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array:24 [ "pii" => "S2529849622001046" "issn" => "25298496" "doi" => "10.1016/j.neucie.2022.09.003" "estado" => "S300" "fechaPublicacion" => "2023-09-01" "aid" => "567" "copyright" => "Sociedad Española de Neurocirugía" "copyrightAnyo" => "2022" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Neurocirugia. 2023;34:228-37" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "Traduccion" => array:1 [ "en" => array:19 [ "pii" => "S1130147322000975" "issn" => "11301473" "doi" => "10.1016/j.neucir.2022.09.002" "estado" => "S300" "fechaPublicacion" => "2023-09-01" "aid" => "567" "copyright" => "Sociedad Española de Neurocirugía" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Neurocirugia. 2023;34:228-37" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Clinical research</span>" "titulo" => "Comparison of intraoperative imaging guided versus microelectrode recording guided deep brain stimulation for Parkinson's disease: A meta-analysis" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "228" "paginaFinal" => "237" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Comparativa entre la cirugía guiada por imágenes y la estimulación cerebral profunda guiada por microelectrodos en el tratamiento de la enfermedad de Parkinson: un metaanálisis" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0035" "etiqueta" => "Fig. 7" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr7.jpeg" "Alto" => 524 "Ancho" => 3175 "Tamanyo" => 140476 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">Forest plots of postoperative quality of life improvement% between IMG guided and MER guided DBS.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Tsung-Che Chuang, Jia-Qi Tan, Shu-Mei Chen" "autores" => array:3 [ 0 => array:2 [ "nombre" => "Tsung-Che" "apellidos" => "Chuang" ] 1 => array:2 [ "nombre" => "Jia-Qi" "apellidos" => "Tan" ] 2 => array:2 [ "nombre" => "Shu-Mei" "apellidos" => "Chen" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S2529849622001046" "doi" => "10.1016/j.neucie.2022.09.003" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2529849622001046?idApp=UINPBA00004B" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1130147322000975?idApp=UINPBA00004B" "url" => "/11301473/0000003400000005/v1_202309041031/S1130147322000975/v1_202309041031/en/main.assets" ] ] "itemSiguiente" => array:19 [ "pii" => "S2529849622001058" "issn" => "25298496" "doi" => "10.1016/j.neucie.2022.09.004" "estado" => "S300" "fechaPublicacion" => "2023-09-01" "aid" => "568" "copyright" => "Sociedad Española de Neurocirugía" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Neurocirugia. 2023;34:238-46" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "es" => array:14 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Investigación clínica</span>" "titulo" => "Utilidad de la monitorización neurofisiológica intraoperatoria como valor pronóstico de la parálisis facial posquirúrgica en schwannomas vestibulares" "tienePdf" => "es" "tieneTextoCompleto" => "es" "tieneResumen" => array:3 [ 0 => "es" 1 => "es" 2 => "en" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "238" "paginaFinal" => "246" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Utility of the intraoperative neurophysiological monitoring as a prognostic value of postoperative facial paresis in vestibul<span class="elsevierStyleItalic">ar schwannomas</span>" ] ] "contieneResumen" => array:2 [ "es" => true "en" => true ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig1" "etiqueta" => "Figura 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1992 "Ancho" => 2508 "Tamanyo" => 445343 ] ] "descripcion" => array:1 [ "es" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Registro de CoMEP. El registro de cada músculo en el período inicial y final de la cirugía. Los registros señalados con flechas blancas corresponden a los registros del final del tiempo quirúrgico. A) Registro de potenciales motores sin variación durante la cirugía. B) Registro patológico en el que puede observarse la caída de amplitud de los potenciales en la monitorización al finalizar la cirugía respecto al registro inicial.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Luis Torres-Carretero, Álvaro Otero-Rodríguez, María Victoria Alejos-Herrera, Gemma Vázquez-Casares, Andoni García-Martín, Patricia Alejandra Garrido-Ruiz" "autores" => array:6 [ 0 => array:2 [ "nombre" => "Luis" "apellidos" => "Torres-Carretero" ] 1 => array:2 [ "nombre" => "Álvaro" "apellidos" => "Otero-Rodríguez" ] 2 => array:2 [ "nombre" => "María Victoria" "apellidos" => "Alejos-Herrera" ] 3 => array:2 [ "nombre" => "Gemma" "apellidos" => "Vázquez-Casares" ] 4 => array:2 [ "nombre" => "Andoni" "apellidos" => "García-Martín" ] 5 => array:2 [ "nombre" => "Patricia Alejandra" "apellidos" => "Garrido-Ruiz" ] ] ] ] "resumen" => array:1 [ 0 => array:3 [ "titulo" => "Highlights" "clase" => "author-highlights" "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall"><ul class="elsevierStyleList" id="lis0005"><li class="elsevierStyleListItem" id="lsti0005"><span class="elsevierStyleLabel">•</span><p id="par0005" class="elsevierStylePara elsevierViewall">La variación de amplitud de los CoMEP predice la función facial inmediata.</p></li><li class="elsevierStyleListItem" id="lsti0010"><span class="elsevierStyleLabel">•</span><p id="par0010" class="elsevierStylePara elsevierViewall">Un valor umbral<span class="elsevierStyleHsp" style=""></span>><span class="elsevierStyleHsp" style=""></span>0,35<span class="elsevierStyleHsp" style=""></span>mA predice un mal resultado funcional en el 75% de los casos.</p></li><li class="elsevierStyleListItem" id="lsti0015"><span class="elsevierStyleLabel">•</span><p id="par0015" class="elsevierStylePara elsevierViewall">No podemos basar el manejo clínico en el registro neurofisiológico intraoperatorio.</p></li><li class="elsevierStyleListItem" id="lsti0020"><span class="elsevierStyleLabel">•</span><p id="par0020" class="elsevierStylePara elsevierViewall">A pesar de un mal registro inicial, los pacientes tienden a mejorar a largo plazo.</p></li></ul></p></span>" ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S1130147322000987" "doi" => "10.1016/j.neucir.2022.09.003" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1130147322000987?idApp=UINPBA00004B" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2529849622001058?idApp=UINPBA00004B" "url" => "/25298496/0000003400000005/v1_202309042000/S2529849622001058/v1_202309042000/es/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S2529849622001022" "issn" => "25298496" "doi" => "10.1016/j.neucie.2022.08.002" "estado" => "S300" "fechaPublicacion" => "2023-09-01" "aid" => "564" "copyright" => "Sociedad Española de Neurocirugía" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Neurocirugia. 2023;34:221-7" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Clinical research</span>" "titulo" => "Long insular artery damage might be a key sign for predicting functional prognosis of putaminal hemorrhage" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "221" "paginaFinal" => "227" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "El daño de la arteria insular larga podría ser un signo clave para predecir el pronóstico funcional de la hemorragia putaminal" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 925 "Ancho" => 1672 "Tamanyo" => 137837 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Definition of initial long insular artery damage. The vascular territories of subcortical white matter and the basal ganglia on coronal images are schematically shown. These areas are supplied by three individual arteries branching from the middle cerebral artery, namely the lenticulostriate artery (LSA: bold line) from the M1 segment, the long insular artery (LIA: dashed line) from the M2 segment, and the white matter medullary arteries (WMMAs: dotted lines) from the M3 or M4 segment (A). To standardize radiologic interpretation, the radiologists drew a virtual line from the tip of the anterior horn to the top of the superior limb of the insular cleft (the A–I line). We defined initial LIA damage based on the presence of a hematoma reaching the highest level of the temporal ventricle on coronal or axial CT slices (B).</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Yuki Amano, Yohei Yamaguchi, Toshiaki Osato, Toshiichi Watanabe, Kenji Kamiyama, Hirohiko Nakamura" "autores" => array:6 [ 0 => array:2 [ "nombre" => "Yuki" "apellidos" => "Amano" ] 1 => array:2 [ "nombre" => "Yohei" "apellidos" => "Yamaguchi" ] 2 => array:2 [ "nombre" => "Toshiaki" "apellidos" => "Osato" ] 3 => array:2 [ "nombre" => "Toshiichi" "apellidos" => "Watanabe" ] 4 => array:2 [ "nombre" => "Kenji" "apellidos" => "Kamiyama" ] 5 => array:2 [ "nombre" => "Hirohiko" "apellidos" => "Nakamura" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S1130147322000793" "doi" => "10.1016/j.neucir.2022.08.003" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1130147322000793?idApp=UINPBA00004B" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2529849622001022?idApp=UINPBA00004B" "url" => "/25298496/0000003400000005/v1_202309042000/S2529849622001022/v1_202309042000/en/main.assets" ] "en" => array:21 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Clinical research</span>" "titulo" => "Comparison of intraoperative imaging guided versus microelectrode recording guided deep brain stimulation for Parkinson's disease: A meta-analysis" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "228" "paginaFinal" => "237" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Tsung-Che Chuang, Jia-Qi Tan, Shu-Mei Chen" "autores" => array:3 [ 0 => array:3 [ "nombre" => "Tsung-Che" "apellidos" => "Chuang" "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">1</span>" "identificador" => "fn0005" ] ] ] 1 => array:3 [ "nombre" => "Jia-Qi" "apellidos" => "Tan" "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">1</span>" "identificador" => "fn0005" ] ] ] 2 => array:4 [ "nombre" => "Shu-Mei" "apellidos" => "Chen" "email" => array:1 [ 0 => "chen5319@tmu.edu.tw" ] "referencia" => array:3 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] 2 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] ] "afiliaciones" => array:3 [ 0 => array:3 [ "entidad" => "Department of Primary Medicine, Shuang-Ho Hospital, New Taipei, Taiwan" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Department of Surgery, School of Medicine, Taipei Medical University, Taipei, Taiwan" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Department of Neurosurgery, Taipei Medical University Hospital, Taipei Medical University, Taipei, Taiwan" "etiqueta" => "c" "identificador" => "aff0015" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "<span class="elsevierStyleItalic">Corresponding author</span>." