Combined Diffuse Light Reflectance and Electrical Impedance Measurements as a Navigation Aid in Deep Brain Surgery

Aim: The aim of this study is to investigate reflected light intensity combined with impedance for navigation aid during stereotactic neurosurgery. Methods: During creation of 21 trajectories for stereotactic implantation of deep brain stimulation electrodes in the globus pallidus internus or subthalamus (zona incerta or subthalamic nucleus), impedance at 512 kHz and reflected light intensity at 780 nm were measured continuously and simultaneously with a radio frequency electrode containing optical fibres. The signals were compared with anatomy determined from pre- and postoperative MRI and CT. The measurements were performed within minutes and signal analysis was done post-operatively. Results: Reflected light intensity was low from cortex, lateral ventricle, caudate nucleus and putamen. It was intermediate from globus pallidus and thalamus while it was high from subcortical white matter, internal capsule and the subthalamus. The electric impedance was less consistent but generally low in the cortex, intermediate in subcortical white matter, the putamen, the globus pallidus and the thalamus and high in the internal capsule and the subthalamus. Conclusion: Reflected light intensity and electric impedance give complementary information about passed tissue and the combination seems promising for navigation aid during stereotactic neurosurgery. Original Publication: Johannes D. Johansson, Patric Blomstedt, Neda Haj-Hosseini, Tommy Bergenheim, Ola Eriksson and Karin Wårdell, Combined diffuse light reflectance and electric impedance measurements for navigation aid in deep brain surgery, 2009, Stereotactic and Functional Neurosurgery, (87), 2, 105-113. http://dx.doi.org/10.1159/000202977 Copyright: S. Karger AG http://www.karger.com/