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  Microelectrode
recording, or MER, is the most precise method of localizing the
surgical site. Dr. Lenz pioneered the technique of recording activity
from single neurons, as well as microstimulation with a custom designed
microelectrode. The use of this technique has been endorsed by the Task
Force on Surgery for Parkinson's Disease of the American Academy of Neurology
Therapeutic and Technology Assessment Committee: Evaluation of Surgery
for Parkinson's Disease. Dr Lenz has performed microrecordings in more
than 800 cases of functional stereotactic procedures during the course
of his training and practice. Lance Rowland, BS,
a neurophysiology technician working with Dr Lenz, has a similar breadth
of experience based on his research recordings with Dr Mahlon DeLong prior
to his involvement with functional stereotactic cases. MER is used to further define the image-derived target. Because not all brains are the same, the information obtained from MER gives a more accurate target for final DBS placement. As the microelectrode passes along its trajectory, Dr Lenz and his neurophysiology team are able to visualize and hear the neuronal activity from different areas of the brain. The patient also is able to hear brain activity and discussions of the neurophysiology team throughout the surgery. As the microlectrode passes through the basal ganglia and the thalamus toward its final target (STN, GPi, Vim), we are able to identify specific structures based on unique patterns of spontaneous neuronal activity. Dr Lenz also moves specific joints in the upper and lower extremities of the patient in an attempt to modulate the activity in the sensorimotor portion of the final target. This allows us to create a map of the body within the desired target. Below are maps of the, subthalamus, basal ganglia, and thalamus, with examples of the MERs as they pertain to each structure. Clicking on each of the structures below will enable you to see and hear a video of neuronal activity. If your PC does not have a media player installed, click here to install Quick Time, a media player included on this CD.
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