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首页> 外文期刊>Neurosurgery >Deep brain stimulator electrodes used for lesioning: proof of principle.
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Deep brain stimulator electrodes used for lesioning: proof of principle.

机译：用于损伤的深部脑刺激电极：原理证明。

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OBJECTIVE: Patients with chronically implanted deep brain stimulator (DBS) electrodes can encounter complications requiring hardware removal. We assessed the safety and efficacy of using implanted DBS electrodes to create a therapeutic lesion before their removal. METHODS: Revision or removal of the DBS electrodes was required in two patients who had previously undergone DBS implantation. We conducted a series of in vitro experiments to confirm that the DBS electrodes could be used to generate radiofrequency lesions and to assess the relationship between radiofrequency parameters and lesion size. With this information, and with the approval of the hospital ethical review board, implanted electrodes were used to create incremental radiofrequency lesions in the thalamus in one patient and in the subthalamic nucleus in another. The procedures were performed under local anesthesia with contiguous contacts of the DBS lead connected to the active and reference sites of the RF generator to create a bipolar lesion. RESULTS: A 51-year-old man with essential tremor and a thalamic DBS required repeated battery changes secondary to tolerance and high voltage demands. Rather than replacing the battery, a radiofrequency thalamotomy was performed by using the existing left DBS electrode. At the 6-month follow-up examination, successful lesioning provided near complete tremor control. A second patient, a 50-year-old man with Parkinson's disease who had undergone bilateral subthalamic deep brain stimulation, developed skin erosion over the DBS hardware. A subthalamic nucleus lesion was made through the right DBS electrode. Lesion position and size were confirmed with magnetic resonance imaging. CONCLUSION: Lesions can be made through chronically implanted DBS electrodes in a safe, graded fashion and can produce therapeutic benefit.
机译：目的：长期植入深部脑刺激器（DBS）电极的患者可能会遇到需要去除硬件的并发症。我们评估了使用植入的DBS电极在移除前创建治疗性病变的安全性和有效性。方法：两名以前曾接受过DBS植入的患者需要翻修或摘除DBS电极。我们进行了一系列的体外实验，以确认DBS电极可用于产生射频损伤并评估射频参数与损伤大小之间的关系。有了这些信息，并且在医院伦理审查委员会的批准下，植入的电极被用于在一名患者的丘脑中以及在另一名患者的丘脑下核中产生递增的射频损伤。该程序是在局部麻醉下进行的，DBS引线的连续触点连接到RF发生器的活动位点和参考位点，从而形成双极病变。结果：一名患有严重震颤和丘脑DBS的51岁男子，由于耐受力和高电压要求，需要反复更换电池。通过使用现有的左DBS电极进行射频丘脑切开术，而不是更换电池。在为期6个月的随访检查中，成功的病变提供了几乎完全的震颤控制。第二例患者，是一名患有帕金森氏病的50岁男性，曾接受过双侧丘脑底深部脑刺激，在DBS硬件上出现了皮肤侵蚀。通过右DBS电极形成丘脑下核病变。病变位置和大小通过磁共振成像确认。结论：可以通过安全，分级的方式通过长期植入DBS电极来制造病变，并可以产生治疗效果。

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