Identification of Somatotopic Organization and Optimal Stimulation Site Within the Subthalamic Nucleus for Parkinson's Disease

Tatsuya Sasaki, Ken Kuwahara, Ittetsu Kin, Mihoko Okazaki, Susumu Sasada, Aiko Shinko, Masahiro Kameda, Takao Yasuhara, Takashi Agari, Isao Date

Research output: Contribution to journalArticle

Abstract

BACKGROUND: Details of the somatotopy within the subthalamic nucleus (STN) are still poorly understood; however, the STN is a common target of deep brain stimulation (DBS) for Parkinson disease. OBJECTIVE: To examine somatotopic organization within the STN and identify optimal stimulation sites from 77 surgical cases with microelectrode recording. METHODS: STN-DBS was performed for 77 patients with Parkinson disease between 2010 and 2014. We performed passive movements of each joint and captured single neuronal activities to identify movement-related cells (MRCs). The sites of MRCs and active contacts were determined by measuring their distances from the first contact of DBS electrode. Their positional correlations were directly and indirectly analyzed. RESULTS: The number of obtained MRCs was 264, of which 151 responded to multiple joints. The average x-, y-, and z-coordinates of the cells of the upper and lower limbs from the midcommisural point were 13.1 ± 1.1 and 12.7 ± 1.2, 0.22 ± 1.3 and-0.45 ± 1.5, and-2.5 ± 1.1 and-3.0 ± 1.4 mm, respectively. Most MRCs were distributed in the upper third of the STN, in its superior, lateral, and posterior regions, along the DBS electrode routes. Active contacts were observed to lie slightly inferior, medial, and posterior to the average MRC position. CONCLUSION: Somatotopic organization of the STN was easier to observe in the present study than in previous studies. Optimal stimulation sites were located inferior, medial, and posterior to the average MRC location. The sites may correspond to associative or motor parts through which fibers from the supplementary motor area pass.

Original languageEnglish
Pages (from-to)239-246
Number of pages8
JournalOperative Neurosurgery
Volume17
Issue number3
DOIs
Publication statusPublished - Sep 1 2019

Fingerprint

Subthalamic Nucleus
Cell Movement
Parkinson Disease
Deep Brain Stimulation
Electrodes
Joints
Motor Cortex
Microelectrodes
Lower Extremity

Keywords

  • Deep brain stimulation
  • Microelectrode recording
  • Movement-related cell
  • Parkinson's disease
  • Somatotopic organization
  • Subthalamic nucleus

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

Cite this

Identification of Somatotopic Organization and Optimal Stimulation Site Within the Subthalamic Nucleus for Parkinson's Disease. / Sasaki, Tatsuya; Kuwahara, Ken; Kin, Ittetsu; Okazaki, Mihoko; Sasada, Susumu; Shinko, Aiko; Kameda, Masahiro; Yasuhara, Takao; Agari, Takashi; Date, Isao.

In: Operative Neurosurgery, Vol. 17, No. 3, 01.09.2019, p. 239-246.

Research output: Contribution to journalArticle

Sasaki, Tatsuya ; Kuwahara, Ken ; Kin, Ittetsu ; Okazaki, Mihoko ; Sasada, Susumu ; Shinko, Aiko ; Kameda, Masahiro ; Yasuhara, Takao ; Agari, Takashi ; Date, Isao. / Identification of Somatotopic Organization and Optimal Stimulation Site Within the Subthalamic Nucleus for Parkinson's Disease. In: Operative Neurosurgery. 2019 ; Vol. 17, No. 3. pp. 239-246.
@article{6b983bdf4a6743fea460560ac39b479b,
title = "Identification of Somatotopic Organization and Optimal Stimulation Site Within the Subthalamic Nucleus for Parkinson's Disease",
abstract = "BACKGROUND: Details of the somatotopy within the subthalamic nucleus (STN) are still poorly understood; however, the STN is a common target of deep brain stimulation (DBS) for Parkinson disease. OBJECTIVE: To examine somatotopic organization within the STN and identify optimal stimulation sites from 77 surgical cases with microelectrode recording. METHODS: STN-DBS was performed for 77 patients with Parkinson disease between 2010 and 2014. We performed passive movements of each joint and captured single neuronal activities to identify movement-related cells (MRCs). The sites of MRCs and active contacts were determined by measuring their distances from the first contact of DBS electrode. Their positional correlations were directly and indirectly analyzed. RESULTS: The number of obtained MRCs was 264, of which 151 responded to multiple joints. The average x-, y-, and z-coordinates of the cells of the upper and lower limbs from the midcommisural point were 13.1 ± 1.1 and 12.7 ± 1.2, 0.22 ± 1.3 and-0.45 ± 1.5, and-2.5 ± 1.1 and-3.0 ± 1.4 mm, respectively. Most MRCs were distributed in the upper third of the STN, in its superior, lateral, and posterior regions, along the DBS electrode routes. Active contacts were observed to lie slightly inferior, medial, and posterior to the average MRC position. CONCLUSION: Somatotopic organization of the STN was easier to observe in the present study than in previous studies. Optimal stimulation sites were located inferior, medial, and posterior to the average MRC location. The sites may correspond to associative or motor parts through which fibers from the supplementary motor area pass.",
keywords = "Deep brain stimulation, Microelectrode recording, Movement-related cell, Parkinson's disease, Somatotopic organization, Subthalamic nucleus",
author = "Tatsuya Sasaki and Ken Kuwahara and Ittetsu Kin and Mihoko Okazaki and Susumu Sasada and Aiko Shinko and Masahiro Kameda and Takao Yasuhara and Takashi Agari and Isao Date",
year = "2019",
month = "9",
day = "1",
doi = "10.1093/ons/opy351",
language = "English",
volume = "17",
pages = "239--246",
journal = "Operative Neurosurgery",
issn = "2332-4252",
publisher = "Lippincott Williams and Wilkins",
number = "3",

