients undergone surgical DBS procedure in the STN that were divided in two groups of fifteen patients. For the first group the electrophysiological procedure consisted in MER only and for the second group LFP recording was also performed. The main results obtained were that in the Z-axis the length, defined as the presence of beta-activity, of the sensoriomotor region is shorter that the global length of the STN. The electrophysiological procedure was around 20 min shorter in each brain side combining together MER and LFP. There is an open debate about the functional-based methods to target deep brain structures for DBS versus image-based methods with a bias to the latter. An image-based procedure does not gives functional information and the objective of the DBS is a functional modulation of neuronal circuits. In conclusion MER together LFP give functional information that allows a more accurate placement of the DBS leads improving the outcomes of the therapy and does not increase the risk of bleeding in microelectrode trajectories.