{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T01:13:34Z","timestamp":1792804414430,"version":"4.5.0"},"reference-count":17,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JNS"],"published-print":{"date-parts":[[2013,8]]},"abstract":"<jats:sec>\n<jats:title>Object<\/jats:title>\n<jats:p>In this prospective study the authors' objective was to evaluate the accuracy of deep brain stimulation (DBS) electrode placement using image guidance for direct anatomical targeting with intraoperative CT.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Methods<\/jats:title>\n<jats:p>Preoperative 3-T MR images were merged with intraoperative CT images for planning. Electrode targets were anatomical, based on the MR images. A skull-mounted NexFrame system was used for electrode placement, and all procedures were performed under general anesthesia. After electrode placement, intraoperative CT images were merged with trajectory planning images to calculate accuracy. Accuracy was assessed by both vector error and deviation off the planned trajectory.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Results<\/jats:title>\n<jats:p>Sixty patients (33 with Parkinson disease, 26 with essential tremor, and 1 with dystonia) underwent the procedure. Patient's mean age was 64 \u00b1 9.5 years. Over an 18-month period, 119 electrodes were placed (all bilateral, except one). Electrode implant locations were the ventral intermediate nucleus (VIM), globus pallidus internus (GPI), and subthalamic nucleus (STN) in 25, 23, and 12 patients, respectively. Target accuracy measurements were as follows: mean vector error 1.59 \u00b1 1.11 mm and mean deviation off trajectory 1.24 \u00b1 0.87 mm. There was no statistically significant difference between the accuracy of left and right brain electrodes. There was a statistically significant (negative) correlation between the distance of the closest approach of the electrode trajectory to the ventricular wall of the lateral ventricle and vector error (r<jats:sup>2<\/jats:sup> = \u22120.339, p &lt; 0.05, n = 76), and the deviation from the planned trajectory (r<jats:sup>2<\/jats:sup> = \u22120.325, p &lt; 0.05, n = 77). Furthermore, when the distance from the electrode trajectory and the ventricular wall was &lt; 4 mm, the correlation of the ventricular distance to the deviation from the planned trajectory was stronger (r<jats:sup>2<\/jats:sup> = \u22120.419, p = 0.05, n = 19). Electrodes placed in the GPI were significantly more accurate than those placed in the VIM (p &lt; 0.05). Only 1 of 119 electrodes required intraoperative replacement due to a vector error &gt; 3 mm. In this series there was one infection and no intraparenchymal hemorrhages.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Conclusions<\/jats:title>\n<jats:p>Placement of DBS electrodes using an intraoperative CT scanner and the NexFrame achieves an accuracy that is at least comparable to other methods.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2013.4.jns122324","type":"journal-article","created":{"date-parts":[[2013,5,31]],"date-time":"2013-05-31T14:11:57Z","timestamp":1370009517000},"page":"301-306","source":"Crossref","is-referenced-by-count":237,"title":["Accuracy of deep brain stimulation electrode placement using intraoperative computed tomography without microelectrode recording"],"prefix":"10.3171","volume":"119","author":[{"given":"Kim J.","family":"Burchiel","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shirley","family":"McCartney","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Albert","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed M.","family":"Raslan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-jns122324","series-title":"Lancet","doi-asserted-by":"publisher","first-page":"403","DOI":"10.1016\/0140-6736(91)91175-T","article-title":"Long-term suppression of tremor by chronic stimulation of the ventral intermediate thalamic nucleus","volume":"337","author":"Benabid","year":"1991"},{"key":"b2-jns122324","series-title":"Microelectrode Recording in Movement Disorder Surgery","first-page":"208","article-title":"The future of microelectrode recording","author":"Burchiel","year":"2004"},{"key":"b3-jns122324","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"1375","DOI":"10.1097\/00006123-199912000-00024","article-title":"Comparison of pallidal and subthalamic nucleus deep brain stimulation for advanced Parkinson's disease: results of a randomized, blinded pilot study","volume":"45","author":"Burchiel","year":"1999"},{"key":"b4-jns122324","series-title":"N Engl J Med","doi-asserted-by":"publisher","first-page":"896","DOI":"10.1056\/NEJMoa060281","article-title":"A randomized trial of deep-brain stimulation for Parkinson's disease","volume":"355","author":"Deuschl","year":"2006"},{"key":"b5-jns122324","series-title":"Stereotact Funct Neurosurg","doi-asserted-by":"publisher","first-page":"146","DOI":"10.1159\/000068960","article-title":"Safety and risk of microelectrode recording in surgery for movement disorders","volume":"78","author":"Hariz","year":"2002"},{"key":"b6-jns122324","series-title":"Comput Aided Surg","doi-asserted-by":"publisher","first-page":"155","DOI":"10.3109\/10929080500050249","article-title":"The application accuracy of a skull-mounted trajectory guide system for image-guided functional neurosurgery","volume":"9","author":"Henderson","year":"2004"},{"key":"b7-jns122324","series-title":"N Engl J Med","doi-asserted-by":"publisher","first-page":"1978","DOI":"10.1056\/NEJMoa063618","article-title":"Pallidal deep-brain stimulation in primary generalized or segmental dystonia","volume":"355","author":"Kupsch","year":"2006"},{"key":"b8-jns122324","series-title":"Atlas for Stereotaxy of the Human Brain","author":"Schaltenbrand","year":"1977"},{"key":"b9-jns122324","series-title":"J Neurol Neurosurg Psychiatry","doi-asserted-by":"publisher","first-page":"136","DOI":"10.1136\/jnnp.2006.104067","article-title":"Deep brain stimulation in 18 patients with severe Gilles de la Tourette syndrome refractory to treatment: the surgery and stimulation","volume":"79","author":"Servello","year":"2008"},{"issue":"1 Suppl Operative","key":"b10-jns122324","series-title":"Neurosurgery","first-page":"114","article-title":"Intraoperative computed tomography for deep brain stimulation surgery: technique and accuracy assessment","volume":"68","author":"Shahlaie","year":"2011"},{"key":"b11-jns122324","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"370","DOI":"10.3171\/jns.2002.97.2.0370","article-title":"Implantation of deep brain stimulators into the subthalamic nucleus: technical approach and magnetic resonance imaging-verified lead locations","volume":"97","author":"Starr","year":"2002"},{"key":"b12-jns122324","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"479","DOI":"10.3171\/2009.6.JNS081161","article-title":"Subthalamic nucleus deep brain stimulator placement using high-field interventional magnetic resonance imaging and a skull-mounted aiming device: technique and application accuracy. 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