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Comparativa entre la cirugía guiada por imágenes y la estimulación cerebral profunda guiada por microelectrodos en el tratamiento de la enfermedad de Parkinson: un metaanálisis" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0010" "etiqueta" => "Fig. 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 1224 "Ancho" => 3176 "Tamanyo" => 323282 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Subgroup analysis: forest plots of accuracy of lead placement between IMG guided and MER guided DBS according to intraoperative imaging technology. iCT<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>intraoperative computed tomography, iMRI<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>intraoperative magnetic resonance imaging,.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Parkinson's disease (PD) is a progressive, neurodegenerative syndrome involving multiple motor and non-motor neural circuits in the basal ganglia.<a class="elsevierStyleCrossRef" href="#bib0185"><span class="elsevierStyleSup">1</span></a> PD is characterized by motor symptoms, such as resting tremor, bradykinesia, postural instability, and rigidity. Dopaminergic medications are primarily used to treat these motor symptoms.<a class="elsevierStyleCrossRef" href="#bib0190"><span class="elsevierStyleSup">2</span></a> However, medication-related complications, including dyskinesia and “on–off” fluctuations develop in a majority of patients after long-term therapy.<a class="elsevierStyleCrossRef" href="#bib0195"><span class="elsevierStyleSup">3</span></a> In addition, progressive resistance to carbidopa–levodopa and other pharmacologic therapies may develop for certain symptoms such as difficulties in gait, balance, speech, or swallowing.<a class="elsevierStyleCrossRef" href="#bib0185"><span class="elsevierStyleSup">1</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">Deep brain stimulation (DBS) was developed as a treatment for patients with related motor complications after medical treatment and therapeutic failures,<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">4</span></a> and has been established to be an effective treatment for control of the motor symptoms and further reduces the need for high dosage medications for PD.<a class="elsevierStyleCrossRef" href="#bib0205"><span class="elsevierStyleSup">5</span></a> Appropriate placement of the electrode in the targeted structure largely determines the clinical effect of DBS.<a class="elsevierStyleCrossRef" href="#bib0210"><span class="elsevierStyleSup">6</span></a> Therefore, utilizing imaging or other technology to evaluate the electrode position during or immediately after the operation is crucial. Traditionally, most centers would use intraoperative microelectrode recording (MER) and/or macro-stimulation in awake patients to refine targeting based on intraoperative data.<a class="elsevierStyleCrossRefs" href="#bib0215"><span class="elsevierStyleSup">7,8</span></a> MER provides neurophysiological information of the target nuclei during the procedure and remains the gold standard for neurophysiological target optimization and refinement.<a class="elsevierStyleCrossRef" href="#bib0225"><span class="elsevierStyleSup">9</span></a> However, the MER approach performed during an awake state may cause anxiety and discomfort for patients who find the surgery intolerable.<a class="elsevierStyleCrossRef" href="#bib0230"><span class="elsevierStyleSup">10</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">Owing to imaging technological advances in recent years, anatomic verification approaches with intraoperative imaging (IMG) such as intraoperative CT (iCT), or intraoperative MRI (iMRI) performed under general anesthesia without MER has become an alternative way to verify DBS lead placement.<a class="elsevierStyleCrossRefs" href="#bib0235"><span class="elsevierStyleSup">11,12</span></a> Previous studies have indicated IMG guided DBS was more anatomically accurate and comfortable than the traditional MER approach.<a class="elsevierStyleCrossRefs" href="#bib0245"><span class="elsevierStyleSup">13,14</span></a> In addition, this approach has been shown to provide real-time imaging to refine trajectory and evaluate the conditions of pneumocephalus and brain shift prior to lead implantation.<a class="elsevierStyleCrossRefs" href="#bib0255"><span class="elsevierStyleSup">15,16</span></a> Currently, there is still controversy surrounding the necessity of MER for DBS.<a class="elsevierStyleCrossRefs" href="#bib0265"><span class="elsevierStyleSup">17,18</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">This meta-analysis aims to explore accuracy of lead placement, clinical efficacy and safety between IMG guided and MER guided DBS for PD.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Methods</span><p id="par0025" class="elsevierStylePara elsevierViewall">The databases PubMed, Embase, Web of Science, and Cochrane Library were searched on Mar 2021 from the time of their inception to the current time. The initial electronic search strategy would be supplemented by hand searching the reference lists from eligible included studies. Keyword input for searching included: (((Microelectrode recording OR “MER”) AND (Parkinson's disease)) AND (deep brain stimulation)) AND (intraoperative MRI or CT OR Interventional MRI or CT OR “MRI” OR “CT” OR “iMRI” OR “iCT”).</p><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Inclusion and exclusion criteria</span><p id="par0030" class="elsevierStylePara elsevierViewall">Inclusion criteria were as follow: (i) Randomized controlled trials or prospective and retrospective cohort studies. (ii) Direct comparison between IMG guided and microelectrode recording guided deep brain stimulation for Parkinson's disease. (iii) At least one of the outcome indicators, including treatment efficacy, complications, surgical accuracy and operation time. (iv) Papers only in English.</p><p id="par0035" class="elsevierStylePara elsevierViewall">Studies will be excluded if it only contains the data of either IMG guided DBS or microelectrode recording-guided DBS. To identify additional articles, we hand-searched reference lists of relevant systematic reviews and included studies.</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Data extraction (selection and coding)</span><p id="par0040" class="elsevierStylePara elsevierViewall">Literature search results were exported to Endnote X9 for initial assessment of duplicates. During the first round of screening, abstracts and titles were screened according to inclusion criteria. Two reviewers independently screened the full texts and extracted the data. Any discrepancy was resolved through discussion, or if necessary by a third member of the study team. The final results of the search strategy were presented in a PRISMA flowchart.</p><p id="par0045" class="elsevierStylePara elsevierViewall">From the retrieved studies, data were extracted as follow:</p><p id="par0050" class="elsevierStylePara elsevierViewall">(a) Study designs, authors, published year; (b) Participant's characteristics; (c) Number of participants; (d) Type of interventions; (e) Outcome measures and (f) Time of measurements.</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Statistical analysis and data synthesis</span><p id="par0055" class="elsevierStylePara elsevierViewall">Extracted data were summarized into a meta-analysis using Review Manager 5.3 analysis software. The differences of accuracy of lead placement, changes% in Unified Parkinson's Disease Rating Scale and levodopa equivalent daily dose (LEDD) between IMG and MER guided DBS were estimated using weighted mean difference (WMD) and 95% confidence intervals (CIs). Statistical significance was defined as <span class="elsevierStyleItalic">P</span> value<span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>0.05. Heterogeneity among the included studies were assessed using chi-squared test (Chi<span class="elsevierStyleSup">2</span>) and <span class="elsevierStyleItalic">I</span>-squared statistic test (<span class="elsevierStyleItalic">I</span><span class="elsevierStyleSup">2</span>). Random-effect model was chosen based on the amount of heterogeneity.</p><p id="par0060" class="elsevierStylePara elsevierViewall">For different IMG technology or DBS targeting sites, result of each outcome was presented as subgroups. Subgroup differences were measured using chi-squared test and <span class="elsevierStyleItalic">I</span>-squared statistic test. We also conducted a sensitivity analysis to assess the effect of risk of bias on the results of primary analyzes. Sensitivity analysis determined the effect of restricting the analysis to low risk of bias for the main domains. We did not analyze publication bias due to the limited number of included studies which may result in low statistical power.</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Risk of bias (quality) assessment</span><p id="par0065" class="elsevierStylePara elsevierViewall">Two authors independently assessed the quality of each included study by using the Risk of Bias In Non-randomized Studies – of Interventions (ROBINS-I). Risk of bias was assessed and determined using seven domains. If consensus was unable to be achieved, a third reviewer would arbitrate.