Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2022;12(7):2059-2069.
doi: 10.3233/JPD-223333.

The Role of Microelectrode Recording in Deep Brain Stimulation Surgery for Parkinson's Disease: A Systematic Review and Meta-Analysis

R Saman Vinke  1 , Martin Geerlings  1 , Ashok K Selvaraj  1 , Dejan Georgiev  2   3 , Bastiaan R Bloem  4 , Rianne A J Esselink  4 , Ronald H M A Bartels  1
Affiliations
Meta-Analysis

The Role of Microelectrode Recording in Deep Brain Stimulation Surgery for Parkinson's Disease: A Systematic Review and Meta-Analysis

R Saman Vinke et al. J Parkinsons Dis. 2022.

Abstract

Background: STN-DBS is a cornerstone in the treatment of advanced Parkinson's disease (PD). The traditional approach is to use an awake operative technique with microelectrode recording (MER). However, more centers start using an asleep MRI-guided technique without MER.

Objective: We systematically reviewed the literature to compare STN-DBS surgery with and without MER for differences in clinical outcome.

Methods: We systematically searched PubMed, Embase, MEDLINE, and Web of Science databases for randomized clinical trials and consecutive cohort studies published between 01-01-2000 and 26-08-2021, that included at least 10 PD patients who had received bilateral STN-DBS.

Results: 2,129 articles were identified. After abstract screening and full-text review, 26 studies were included in the final analysis, comprising a total of 34 study groups (29 MER and 5 non-MER). The standardized mean difference (SMD) in change in motor symptoms between baseline (OFF medication) and 6-24 months follow-up (OFF medication and ON stimulation) was 1.64 for the MER group and 1.87 for non-MER group (p = 0.59). SMD in change in levodopa equivalent daily dose (LEDD) was 1.14 for the MER group and 0.65 for non-MER group (p < 0.01). Insufficient data were available for comparative analysis of PDQ-39 and complications.

Conclusion: The change in motor symptoms from baseline to follow-up did not differ between studies that used MER and those that did not. The postoperative reduction in LEDD from baseline to follow-up was greater in the MER-group. In the absence of high-quality studies comparing both methods, there is a clear need for a well-designed comparative trial.

Keywords: Deep brain stimulation; MRI; Parkinson’s disease; microelectrode recording; subthalamic nucleus.

PubMed Disclaimer

Conflict of interest statement

The authors report no conflicts of interest and have nothing to disclose related to the research in this manuscript.

Figures

Fig. 1
Fig. 1
Flow diagram summarizing the literature review and the process of selection for the articles ultimately included in the meta-analysis.
Fig. 2
Fig. 2
Forest plot of the standardized mean difference of the UPDRS-III of A) MER group and B) non-MER group.
Fig. 3
Fig. 3
Forest plot of the standardized mean difference of the LEDD of A) MER group and B) non-MER group.
See this image and copyright information in PMC

References

    1. Dorsey ER, Bloem BR (2018) The Parkinson pandemic-a call to action. JAMA Neurol 75, 9–10. - PubMed
    1. Abosch A, Timmermann L, Bartley S, Rietkerk HG, Whiting D, Connolly PJ, Lanctin D, Hariz MI (2013) An international survey of deep brain stimulation procedural steps. Stereotact Funct Neurosurg 91, 1–11. - PubMed
    1. Wodarg F, Herzog J, Reese R, Falk D, Pinsker MO, Steigerwald F, Jansen O, Deuschl G, Mehdorn HM, Volkmann J (2012) Stimulation site within the MRI-defined STN predicts postoperative motor outcome. Mov Disord 27, 874–879. - PubMed
    1. Bos MJ, de Korte-de Boer D, Alzate Sanchez AM, Duits A, Ackermans L, Temel Y, Absalom AR, Buhre WF, Roberts MJ, Janssen MLF (2021) Impact of procedural sedation on the clinical outcome of microelectrode recording guided deep brain stimulation in patients with Parkinson’s disease. J Clin Med 10, 1557. - PMC - PubMed
    1. Lefranc M, Zouitina Y, Tir M, Merle P, Ouendo M, Constans JM, Godefroy O, Peltier J, Krystkowiak P (2017) Asleep robot-assisted surgery for the implantation of subthalamic electrodes provides the same clinical improvement and therapeutic window as awake surgery. World Neurosurg 106, 602–608. - PubMed