Turkish Neurosurgery
Comparison of Electrophysiological and Radiological Subthalamic Nucleus Length and Volume
Bekir Tuğcu1, Ozan Haşimoğlu1, Ayça Altınkaya2, Ozan Barut1, Taha Hanoğlu1
1University of Health Sciences, Hamidiye Faculty of Medicine, Başakşehir Çam and Sakura City Hospital, Neurosurgery , İstanbul,
2University of Health Sciences, Hamidiye Faculty of Medicine, Başakşehir Çam and Sakura City Hospital, Neurology, istanbul,
DOI: 10.5137/1019-5149.JTN.42157-22.1

Aim:Subthalamic nucleus (STN) deep brain stimulation (DBS) is a well-accepted treatment in patients with advanced Parkinson\'s disease (PD). Radiology based preoperative planning is the most critical step in this surgical procedure. This surgical technique can be refined and improved with using intraoperative microelectrode recording (MER). We aimed to demonstrate consistency between preoperative radiologic STN volume and intraoperative neurophysiologic STN length.Material and Methods:Sixty-one patients with PD were enrolled. The volumes of the STN were measured using magnetic resonance images 3-dimensional volume reconstructions of stereotactic magnetic resonance images. MER were performed in all patient and the maximal electrophysiologic length of the STN was recorded each patient. In the postoperative period, the permanent electrode was modeled and reconstructed in 3D, and the longest distance traveled in the STN was calculatedResults:Sixty-one patients (122 STNs) who underwent surgery between 2012-2022 were included in the study. Thirty-six (59%) of the patients were male, and 25 (41%) were female. We used a total of 166 electrodes. The most common end alignment used was center with 86. STN length averaged 4.9 mm (0-10.5 mm). The mean STN volume was 0.11 cm3. The STN Volume of men were significantly higher than women. The STN Length, Volume, and the target MER length showed a positive correlation significantly.Conclusion:With radiological advances, it is possible to better visualize the target points and define the boundaries better, and direct methods can be used more in making targeting plans. MER records obtained during surgery and STN dimensions in pre-surgical planning show compatibility, and it is seen that there may be differences between the right and left sides because of brain shifting. Although radiology is increasingly providing better support, electrophysiological recordings provides real-time information on the electrodes\' locations and give the opportunity to surgical team choosing alternative target.

Corresponding author : Bekir Tuğcu