</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Study registration</span><p id="par0070" class="elsevierStylePara elsevierViewall">We have registered the study on the PROSPERO International Prospective Register of Systematic Reviews (ID: CRD42020195720).</p></span></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Results</span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Identification of included study</span><p id="par0075" class="elsevierStylePara elsevierViewall"><a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a> presents the screening and selection process. After a comprehensive search, a total of 484 studies were identified through four databases (PubMed, Embase, Cochrane library and Web of science), and an additional hand-searched study was found through PubMed. Initially, 183 duplicate studies were excluded and 260 studies were excluded after title and abstract screening. Thus, there were 42 studies that underwent full-text screening. Finally, 7 studies<a class="elsevierStyleCrossRefs" href="#bib0230"><span class="elsevierStyleSup">10,19–24</span></a> were included in the qualitative analysis, a study<a class="elsevierStyleCrossRef" href="#bib0300"><span class="elsevierStyleSup">24</span></a> was excluded due to being an unpublished study and incomplete individual data, and the remaining 6 studies<a class="elsevierStyleCrossRefs" href="#bib0230"><span class="elsevierStyleSup">10,19–23</span></a> were further summarized in our analysis.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Methodological quality of included study</span><p id="par0080" class="elsevierStylePara elsevierViewall">The methodological quality of each study was assessed by two reviewers according to the ROBINS-I tool<a class="elsevierStyleCrossRef" href="#bib0305"><span class="elsevierStyleSup">25</span></a> (<a class="elsevierStyleCrossRef" href="#sec0150">Supplementary Table S1)</a>. Generally, overall risk of bias was low in three studies<a class="elsevierStyleCrossRefs" href="#bib0230"><span class="elsevierStyleSup">10,19,22</span></a> and moderate in another three studies.<a class="elsevierStyleCrossRefs" href="#bib0280"><span class="elsevierStyleSup">20,21,23</span></a> Most studies showed low risk in confounding domain due to similar baseline participant characteristics in disease duration, mean age and Unified Parkinson's Disease Rating Scale part III (UPDRS-III), except for one study<a class="elsevierStyleCrossRef" href="#bib0280"><span class="elsevierStyleSup">20</span></a> that showed moderate risk, since all the leads in this study were performed under MER guidance over the first five years of the study period. A study<a class="elsevierStyleCrossRef" href="#bib0280"><span class="elsevierStyleSup">20</span></a> showed moderate risk in intervention domain, since more patients underwent MER guided DBS via unilateral lead instead of bilateral leads. In post-intervention domain, two studies showed moderate risk of bias due to missing follow-up data.</p></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Study characteristics</span><p id="par0085" class="elsevierStylePara elsevierViewall">A total of 6 studies<a class="elsevierStyleCrossRefs" href="#bib0230"><span class="elsevierStyleSup">10,19–23</span></a> including 5 retrospective<a class="elsevierStyleCrossRefs" href="#bib0230"><span class="elsevierStyleSup">10,19–22</span></a> and 1 prospective<a class="elsevierStyleCrossRef" href="#bib0295"><span class="elsevierStyleSup">23</span></a> cohort studies, met the inclusion criteria and were included in the analysis. The characteristics of included studies are detailed in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>. A total of 478 participants and 915 electrodes were included. The mean age of the population was 63.61 years old. Among the included studies, IMG technology was performed using intraoperative CT (iCT)<a class="elsevierStyleCrossRefs" href="#bib0290"><span class="elsevierStyleSup">22,23</span></a> or intraoperative MRI (iMRI).<a class="elsevierStyleCrossRefs" href="#bib0230"><span class="elsevierStyleSup">10,19–21</span></a> Besides, 3 studies<a class="elsevierStyleCrossRefs" href="#bib0230"><span class="elsevierStyleSup">10,19,21</span></a> reported DBS implanted in the subthalamic nucleus (STN), 1 study<a class="elsevierStyleCrossRef" href="#bib0280"><span class="elsevierStyleSup">20</span></a> in the globus pallidus pars interna (GPi) and 2 studies<a class="elsevierStyleCrossRefs" href="#bib0290"><span class="elsevierStyleSup">22,23</span></a> in the either STN or GPi. In addition, Chen et al.<a class="elsevierStyleCrossRef" href="#bib0295"><span class="elsevierStyleSup">23</span></a> reported the independent data of GPi- and STN-DBS respectively, so we included the data of GPi- and STN-DBS.</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia></span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0120">Lead placement</span><span id="sec0065" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0125">Stereotactic accuracy (radial error)</span><p id="par0190" class="elsevierStylePara elsevierViewall">Three studies<a class="elsevierStyleCrossRefs" href="#bib0230"><span class="elsevierStyleSup">10,20,23</span></a> comprising of 388 leads were included (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>). The overall weighted mean difference (WMD) was −0.45 (95% CI<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>−1.11 to 0.20), with high heterogeneity (<span class="elsevierStyleItalic">I</span><span class="elsevierStyleSup">2</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>99%, <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>.00001), even after applying a random effect model. Subgroup analysis was conducted according to IMG technology and DBS targeted site. Subgroup analysis revealed significant differences between iCT and iMRI guided DBS (<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>0.02, <span class="elsevierStyleItalic">I</span><span class="elsevierStyleSup"><span class="elsevierStyleItalic">2</span></span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>81.6), suggesting that iMRI guided DBS is more accurate than iCT guided DBS. Besides, no significant differences were observed between GPi and STN DBS (<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.41, <span class="elsevierStyleItalic">I</span><span class="elsevierStyleSup"><span class="elsevierStyleItalic">2</span></span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0%) (<a class="elsevierStyleCrossRef" href="#sec0150">Supplementary Fig. S1</a>).</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia></span><span id="sec0070" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0130">Lead passes per trajectory</span><p id="par0095" class="elsevierStylePara elsevierViewall">Two studies<a class="elsevierStyleCrossRefs" href="#bib0285"><span class="elsevierStyleSup">21,23</span></a> comprising of 264 patients (including Chen, GPi and STN, respectively) reported lead passes per trajectory (<a class="elsevierStyleCrossRef" href="#fig0015">Fig. 3</a>). The overall WMD was −0.18 (95% CI<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>−0.41 to 0.06). No significant difference was noted between these two DBS techniques.</p><elsevierMultimedia ident="fig0015"></elsevierMultimedia></span><span id="sec0075" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0135">Operative and procedure time</span><p id="par0100" class="elsevierStylePara elsevierViewall">Two studies<a class="elsevierStyleCrossRefs" href="#bib0275"><span class="elsevierStyleSup">19,23</span></a> reported the operative and procedure time (<a class="elsevierStyleCrossRef" href="#fig0020">Fig. 4</a>). A total of 86 patients underwent only electrodes placement in the first operation and battery placement in the second operation, whereas a total of 112 patients underwent electrode and battery placement during the same operation. There were no significant differences between IMG and MER guided DBS, whether the electrode and battery placement were done during the same operation or only electrode placement was done during the first operation.</p><elsevierMultimedia ident="fig0020"></elsevierMultimedia></span></span><span id="sec0080" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0140">Clinical outcomes</span><span id="sec0085" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0145">Motor function: UPDRS-III</span><p id="par0105" class="elsevierStylePara elsevierViewall">Five studies<a class="elsevierStyleCrossRefs" href="#bib0230"><span class="elsevierStyleSup">10,20–23</span></a> comprising of 435 patients (including Chen et al.<a class="elsevierStyleCrossRef" href="#bib0295"><span class="elsevierStyleSup">23</span></a> GPi and STN, respectively) reported improvement% of UPDRS-III (off medication/off DBS to off medication/on DBS) (<a class="elsevierStyleCrossRef" href="#fig0025">Fig. 5</a>). No significant difference was observed between the two implantation techniques (95% CI<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>−5.34 to 12.16, <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.45), with high heterogeneity (<span class="elsevierStyleItalic">I</span><span class="elsevierStyleSup">2</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>89%). Subgroup analysis was performed according to DBS targeting site (<a class="elsevierStyleCrossRef" href="#sec0150">Supplementary Fig. S2). The WMD of GPi- and STN-DBS were 8.76 (95% CI</a><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>−9.55 to 27.06, <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.35) and 2.61 (95% CI<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>−4.20 to 9.42, <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.45), respectively. Subgroup analysis still showed high heterogeneity (<span class="elsevierStyleItalic">I</span><span class="elsevierStyleSup">2</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>94% and 71%, respectively).