Objective: We evaluate potential targets for Deep Brain Stimulation (DBS) based on test stimulation and chronic recording from temporary depth electrodes placed in a Neuromodulation Monitoring Unit (NMU). We present the outcome of the first 30 cases using this technique for determining optimal functional anatomical DBS targets in children.
Background: For rare diseases the optimal target for DBS is not known. We have found that the best target will vary depending on the etiology and anatomic distribution of injury in each child. Successful outcome of DBS in a broader group of children requires the ability to find individualized targets specific to each child’s injury, deficits, and potential function.
Method: Up to 12 Adtech ™ MM16C temporary depth electrodes are implanted using robot-assisted stereotactic guidance in multiple regions of basal ganglia and thalamus.
Children are monitored 24 hours per day for up to 1 week in a neuromodulation monitoring unit with continuous and simultaneous recording and test stimulation. Selection of the 4 best electrodes (2 per side) for permanent implantation is made based on the response to stimulation and the correlation of recorded activity in each region with dystonic movements.
Results: Since 2015, a total of 30 children have undergone test lead implantation in the NMU.
The mean improvement in BADS was 4.3 (95% CI: 3.1, 5.5, p < 0.001).and in BFMDRS was 26.4 (95% CI: 19.5, 33.2, p < 0.001). Adverse responses to temporary leads included transient sleepiness. All adverse events self-resolved.
Conclusion: The new method of DBS targeting identified different targets that varied between children, and uses only equipment that is widely available for epilepsy-monitoring. This method may increase effectiveness and allow DBS to be applied to a broader range of children including those with diagnoses not previously known to respond to stimulation.
Extension of the NMU technique for other indications including adult disorders may allow greater safety and broader applicability of DBS for functional neurosurgery.
To cite this abstract in AMA style:
T. Sanger, J. Maclean, A. Tongol, J. Olaya, M. Liker. DBS Targeting in a Neuromodulation Monitoring Unit – First 30 cases [abstract]. Mov Disord. 2022; 37 (suppl 2). https://www.mdsabstracts.org/abstract/dbs-targeting-in-a-neuromodulation-monitoring-unit-first-30-cases/. Accessed June 15, 2025.« Back to 2022 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/dbs-targeting-in-a-neuromodulation-monitoring-unit-first-30-cases/