Intraoperative micro- and macrostimulation of the subthalamic nucleus in Parkinson's disease

Authors

  • Pierre Pollak MD,

    Corresponding author
    1. Department of Clinical and Biological Neurosciences, Service de Neurologie, Centre Hospitalier Universitaire de Grenoble, Grenoble, France
    2. INSERM Unit 318, Joseph Fourier University, Grenoble, France
    • Department of Neurology, University of Grenoble, BP 217, 38043 Grenoble Cedex 9, France
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  • Paul Krack MD,

    1. Department of Clinical and Biological Neurosciences, Service de Neurologie, Centre Hospitalier Universitaire de Grenoble, Grenoble, France
    2. INSERM Unit 318, Joseph Fourier University, Grenoble, France
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  • Valérie Fraix MD,

    1. Department of Clinical and Biological Neurosciences, Service de Neurologie, Centre Hospitalier Universitaire de Grenoble, Grenoble, France
    2. INSERM Unit 318, Joseph Fourier University, Grenoble, France
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  • Alexandre Mendes MD,

    1. Department of Clinical and Biological Neurosciences, Service de Neurologie, Centre Hospitalier Universitaire de Grenoble, Grenoble, France
    2. INSERM Unit 318, Joseph Fourier University, Grenoble, France
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  • Elena Moro MD,

    1. Department of Clinical and Biological Neurosciences, Service de Neurologie, Centre Hospitalier Universitaire de Grenoble, Grenoble, France
    2. INSERM Unit 318, Joseph Fourier University, Grenoble, France
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  • Stephan Chabardes MD,

    1. INSERM Unit 318, Joseph Fourier University, Grenoble, France
    2. Department of Clinical and Biological Neurosciences, Service de Neurochirurgie, Centre Hospitalier Universitaire de Grenoble, Grenoble, France
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  • Alim-Louis Benabid MD, PhD

    1. INSERM Unit 318, Joseph Fourier University, Grenoble, France
    2. Department of Clinical and Biological Neurosciences, Service de Neurochirurgie, Centre Hospitalier Universitaire de Grenoble, Grenoble, France
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Abstract

Studying the clinical effects induced by electrical stimulation of the subthalamic nucleus (STN) area in a parkinsonian patient under local anesthesia is a mandatory step to determine the precise location of the final chronic electrode. Using multiple microelectrodes, preferably in a concentric parallel array allows a precise mapping of the STN region. The most reliable features to determine the suitable target are stimulation-induced dyskinesias and rigidity decrease at a low intensity without adverse effects or only at far higher intensities. New skills are needed to assess all stimulation-induced effects and interpret them in anatomo-functional terms. © 2002 Movement Disorder Society

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