</p><elsevierMultimedia ident="fig0025"></elsevierMultimedia><p id="par0110" class="elsevierStylePara elsevierViewall">The sensitivity analysis indicated that heterogeneity was significantly reduced from 92% to 58%, when we excluded the study by Bezchlibnyk et al.<a class="elsevierStyleCrossRef" href="#bib0280"><span class="elsevierStyleSup">20</span></a> However, the results remained similar even after this exclusion.</p></span><span id="sec0090" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0150">Medication dosage reduction%</span><p id="par0115" class="elsevierStylePara elsevierViewall">Four studies<a class="elsevierStyleCrossRefs" href="#bib0230"><span class="elsevierStyleSup">10,19–21</span></a> comprising of 276 patients reported LEDD reduction (<a class="elsevierStyleCrossRef" href="#fig0030">Fig. 6</a>). No significant difference was observed between IMG and MER-guided DBS (95% CI<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>−1.40 to 11.39, <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.13). However, there was high heterogeneity for the LEDD reduction% (<span class="elsevierStyleItalic">I</span><span class="elsevierStyleSup">2</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>78%, <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.004).</p><elsevierMultimedia ident="fig0030"></elsevierMultimedia></span><span id="sec0095" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0155">Quality of life</span><p id="par0120" class="elsevierStylePara elsevierViewall">The quality of life was assessed using Parkinson's disease questionnaire (PDQ-39) (<a class="elsevierStyleCrossRef" href="#fig0035">Fig. 7</a>). Two studies<a class="elsevierStyleCrossRefs" href="#bib0285"><span class="elsevierStyleSup">21,22</span></a> reported improvement of PDQ-39 after DBS implantation. No significant difference was found between IMG and MER guided DBS (95% CI<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>−7.48 to 15.29, <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.50).</p><elsevierMultimedia ident="fig0035"></elsevierMultimedia></span><span id="sec0100" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0160">Adverse events</span><p id="par0125" class="elsevierStylePara elsevierViewall">There were six studies<a class="elsevierStyleCrossRefs" href="#bib0230"><span class="elsevierStyleSup">10,19–23</span></a> that reported adverse events, including hardware complications, pulmonary embolism, stroke, hemorrhage, seizure, mortality and infection during the follow-up period. Pooling statistics were performed for all reported adverse events (<a class="elsevierStyleCrossRef" href="#sec0150">Supplementary Table S2</a>). No significant difference was observed between IMG or MER guided DBS in each reported adverse event.</p></span></span></span><span id="sec0105" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0165">Discussion</span><p id="par0130" class="elsevierStylePara elsevierViewall">Our meta-analysis summarized the relevant evidence from 6 studies,<a class="elsevierStyleCrossRefs" href="#bib0230"><span class="elsevierStyleSup">10,19–23</span></a> published between 2016 and 2020. Our findings confirmed that stereotactic accuracy of lead placement and clinical outcomes, including improvement of motor function, quality of life and medication dosage reduction under IMG guided DBS were comparable to the traditional MER guided DBS for PD.</p><span id="sec0110" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0170">Lead placement</span><p id="par0135" class="elsevierStylePara elsevierViewall">Among the included studies, the stereotactic error of lead placement from intended target ranged from 0.8<a class="elsevierStyleCrossRefs" href="#bib0230"><span class="elsevierStyleSup">10,23</span></a> to 1.94<span class="elsevierStyleHsp" style=""></span>mm,<a class="elsevierStyleCrossRef" href="#bib0280"><span class="elsevierStyleSup">20</span></a> consistent with prior studies that indicated radial error of 0.84<span class="elsevierStyleHsp" style=""></span>mm<a class="elsevierStyleCrossRef" href="#bib0310"><span class="elsevierStyleSup">26</span></a> to 2.1<span class="elsevierStyleHsp" style=""></span>mm<a class="elsevierStyleCrossRef" href="#bib0315"><span class="elsevierStyleSup">27</span></a> under MER guidance and submillimetric error<a class="elsevierStyleCrossRefs" href="#bib0320"><span class="elsevierStyleSup">28,29</span></a> under IMG guidance. Subgroup analysis in our study showed that intraoperative MRI guided DBS was more accurate than intraoperative CT guided DBS, and only borderline statistical difference (<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.02) was noted. This result corresponded with Pezeshkian et al.<a class="elsevierStyleCrossRef" href="#bib0330"><span class="elsevierStyleSup">30</span></a> that indicated similar accuracies of lead placement under iCT and iMRI guidance (1.52<span class="elsevierStyleHsp" style=""></span>mm and 1.08<span class="elsevierStyleHsp" style=""></span>mm, respectively). Besides, Lee et al.<a class="elsevierStyleCrossRef" href="#bib0230"><span class="elsevierStyleSup">10</span></a> reported that IMG guided (0.7<span class="elsevierStyleHsp" style=""></span>mm, SD<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.4<span class="elsevierStyleHsp" style=""></span>mm) was more accurate than MER guided DBS (1.8<span class="elsevierStyleMonospace">Y</span>mm, SD<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.8<span class="elsevierStyleHsp" style=""></span>mm) at the second lead placement site. According to the authors, the potential explanations of this discrepancy were as following: all leads were placed with a single penetration under iMRI guidance thus limiting CSF loss and brain shift. Besides, there was possible association between MER and dislocation of anatomical targets secondary to air inflow and brain shift.<a class="elsevierStyleCrossRef" href="#bib0335"><span class="elsevierStyleSup">31</span></a> Finally, trajectory in IMG guided DBS could be adjusted prior to lead implantation to account for brain shift by providing real-time imaging to refine a trajectory and evaluate the effect of pneumocephalus and brain shift.<a class="elsevierStyleCrossRefs" href="#bib0230"><span class="elsevierStyleSup">10,15,16</span></a></p><p id="par0140" class="elsevierStylePara elsevierViewall">In addition, there were no differences in lead passes per trajectory in our analysis. Previous studies<a class="elsevierStyleCrossRefs" href="#bib0340"><span class="elsevierStyleSup">32,33</span></a> indicated that intracerebral hemorrhage risk was related to lead passes per trajectory. Lee et al.<a class="elsevierStyleCrossRef" href="#bib0230"><span class="elsevierStyleSup">10</span></a> indicated that IMG guidance allowed immediate detection of hemorrhages, which can then be rapidly addressed. In addition, Liu et al.<a class="elsevierStyleCrossRef" href="#bib0285"><span class="elsevierStyleSup">21</span></a> also reported that patients with asymptomatic hemorrhage had higher lead passes (1.8<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>1.1 compared to 1.5<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>0.7), consistent with previous studies.<a class="elsevierStyleCrossRefs" href="#bib0340"><span class="elsevierStyleSup">32,33</span></a> In our study, no statistically significant difference in asymptomatic hemorrhage between MER and IMG guidance DBS was observed (intracranial hemorrhage rate 2.27% and 3.82%, respectively).</p></span><span id="sec0115" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0175">OR/procedure time</span><p id="par0145" class="elsevierStylePara elsevierViewall">Mirzadeh et al.<a class="elsevierStyleCrossRef" href="#bib0350"><span class="elsevierStyleSup">34</span></a> reported that MER was an independent contributing factor to increased procedure/OR time. However, there was no significant difference in OR/procedure time in our analysis. Besides, high heterogeneity was observed in two included studies.<a class="elsevierStyleCrossRefs" href="#bib0275"><span class="elsevierStyleSup">19,23</span></a> Different IMG technology might be the reason for this heterogeneity, in which Chen et al.<a class="elsevierStyleCrossRef" href="#bib0295"><span class="elsevierStyleSup">23</span></a> used iCT and Saleh et al.<a class="elsevierStyleCrossRef" href="#bib0275"><span class="elsevierStyleSup">19</span></a> used iMRI. Pezeshkian et al.<a class="elsevierStyleCrossRef" href="#bib0330"><span class="elsevierStyleSup">30</span></a> indicated that unlike intraoperative MRI, CT scanner could be performed while still in the same operating room without requiring repositioning or dislocation of the stereotactic head frame, thus being less time-consuming. This was consistent with our analysis, in which Saleh et al.<a class="elsevierStyleCrossRef" href="#bib0275"><span class="elsevierStyleSup">19</span></a> reported that MER guided DBS was less time consuming than iMRI approach. In contrast, Chen et al.<a class="elsevierStyleCrossRef" href="#bib0295"><span class="elsevierStyleSup">23</span></a> reported that MER approach was more time consuming than iCT approach. The learning curve of each surgeon was a contributor to surgery duration, in which Saleh et al.<a class="elsevierStyleCrossRef" href="#bib0275"><span class="elsevierStyleSup">19</span></a> revealed that operative times decreased when more patients underwent DBS and surgical experience was accrued.</p></span><span id="sec0120" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0180">Clinical outcomes</span><p id="par0150" class="elsevierStylePara elsevierViewall">Postoperative UPDRS III scores improved significantly in all included studies,<a class="elsevierStyleCrossRefs" href="#bib0230"><span class="elsevierStyleSup">10,20–23</span></a> regardless of MER or IMG guided DBS, which ranged from 25.5%<a class="elsevierStyleCrossRef" href="#bib0280"><span class="elsevierStyleSup">20</span></a> to 66.3%.<a class="elsevierStyleCrossRef" href="#bib0285"><span class="elsevierStyleSup">21</span></a> Among the included studies, Bezchlibnyk et al.