Deep brain stimulation: overview and update

Abstract

Objective: To summarize the techniques for physiological localization that contribute to increased accuracy in the surgical treatment of movement disorders.

Methods: Initial targeting through imaging referenced to stereotactic atlas are confirmed through physiological localization. Spontaneous recording, elicited recording, evoked potentials and stimulation provided physiological localization for target confirmation in the placement of lesions or DBS.

Results: Imaging and stereotactic techniques produce inaccuracy that may be address by physiological localization. Microelectrode recording from basal ganglia and thalamic sites provides signature neuronal patterns to confirm and guide the trajectory. Spontaneous and elicited neuronal response are recorded from microelectrodes.

Conclusions: Accuracy of movement disorders surgery is enhance through use of physiological localization. A multimodality approach provides techniques that allow localization in a variety of patient and environmental conditions.