Pallidotomy Lesion Locations: Significance of Microelectrode Refinement

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Abstract
Tsao et al. at the University of Kansas ask the very important question,"What if lesioning was performed strictly on an anatomic basis rather than using microelectrodes to adjust the final target location?" Experts using the microelectrode technique have demonstrated for decades the inadequacy of anatomic localization. This study uses the postoperative magnetic resonance image and overlays the anatomic target that allows a very graphic demonstration of the potential deviation that can occur based on anatomic localization alone. The history of microelectrode recording is one of refining the target electrophysiologically to make, in the case of the thalamotomy, the smallest effective lesion, and in the case of pallidotomy, the maximum effective lesion. The microelectrode recording allows one to correct for anatomic variation as well as mechanical translational errors.

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