<a class="elsevierStyleCrossRef" href="#bib0280"><span class="elsevierStyleSup">20</span></a> reported the lowest improvement (25.5%) for MER approach. This result was vastly similar to the previous randomized controlled trials using MER guidance (Odekerken et al.<a class="elsevierStyleCrossRef" href="#bib0355"><span class="elsevierStyleSup">35</span></a> 26%). Bezchlibnyk et al.<a class="elsevierStyleCrossRef" href="#bib0280"><span class="elsevierStyleSup">20</span></a> considered this to be due to the MER approach group having more patients (43.8%) that were treated via unilateral leads instead of bilateral. Therefore, we conducted the sensitivity analysis excluding this study,<a class="elsevierStyleCrossRef" href="#bib0280"><span class="elsevierStyleSup">20</span></a> and heterogeneity was reduced significantly from moderate to low (92% to 58%). However, the overall results remained similar even after the exclusion. In addition, our subgroup analysis indicated no significant difference between GPi- and STN-DBS on UPDRS-III improvement, and this result was consistent with previous meta-analysis.<a class="elsevierStyleCrossRef" href="#bib0360"><span class="elsevierStyleSup">36</span></a></p><p id="par0155" class="elsevierStylePara elsevierViewall">There were no statistically significant differences in each pooling adverse event and hardware related complication in our analysis (<a class="elsevierStyleCrossRef" href="#sec0150">Supplementary Table S2</a>). Acute complications such as brain hemorrhage (3.82% and 2.27%, respectively) and hardware related complications (e.g. lead revision, fracture or reposition) were rare in both techniques. Therefore, DBS is a relatively safe surgery regardless of the two guidance methods.</p></span><span id="sec0125" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0185">Strengths and limitations</span><p id="par0160" class="elsevierStylePara elsevierViewall">To our knowledge, this is the first meta-analysis to directly compare the clinical efficacy and lead placement between IMG and MER guided DBS. However, there are several limitations that must be addressed. First, all included studies were cohort studies (5 retrospective<a class="elsevierStyleCrossRefs" href="#bib0230"><span class="elsevierStyleSup">10,19–22</span></a> and 1 prospective design<a class="elsevierStyleCrossRef" href="#bib0295"><span class="elsevierStyleSup">23</span></a>), which possibly contributed to high heterogeneity in our analysis, even after applying the random effect model. Difference in IMG technology and DBS target locations should also be taken into consideration. Subgroup analysis was performed to assess the effects of IMG technology and DBS targeting location respectively. In addition, we did not analyze publication bias due to the limited number of studies which may result in low statistical power. Finally, this analysis provided a strong comparison between the two DBS implantation techniques. However, more and larger randomized clinical trials to directly compare and confirm stereotactic accuracy of lead placement and clinical efficacy between the two implantation technologies is required.</p></span></span><span id="sec0130" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0190">Conclusions</span><p id="par0165" class="elsevierStylePara elsevierViewall">Our study demonstrated that both IMG and MER guided deep brain stimulation offered effective treatment for control of motor symptoms in PD patients. Besides, IMG guided DBS is comparable to MER guided DBS, in terms of safety, accuracy and efficiency. It is recommended for each hospital to select DBS guidance technology based on available resources and equipment.</p></span><span id="sec0135" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0195">Funding</span><p id="par0170" class="elsevierStylePara elsevierViewall">This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.</p></span><span id="sec0140" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0200">Conflict of interest</span><p id="par0175" class="elsevierStylePara elsevierViewall">The authors have no conflicts of interest relevant to this article.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:12 [ 0 => array:3 [ "identificador" => "xres1958132" "titulo" => "Abstract" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Background" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Methods" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Conclusions" ] ] ] 1 => array:2 [ "identificador" => "xpalclavsec1685275" "titulo" => "Keywords" ] 2 => array:3 [ "identificador" => "xres1958131" "titulo" => "Resumen" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0025" "titulo" => "Antecedentes" ] 1 => array:2 [ "identificador" => "abst0030" "titulo" => "Métodos" ] 2 => array:2 [ "identificador" => "abst0035" "titulo" => "Resultados" ] 3 => array:2 [ "identificador" => "abst0040" "titulo" => "Conclusiones" ] ] ] 3 => array:2 [ "identificador" => "xpalclavsec1685274" "titulo" => "Palabras clave" ] 4 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 5 => array:3 [ "identificador" => "sec0010" "titulo" => "Methods" "secciones" => array:5 [ 0 => array:2 [ "identificador" => "sec0015" "titulo" => "Inclusion and exclusion criteria" ] 1 => array:2 [ "identificador" => "sec0020" "titulo" => "Data extraction (selection and coding)" ] 2 => array:2 [ "identificador" => "sec0025" "titulo" => "Statistical analysis and data synthesis" ] 3 => array:2 [ "identificador" => "sec0030" "titulo" => "Risk of bias (quality) assessment" ] 4 => array:2 [ "identificador" => "sec0035" "titulo" => "Study registration" ] ] ] 6 => array:3 [ "identificador" => "sec0040" "titulo" => "Results" "secciones" => array:5 [ 0 => array:2 [ "identificador" => "sec0045" "titulo" => "Identification of included study" ] 1 => array:2 [ "identificador" => "sec0050" "titulo" => "Methodological quality of included study" ] 2 => array:2 [ "identificador" => "sec0055" "titulo" => "Study characteristics" ] 3 => array:3 [ "identificador" => "sec0060" "titulo" => "Lead placement" "secciones" => array:3 [ 0 => array:2 [ "identificador" => "sec0065" "titulo" => "Stereotactic accuracy (radial error)" ] 1 => array:2 [ "identificador" => "sec0070" "titulo" => "Lead passes per trajectory" ] 2 => array:2 [ "identificador" => "sec0075" "titulo" => "Operative and procedure time" ] ] ] 4 => array:3 [ "identificador" => "sec0080" "titulo" => "Clinical outcomes" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "sec0085" "titulo" => "Motor function: UPDRS-III" ] 1 => array:2 [ "identificador" => "sec0090" "titulo" => "Medication dosage reduction%" ] 2 => array:2 [ "identificador" => "sec0095" "titulo" => "Quality of life" ] 3 => array:2 [ "identificador" => "sec0100" "titulo" => "Adverse events" ] ] ] ] ] 7 => array:3 [ "identificador" => "sec0105" "titulo" => "Discussion" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "sec0110" "titulo" => "Lead placement" ] 1 => array:2 [ "identificador" => "sec0115" "titulo" => "OR/procedure time" ] 2 => array:2 [ "identificador" => "sec0120" "titulo" => "Clinical outcomes" ] 3 => array:2 [ "identificador" => "sec0125" "titulo" => "Strengths and limitations" ] ] ] 8 => array:2 [ "identificador" => "sec0130" "titulo" => "Conclusions" ] 9 => array:2 [ "identificador" => "sec0135" "titulo" => "Funding" ] 10 => array:2 [ "identificador" => "sec0140" "titulo" => "Conflict of interest" ] 11 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2022-04-29" "fechaAceptado" => "2022-09-12" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec1685275" "palabras" => array:5 [ 0 => "Deep brain stimulation" 1 => "Interventional magnetic resonance imaging" 2 => "Intraoperative computed tomography" 3 => "Microelectrodes" 4 => "Parkinson's disease" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec1685274" "palabras" => array:5 [ 0 => "Estimulación cerebral profunda" 1 => "Resonancia magnética intervencionista mediante imágenes" 2 => "Tomografía computarizada intraoperatoria" 3 => "Microelectrodos" 4 => "Enfermedad de Parkinson" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:3 [ "titulo" => "Abstract" "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Background</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Traditionally, most centers would use microelectrode recording (MER) to refine targeting in deep brain stimulation (DBS) surgery. In recent years, intraoperative imaging (IMG) guided DBS has become an alternative way to verify lead placement. Currently, there is still controversy surrounding the necessity of MER or IMG for DBS. This meta-analysis aims to explore lead accuracy, clinical efficacy and safety between IMG and MER guided DBS for Parkinson's disease (PD).</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Methods</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">PubMed, Embase, Web of Science, Cochrane Library were searched up to Mar, 2021 for studies reporting comparisons between IMG and MER guided DBS for PD. Subgroup analysis was conducted to assess effects of different IMG technology and DBS targeting site.</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Six studies, comprising of 478 patients were included in our analysis. The mean difference between the two implantation techniques in stereotactic accuracy, lead passes per trajectory, improvement% of Unified Parkinson's Disease Rating Scale part III and levodopa equivalent daily dose were −0.45 (95% confidence interval, CI<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>−1.11 to 0.20), −0.18 (95% CI<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>−0.41 to 0.06), 3.40 (95% CI<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>−5.36 to 12.16), and 5.00 (95% CI<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>−1.40 to 11.39), respectively. No significant differences were observed in each adverse event and operation/procedure time between the two implantation techniques.