Technique of microelectrode insertion into the subthalamic nucleus in deep brain stimulation for patients with Parkinson’s disease: Summary of the Ph.D. Thesis in Medical Sciences: 321.21 Neurosurgery

Abstract

INTRODUCTION. Parkinson’s disease (PD) is the second most frequent neurodegenerative disorder after Alzheimer’s disease, with a prevalence of 1% in people over 60 years old and up to 4% by the age of 80 [1]. In the Republic of Moldova, estimates suggest around 12,000 patients, corresponding to a prevalence of 1–3% in the elderly population. Motor manifestations (tremor, rigidity, bradykinesia, postural instability) are commonly accompanied by non‑motor symptoms with a major impact on quality of life. Pharmacologic therapy with levodopa and dopamine agonists is effective in the early stages, but in advanced phases motor fluctuations and dyskinesias emerge, significantly reducing benefits. In such cases, neurosurgical options become indispensable. Deep brain stimulation (DBS), introduced in the 1990s, has become the reference method for managing PD refractory to medical treatment, with the subthalamic nucleus (STN) as the main target [2–4]. The accuracy of electrode placement is optimized by intraoperative microelectrode recording (MER), which enables real‑time functional identification of the STN and complements stereotactic imaging data [5,6]. This work aims to evaluate the role of MER in DBS for PD, analyzing technical aspects, clinical effectiveness, and the implications of this method for safety and optimization of surgical management.