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@ARTICLE{Reck:201927,
      author       = {Reck, Christiane and Maarouf, Mohammad and Wojtecki, Lars
                      and Groiss, Stefan and Florin, Esther and Sturm, Volker and
                      Fink, Gereon Rudolf and Schnitzler, Alfons and Timmermann,
                      Lars},
      title        = {{C}linical {O}utcome of {S}ubthalamic {S}timulation in
                      {P}arkinson's {D}isease is {I}mproved by {I}ntraoperative
                      {M}ultiple {T}rajectories {M}icroelectrode {R}ecording},
      journal      = {Journal of neurological surgery / A},
      volume       = {73},
      number       = {06},
      issn         = {2193-6323},
      address      = {New York, NY},
      publisher    = {Thieme},
      reportid     = {FZJ-2015-04217},
      pages        = {377 - 386},
      year         = {2012},
      abstract     = {Background and Study Aims The use of multiple
                      trajectories microelectrode recording (MER) during
                      implantation of deep brain stimulation (DBS) electrodes into
                      the subthalamic nucleus (STN) in patients with Parkinson's
                      disease (PD) is discussed controversially because of
                      possible risks and unclear benefits. The aim of the study is
                      to investigate whether MER combined with intraoperative
                      evaluation of stimulation effects improve clinical outcome
                      in PD patients undergoing STN DBS surgery.Material and
                      Methods Prior to final DBS electrode implantation, we
                      performed multiple trajectories MER and intraoperative test
                      stimulations after magnetic resonance imaging (MRI)-guided
                      planning in 32 PD patients. In further 10 patients no MER
                      (only intraoperative test stimulation) was used.Results We
                      found a significantly better clinical outcome (Unified
                      Parkinson's Disease Rating Scale [UPDRS] III) in patients
                      undergoing MER compared with non-MER patients. In MER
                      patients, DBS electrode placement was performed using the
                      central trajectory in $73\%.$ Another than the central
                      trajectory was taken in $27\%$ of the patients. No
                      difference in clinical outcome between DBS electrodes
                      implanted on the central or a decentral trajectory was
                      observed.Conclusions DBS surgery based on intraoperative
                      multiple trajectories MER and test stimulation improves
                      clinical outcome if compared with intraoperative test
                      stimulation alone. The data suggest that DBS surgery solely
                      based on MRI and intraoperative test stimulation without MER
                      may lead to nonoptimal placement of DBS electrodes and
                      consequently poorer clinical outcome.},
      cin          = {INM-3},
      ddc          = {610},
      cid          = {I:(DE-Juel1)INM-3-20090406},
      pnm          = {333 - Pathophysiological Mechanisms of Neurological and
                      Psychiatric Diseases (POF2-333)},
      pid          = {G:(DE-HGF)POF2-333},
      typ          = {PUB:(DE-HGF)16},
      UT           = {WOS:000321261100004},
      doi          = {10.1055/s-0032-1326957},
      url          = {https://juser.fz-juelich.de/record/201927},
}