</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusions</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Both IMG and MER guided DBS offered effective control of motor symptoms for PD. Besides, IMG guided is comparable to MER guided DBS, in terms of safety, accuracy and efficiency. It is recommended for each hospital to select DBS guidance technology based on available resources and equipment.</p></span>" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Background" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Methods" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Conclusions" ] ] ] "es" => array:3 [ "titulo" => "Resumen" "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Antecedentes</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Tradicionalmente, la mayoría de los centros usaban los microelectrodos de registro (<span class="elsevierStyleItalic">microelectrode recording</span> [MER]) para mejorar la orientación en la cirugía mediante la estimulación cerebral profunda (<span class="elsevierStyleItalic">deep brain stimulation</span> [DBS]). En los últimos años, la DBS orientada mediante imágenes intraoperatorias (<span class="elsevierStyleItalic">intraoperative imaging guided</span> [IMG]) se ha convertido en una forma alternativa de verificar la colocación de los electrodos. Hoy en día, todavía existe controversia en torno al uso de MER o IMG para realizar una DBS. Este metaanálisis tiene como objetivo explorar la precisión de los electrodos, la eficacia clínica y la seguridad entre la DBS guiada mediante IMG y MER en el tratamiento de la enfermedad de Parkinson (EP).</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Métodos</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Se realizaron búsquedas en PubMed, Embase, Web of Science y Cochrane Library hasta marzo de 2021 para localizar estudios que informasen sobre comparaciones entre la DBS guiada mediante IMG y la guiada mediante MER en la EP. Se realizó un análisis de subgrupos para evaluar los efectos de una tecnología IMG y una ubicación DBS guiada diferentes.</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Resultados</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">En nuestro análisis hemos incluido seis estudios con 478 pacientes. La diferencia media entre las dos técnicas de implantación en la precisión estereotáctica, los pasos del electrodo por trayectoria, el porcentaje de mejora de la escala unificada de clasificación de la enfermedad de Parkinson, parte<span class="elsevierStyleHsp" style=""></span>III, y la dosis diaria equivalente de levodopa fueron −0,45 (intervalo de confianza del 95% [IC 95%]: −1,11 a 0,20), −<span class="elsevierStyleHsp" style=""></span>0,18 (IC 95%: −0,41 a 0,06), 3,40 (IC 95%: −5,36 a 12,16) y 5,00 (IC 95%: −1,40 a 11,39), respectivamente. No se observaron diferencias significativas en cada evento adverso y tiempo de operación/procedimiento entre las dos técnicas de implantación.</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusiones</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Tanto la DBS guiada mediante IMG como la guiada mediante MER ofrecieron un control eficaz de los síntomas motores de la EP. Además, la DBS orientada guiada por IMG es comparable a la orientada guiada por MER en cuanto a seguridad, precisión y eficiencia. Se recomienda que cada hospital seleccione la tecnología DBS guiada en función de los recursos y del equipamiento disponibles.</p></span>" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0025" "titulo" => "Antecedentes" ] 1 => array:2 [ "identificador" => "abst0030" "titulo" => "Métodos" ] 2 => array:2 [ "identificador" => "abst0035" "titulo" => "Resultados" ] 3 => array:2 [ "identificador" => "abst0040" "titulo" => "Conclusiones" ] ] ] ] "NotaPie" => array:1 [ 0 => array:3 [ "etiqueta" => "1" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Contributed equally as first authors.</p>" "identificador" => "fn0005" ] ] "apendice" => array:1 [ 0 => array:1 [ "seccion" => array:1 [ 0 => array:4 [ "apendice" => "<p id="par0185" class="elsevierStylePara elsevierViewall">The following are the supplementary data to this article:<elsevierMultimedia ident="upi0005"></elsevierMultimedia></p>" "etiqueta" => "Appendix A" "titulo" => "Supplementary data" "identificador" => "sec0150" ] ] ] ] "multimedia" => array:9 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 2921 "Ancho" => 3174 "Tamanyo" => 424455 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">PRISMA flow diagram.</p>" ] ] 1 => array:7 [ "identificador" => "fig0010" "etiqueta" => "Fig. 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 1224 "Ancho" => 3176 "Tamanyo" => 323282 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Subgroup analysis: forest plots of accuracy of lead placement between IMG guided and MER guided DBS according to intraoperative imaging technology. iCT<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>intraoperative computed tomography, iMRI<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>intraoperative magnetic resonance imaging,.</p>" ] ] 2 => array:7 [ "identificador" => "fig0015" "etiqueta" => "Fig. 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 586 "Ancho" => 3174 "Tamanyo" => 158658 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Forest plots of lead passes per trajectory between IMG guided and MER guided DBS.</p>" ] ] 3 => array:7 [ "identificador" => "fig0020" "etiqueta" => "Fig. 4" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr4.jpeg" "Alto" => 2067 "Ancho" => 3174 "Tamanyo" => 521317 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Forest plots of operative room (OR) and procedure time between IMG and MER guided DBS. IPG<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>internal pulse generators.</p>" ] ] 4 => array:7 [ "identificador" => "fig0025" "etiqueta" => "Fig. 5" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr5.jpeg" "Alto" => 743 "Ancho" => 3174 "Tamanyo" => 215885 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">Forest plots of postoperative UPDRS-III improvement% between IMG and MER guided DBS.</p>" ] ] 5 => array:7 [ "identificador" => "fig0030" "etiqueta" => "Fig. 6" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr6.jpeg" "Alto" => 623 "Ancho" => 3176 "Tamanyo" => 175145 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">Forest plots of postoperative LEDD improvement% between IMG and MER guided DBS.</p>" ] ] 6 => array:7 [ "identificador" => "fig0035" "etiqueta" => "Fig. 7" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr7.jpeg" "Alto" => 525 "Ancho" => 3174 "Tamanyo" => 145722 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">Forest plots of postoperative quality of life improvement% between IMG guided and MER guided DBS.</p>" ] ] 7 => array:8 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at1" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:2 [ "leyenda" => "<p id="spar0085" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleItalic">Abbreviations</span>: UPDRS-III<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>Unified Parkinson's Disease Rating Scale part III, LED<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>levodopa equivalent daily dose, Bil<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>bilateral, Uni<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>unilateral, DBS<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>deep brain stimulation, iCT<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>intraoperative computed tomography, iMRI<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>intraoperative magnetic resonance imaging, STN<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>subthalamic nucleus, GPi<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>globus pallidus pars interna, QoL<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>quality of life, AEs<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>adverse event.</p>" "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td-with-role" title="\n \t\t\t\t\ttable-head\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col">Study no. \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col">Authors & year \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col">Intraoperative imaging technology \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col">Target site \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " colspan="2" align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Durations of illness(Mean age<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>SD) (years)</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col">Months of FU for outcome reported \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " colspan="2" align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Patient no.Mean age<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>SD (years)</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col">Outcomes included in analysis \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">IMG \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">MER \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Intervention \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Comparator \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Bezchlibnyk et al. 2020<a class="elsevierStyleCrossRef" href="#bib0280"><span class="elsevierStyleSup">20</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">iMRI \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Bil/UniGPi \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">10.1<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>0.6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">10.2<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>1.2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">12 months \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">41 patients64.5<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>1.6 yrs \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">16 patients67.8<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>1.6 yrs \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Stereotactic