Our Summary

This research paper discusses a study that looked at whether using a certain method during deep brain stimulation (DBS) surgery affects how accurately the leads (thin wires) are placed in the brain. The method in question is called electrocorticography (ECoG), which is used to monitor the electrical activity of the brain.

The researchers examined 24 patients who had DBS surgery. Ten of these patients also had ECoG during their procedures. After the surgeries, the researchers used CT scans and special software to figure out exactly where the leads were placed. They also looked at how much the brains had shifted during surgery, and whether there was any air in the skull (pneumocephalus), as both of these factors could potentially affect lead placement.

The results showed no significant differences in lead placement accuracy between the patients who had ECoG and those who didn’t. The amount of air in the skull was also similar in both groups. The brains of the patients who had ECoG did shift a bit more during surgery, but this didn’t seem to affect the accuracy of the lead placement.

In conclusion, the study found that using ECoG during DBS surgery doesn’t appear to affect how accurately the leads are placed. This is good news, as ECoG is a useful tool for understanding how the brain works and how DBS affects it.

FAQs

  1. Does the use of electrocorticography during deep brain stimulation surgery affect the accuracy of lead implantation?
  2. Was there a significant difference in the error measurements between those who participated in R-ECoG and those who did not during the DBS surgery?
  3. Did the volume of pneumocephalus correlate with brain shift or Euclidean distance error during the DBS implantation surgery?

Doctor’s Tip

A helpful tip a doctor might tell a patient about brain surgery is to discuss any concerns or questions they have with their surgical team before the procedure. It is important for the patient to feel informed and comfortable with the process in order to have the best possible outcome.

Suitable For

Patients with conditions such as Parkinson’s disease, essential tremor, dystonia, epilepsy, and Tourette syndrome are typically recommended for brain surgery, specifically deep brain stimulation (DBS) surgery. These patients may have not responded well to medication or other treatments, and DBS surgery can be an effective option to help manage their symptoms. Additionally, patients with brain tumors, arteriovenous malformations, or other structural abnormalities in the brain may also be recommended for brain surgery to remove or treat the underlying condition.

Timeline

Before brain surgery:

  1. Patient meets with neurosurgeon to discuss surgery and potential risks and benefits.
  2. Patient undergoes preoperative testing, such as MRI or CT scans, to determine the location of the brain lesion.
  3. Patient may undergo psychological evaluation and counseling to prepare for surgery.
  4. Patient may need to adjust medication regimen leading up to surgery.

During brain surgery:

  1. Patient is brought into the operating room and prepared for surgery.
  2. Anesthesia is administered to put the patient to sleep.
  3. Surgeon makes an incision in the scalp and removes a portion of the skull to access the brain.
  4. Surgeon performs the necessary procedure on the brain, such as tumor removal or deep brain stimulation electrode implantation.
  5. If necessary, temporary subdural electrode strip may be placed for recording electrocorticography data.
  6. Surgeon closes the incision and the patient is taken to recovery.

After brain surgery:

  1. Patient wakes up in the recovery room and is monitored closely for any complications.
  2. Patient may need to stay in the hospital for a few days for observation.
  3. Patient may experience side effects such as headache, nausea, or fatigue.
  4. Patient undergoes postoperative testing, such as MRI or CT scans, to assess the success of the surgery and placement of any devices.
  5. Patient may need to attend follow-up appointments with the neurosurgeon for monitoring and adjustments to treatment plan.
  6. Patient may undergo rehabilitation therapy to regain cognitive or motor function.

What to Ask Your Doctor

  1. What is the purpose of using electrocorticography during my brain surgery?
  2. How will the temporary subdural electrode strip placement affect the accuracy of the lead implantation?
  3. Are there any potential risks or complications associated with using electrocorticography during the surgery?
  4. How will the information gathered from the electrocorticography be used in my treatment plan?
  5. How will the results of the surgery be evaluated to ensure the lead was placed accurately?
  6. Will the use of electrocorticography prolong the duration of the surgery or recovery time?
  7. Are there any specific post-operative care instructions or precautions I should be aware of if electrocorticography is used during the surgery?
  8. How will my progress be monitored after the surgery, particularly in relation to the information gathered from the electrocorticography?
  9. Are there any alternative techniques or approaches that could be considered instead of using electrocorticography during the surgery?
  10. What are the potential long-term benefits of using electrocorticography during the surgery in terms of my overall treatment outcomes?

Reference

Authors: Kons Z, Hadanny A, Bush A, Nanda P, Herrington TM, Richardson RM. Journal: Oper Neurosurg. 2023 May 1;24(5):524-532. doi: 10.1227/ons.0000000000000582. Epub 2022 Dec 23. PMID: 36701668