ABSTRACT
The debate over the need for microelectrode recordings (MERs) during movement
disorder deep brain stimulation (DBS) surgery is still unsettled (1). There are pro-
ponents who unequivocally state that MERs are an absolute necessity for success-
ful DBS surgery. Others point to the fact that clinical outcome is not improved with
MERs, and no well-designed studies exist to prove that they are essential and lead
to improved placement of the stimulating electrodes. Although there might be
some agreement that for ablative procedures MERs are a requirement, the “rever-
sibility” of DBS surgery weakens that argument and leaves room for discussion.
The answer to this fundamental question hinges on the ability of accurate targeting.
As better imaging techniques and targeting software platforms are evolving, the
accuracy of the electrode placement is improving and the need for MERs is
diminishing. However, since direct visualization of subthalamic nucleus (STN) and
globus pallidus internus is difficult at best, most neurosurgeons rely on complimen-
tary tools, such as MER or intra-operative stimulation, to ascertain proper place-
ment of DBS leads. Clearly, there is no better way than physiological target
confirmation to assure an optimal outcome of the surgical procedure.