}

TY - JOUR

T1 - Identification of Somatotopic Organization and Optimal Stimulation Site Within the Subthalamic Nucleus for Parkinson's Disease

AU - Sasaki, Tatsuya

AU - Kuwahara, Ken

AU - Kin, Ittetsu

AU - Okazaki, Mihoko

AU - Sasada, Susumu

AU - Shinko, Aiko

AU - Kameda, Masahiro

AU - Yasuhara, Takao

AU - Agari, Takashi

AU - Date, Isao

PY - 2019/9/1

Y1 - 2019/9/1

N2 - BACKGROUND: Details of the somatotopy within the subthalamic nucleus (STN) are still poorly understood; however, the STN is a common target of deep brain stimulation (DBS) for Parkinson disease. OBJECTIVE: To examine somatotopic organization within the STN and identify optimal stimulation sites from 77 surgical cases with microelectrode recording. METHODS: STN-DBS was performed for 77 patients with Parkinson disease between 2010 and 2014. We performed passive movements of each joint and captured single neuronal activities to identify movement-related cells (MRCs). The sites of MRCs and active contacts were determined by measuring their distances from the first contact of DBS electrode. Their positional correlations were directly and indirectly analyzed. RESULTS: The number of obtained MRCs was 264, of which 151 responded to multiple joints. The average x-, y-, and z-coordinates of the cells of the upper and lower limbs from the midcommisural point were 13.1 ± 1.1 and 12.7 ± 1.2, 0.22 ± 1.3 and-0.45 ± 1.5, and-2.5 ± 1.1 and-3.0 ± 1.4 mm, respectively. Most MRCs were distributed in the upper third of the STN, in its superior, lateral, and posterior regions, along the DBS electrode routes. Active contacts were observed to lie slightly inferior, medial, and posterior to the average MRC position. CONCLUSION: Somatotopic organization of the STN was easier to observe in the present study than in previous studies. Optimal stimulation sites were located inferior, medial, and posterior to the average MRC location. The sites may correspond to associative or motor parts through which fibers from the supplementary motor area pass.

AB - BACKGROUND: Details of the somatotopy within the subthalamic nucleus (STN) are still poorly understood; however, the STN is a common target of deep brain stimulation (DBS) for Parkinson disease. OBJECTIVE: To examine somatotopic organization within the STN and identify optimal stimulation sites from 77 surgical cases with microelectrode recording. METHODS: STN-DBS was performed for 77 patients with Parkinson disease between 2010 and 2014. We performed passive movements of each joint and captured single neuronal activities to identify movement-related cells (MRCs). The sites of MRCs and active contacts were determined by measuring their distances from the first contact of DBS electrode. Their positional correlations were directly and indirectly analyzed. RESULTS: The number of obtained MRCs was 264, of which 151 responded to multiple joints. The average x-, y-, and z-coordinates of the cells of the upper and lower limbs from the midcommisural point were 13.1 ± 1.1 and 12.7 ± 1.2, 0.22 ± 1.3 and-0.45 ± 1.5, and-2.5 ± 1.1 and-3.0 ± 1.4 mm, respectively. Most MRCs were distributed in the upper third of the STN, in its superior, lateral, and posterior regions, along the DBS electrode routes. Active contacts were observed to lie slightly inferior, medial, and posterior to the average MRC position. CONCLUSION: Somatotopic organization of the STN was easier to observe in the present study than in previous studies. Optimal stimulation sites were located inferior, medial, and posterior to the average MRC location. The sites may correspond to associative or motor parts through which fibers from the supplementary motor area pass.

KW - Deep brain stimulation

KW - Microelectrode recording

KW - Movement-related cell

KW - Parkinson's disease

KW - Somatotopic organization

KW - Subthalamic nucleus

UR - http://www.scopus.com/inward/record.url?scp=85071519356&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85071519356&partnerID=8YFLogxK

U2 - 10.1093/ons/opy351

DO - 10.1093/ons/opy351

M3 - Article

C2 - 30445556

AN - SCOPUS:85071519356

VL - 17

SP - 239

EP - 246

JO - Operative Neurosurgery

JF - Operative Neurosurgery

SN - 2332-4252

IS - 3

ER -