errorsUPDRS-III and LEDAEs \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Lee et al. 2018<a class="elsevierStyleCrossRef" href="#bib0230"><span class="elsevierStyleSup">10</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">iMRI \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Bil.STN \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">NA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">NA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6 months \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">21 patients64.9<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>9.9 yrs \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">24 patients66.3<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>6.6 yrs \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Stereotactic errorsUPDRS-III and LEDAEs \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Liu et al. 2017<a class="elsevierStyleCrossRef" href="#bib0285"><span class="elsevierStyleSup">21</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">iMRI \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Bil./Uni.STN \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">NA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">NA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">12 months \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">61 patients63<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>4.5 yrs \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">76 patients62<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>7.7 yrs \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Stereotactic errorsLead passes per trajectoryQoLUPDRS-III and LEDAEs \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Saleh et al. 2016<a class="elsevierStyleCrossRef" href="#bib0275"><span class="elsevierStyleSup">19</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">iMRI \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Bil. STN \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">10.9<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>3.8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">11.3<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>4.9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6 months \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">14 patients64.0<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>11.9 yrs \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">23 patients60.6<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>7.0 yrs \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Operative timeLEDAEs \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5-1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " rowspan="2" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Chen et al. 2018<a class="elsevierStyleCrossRef" href="#bib0295"><span class="elsevierStyleSup">23</span></a></td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " rowspan="2" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">iCT</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">BilGPi \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">10.0<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>5.0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">10.3<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>6.6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " rowspan="2" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6 months</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">62 patients64.0<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>8.6 yrs \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">16 patients62.8<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>11.1 yrs \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Stereotactic accuracyLead passes per trajectoryUPDRS-IIIOperative timeAEs \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5-2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">BilSTN \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">7.5<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>3.4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">8.6<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>4.6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">41 patients64.6<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>8.2 yrs \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">14 patients63.1<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>10.1 yrs \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Stereotactic accuracyLead passes per trajectoryUPDRS-IIIOperative timeAEs \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Brodsky et al. 2017<a class="elsevierStyleCrossRef" href="#bib0290"><span class="elsevierStyleSup">22</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">iCT \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Bil/UniGPi/STN \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">NA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">NA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6-Month \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">30 patients63.7<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>9.79 yrs \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">39 patients63.1<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>7.61 yrs \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">UPDRS-IIIQoLAEs \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab3259042.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0080" class="elsevierStyleSimplePara elsevierViewall">Characteristics of the included studies.</p>" ] ] 8 => array:5 [ "identificador" => "upi0005" "tipo" => "MULTIMEDIAECOMPONENTE" "mostrarFloat" => false "mostrarDisplay" => true "Ecomponente" => array:2 [ "fichero" => "mmc1.doc" "ficheroTamanyo" => 99381 ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:36 [ 0 => array:3 [ "identificador" => "bib0185" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Deep-brain stimulation for Parkinson's disease" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "M.S. Okun" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1056/NEJMct1208070" "Revista" => array:7 [ "tituloSerie" => "N Engl J Med" "fecha" => "2012" "volumen" => "367" "paginaInicial" => "1529" "paginaFinal" => "1538" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23075179" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S0002939409008034" "estado" => "S300" "issn" => "00029394" ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0190" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Parkinson's disease and parkinsonism" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "M.T. Hayes" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.amjmed.2019.03.001" "Revista" => array:6 [ "tituloSerie" => "Am J Med" "fecha" => "2019" "volumen" => "132" "paginaInicial" => "802" "paginaFinal" => "807" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30890425" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0195" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The spectrum of levodopa-induced dyskinesias" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "S. Fahn" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:3 [ "tituloSerie" => "Ann Neurol" "fecha" => "2000" "volumen" => "47" ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0200" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Deep brain stimulation in Parkinson's disease" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "R. Mehanna" 1 => "E.C. Lai" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1186/2047-9158-2-22" "Revista" => array:5 [ "tituloSerie" => "Transl Neurodegener" "fecha" => "2013" "volumen" => "2" "paginaInicial" => "22" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24245947" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0205" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "A randomized trial of deep-brain stimulation for Parkinson's disease" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "G. Deuschl" 1 => "C. Schade-Brittinger" 2 => "P. Krack" 3 => "J. Volkmann" 4 => "H. Schäfer" 5 => "K. Bötzel" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1056/NEJMoa060281" "Revista" => array:6 [ "tituloSerie" => "N Engl J Med" "fecha" => "2006" "volumen" => "355" "paginaInicial" => "896" "paginaFinal" => "908" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16943402" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0210" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Reoperation for suboptimal outcomes after deep brain stimulation surgery" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "T.M. Ellis" 1 => "K.D. Foote" 2 => "H.H. Fernandez" 3 => "A. Sudhyadhom" 4 => "R.L. Rodriguez" 5 => "P. Zeilman" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Neurosurgery" "fecha" => "2008" "volumen" => "63" "paginaInicial" => "754" "paginaFinal" => "760" ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0215" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Deep brain stimulation in Parkinson's disease" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "N. Malek" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.4103/0028-3886.266268" "Revista" => array:7 [ "tituloSerie" => "Neurol India" "fecha" => "2019" "volumen" => "67" "paginaInicial" => "968" "paginaFinal" => "978" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/31512617" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S2213858719304115" "estado" => "S300" "issn" => "22138587" ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0220" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Outcome of bilateral subthalamic nucleus stimulation in the treatment of Parkinson's disease: correlation with intra-operative multi-unit recordings but not with the type of anaesthesia" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "J.P. Lefaucheur" 1 => "J.M. Gurruchaga" 2 => "B. Pollin" 3 => "F. von Raison" 4 => "N. Mohsen" 5 => "M. Shin" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1159/000148246" "Revista" => array:6 [ "tituloSerie" => "Eur Neurol" "fecha" => "2008" "volumen" => "60" "paginaInicial" => "186" "paginaFinal" => "199" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18667827" "web" => "Medline" ] ] ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib0225" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Validity of single tract microelectrode recording in subthalamic nucleus stimulation" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "A. Umemura" 1 => "Y. Oka" 2 => "K. Yamada" 3 => "G. Oyama" 4 => "Y. Shimo" 5 => "N. Hattori" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.2176/nmc.oa2012-0412" "Revista" => array:6 [ "tituloSerie" => "Neurol Med Chir (Tokyo)" "fecha" => "2013" "volumen" => "53" "paginaInicial" => "821" "paginaFinal" => "827" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24140767" "web" => "Medline" ] ] ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib0230" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Outcomes of interventional-MRI versus microelectrode recording-guided subthalamic deep brain stimulation" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "P.S. Lee" 1 => "G.M. Weiner" 2 => "D. Corson" 3 => "J. Kappel" 4 => "Y.F. Chang" 5 => "V.R. Suski" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.3389/fneur.2018.00241" "Revista" => array:6 [ "tituloSerie" => "Front Neurol" "fecha" => "2018" "volumen" => "9" "paginaInicial" => "241" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/29695996" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S0002939411004752" "estado" => "S300" "issn" => "00029394" ] ] ] ] ] ] ] 10 => array:3 [ "identificador" => "bib0235" "etiqueta" => "11" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Accuracy of deep brain stimulation electrode placement using intraoperative computed tomography without microelectrode recording" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "K.J. Burchiel" 1 => "S. McCartney" 2 => "A. Lee" 3 => "A.M. Raslan" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.3171/2013.4.JNS122324" "Revista" => array:7 [ "tituloSerie" => "J Neurosurg" "fecha" => "2013" "volumen" => "119" "paginaInicial" => "301" "paginaFinal" => "306" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23724986" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S0161642016320358" "estado" => "S300" "issn" => "01616420" ] ] ] ] ] ] ] 11 => array:3 [ "identificador" => "bib0240" "etiqueta" => "12" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Deep brain stimulation emergencies: how the new technologies could modify the current scenario" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "G. Cossu" 1 => "M. Sensi" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s11910-017-0761-y" "Revista" => array:5 [ "tituloSerie" => "Curr Neurol Neurosci Rep" "fecha" => "2017" "volumen" => "17" "paginaInicial" => "51" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28497305" "web" => "Medline" ] ] ] ] ] ] ] ] 12 => array:3 [ "identificador" => "bib0245" "etiqueta" => "13" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Clinical outcomes using ClearPoint interventional MRI for deep brain stimulation lead placement in Parkinson's disease" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "J.L. Ostrem" 1 => "N. Ziman" 2 => "N.B. Galifianakis" 3 => "P.A. Starr" 4 => "M.S. Luciano" 5 => "M. Katz" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Neurosurg" "fecha" => "2016" "volumen" => "124" "paginaInicial" => "908" "paginaFinal" => "916" "itemHostRev" => array:3 [ "pii" => "S0161642017335236" "estado" => "S300" "issn" => "01616420" ] ] ] ] ] ] ] 13 => array:3 [ "identificador" => "bib0250" "etiqueta" => "14" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Interventional MRI-guided deep brain stimulation lead implantation" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "P.S. Lee" 1 => "R.M. Richardson" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.nec.2017.05.007" "Revista" => array:6 [ "tituloSerie" => "Neurosurg Clin N Am" "fecha" => "2017" "volumen" => "28" "paginaInicial" => "535" "paginaFinal" => "544" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28917282" "web" => "Medline" ] ] ] ] ] ] ] ] 14 => array:3 [ "identificador" => "bib0255" "etiqueta" => "15" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Brain shift and pneumocephalus assessment during frame-based deep brain stimulation implantation with intraoperative magnetic resonance imaging" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "C.M. Matias" 1 => "L.A. Frizon" 2 => "F. Asfahan" 3 => "J.D. Uribe" 4 => "A.G. Machado" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1093/ons/opx170" "Revista" => array:7 [ "tituloSerie" => "Oper Neurosurg (Hagerstown)" "fecha" => "2018" "volumen" => "14" "paginaInicial" => "668" "paginaFinal" => "674" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28973421" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S0161642014001845" "estado" => "S300" "issn" => "01616420" ] ] ] ] ] ] ] 15 => array:3 [ "identificador" => "bib0260" "etiqueta" => "16" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Placement of deep brain stimulator electrodes using real-time high-field interventional magnetic resonance imaging" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "A.J. Martin" 1 => "P.S. Larson" 2 => "J.L. Ostrem" 3 => "W. Keith Sootsman" 4 => "P. Talke" 5 => "O.M. Weber" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1002/mrm.20675" "Revista" => array:6 [ "tituloSerie" => "Magn Reson Med" "fecha" => "2005" "volumen" => "54" "paginaInicial" => "1107" "paginaFinal" => "1114" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16206144" "web" => "Medline" ] ] ] ] ] ] ] ] 16 => array:3 [ "identificador" => "bib0265" "etiqueta" => "17" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The impact of multichannel microelectrode recording (MER) in deep brain stimulation of the basal ganglia" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "T.M. Kinfe" 1 => "J. Vesper" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Acta Neurochir Suppl" "fecha" => "2013" "volumen" => "117" "paginaInicial" => "27" "paginaFinal" => "33" ] ] ] ] ] ] 17 => array:3 [ "identificador" => "bib0270" "etiqueta" => "18" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Subthalamic nucleus deep brain stimulator placement using high-field interventional magnetic resonance imaging and a skull-mounted aiming device: technique and application accuracy" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "P.A. Starr" 1 => "A.J. Martin" 2 => "J.L. Ostrem" 3 => "P. Talke" 4 => "N. Levesque" 5 => "P.S. Larson" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.3171/2009.6.JNS081161" "Revista" => array:6 [ "tituloSerie" => "J Neurosurg" "fecha" => "2010" "volumen" => "112" "paginaInicial" => "479" "paginaFinal" => "490" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19681683" "web" => "Medline" ] ] ] ] ] ] ] ] 18 => array:3 [ "identificador" => "bib0275" "etiqueta" => "19" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Awake neurophysiologically guided versus asleep MRI-guided STN DBS for Parkinson disease: a comparison of outcomes using levodopa equivalents" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "S. Saleh" 1 => "K.I. Swanson" 2 => "W.B. Lake" 3 => "K.A. Sillay" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1159/000442425" "Revista" => array:6 [ "tituloSerie" => "Stereotact Funct Neurosurg" "fecha" => "2015" "volumen" => "93" "paginaInicial" => "419" "paginaFinal" => "426" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26784455" "web" => "Medline" ] ] ] ] ] ] ] ] 19 => array:3 [ "identificador" => "bib0280" "etiqueta" => "20" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Clinical outcomes of globus pallidus deep brain stimulation for Parkinson disease: a comparison of intraoperative MRI- and MER-guided lead placement" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "Y.B. Bezchlibnyk" 1 => "V.D. Sharma" 2 => "K.B. Naik" 3 => "F. Isbaine" 4 => "J.T. Gale" 5 => "J. Cheng" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "J Neurosurg" "fecha" => "2020" "volumen" => "134" "paginaInicial" => "1072" "paginaFinal" => "1082" ] ] ] ] ] ] 20 => array:3 [ "identificador" => "bib0285" "etiqueta" => "21" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Microelectrode recording-guided versus intraoperative magnetic resonance imaging-guided subthalamic nucleus deep brain stimulation surgery for parkinson disease: a 1-year follow-up study" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "X. Liu" 1 => "J. Zhang" 2 => "K. Fu" 3 => "R. Gong" 4 => "J. Chen" 5 => "J. Zhang" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.wneu.2017.08.077" "Revista" => array:6 [ "tituloSerie" => "World Neurosurg" "fecha" => "2017" "volumen" => "107" "paginaInicial" => "900" "paginaFinal" => "905" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28842228" "web" => "Medline" ] ] ] ] ] ] ] ] 21 => array:3 [ "identificador" => "bib0290" "etiqueta" => "22" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Clinical outcomes of asleep vs awake deep brain stimulation for Parkinson disease" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "M.A. Brodsky" 1 => "S. Anderson" 2 => "C. Murchison" 3 => "M. Seier" 4 => "J. Wilhelm" 5 => "A. Vederman" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Neurology" "fecha" => "2017" "volumen" => "89" "paginaInicial" => "1944" "paginaFinal" => "1950" ] ] ] ] ] ] 22 => array:3 [ "identificador" => "bib0295" "etiqueta" => "23" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Clinical outcomes following awake and asleep deep brain stimulation for Parkinson disease" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "T. Chen" 1 => "Z. Mirzadeh" 2 => "K.M. Chapple" 3 => "M. Lambert" 4 => "H.A. Shill" 5 => "G. Moguel-Cobos" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "J Neurosurg" "fecha" => "2018" "volumen" => "130" "paginaInicial" => "109" "paginaFinal" => "120" ] ] ] ] ] ] 23 => array:3 [ "identificador" => "bib0300" "etiqueta" => "24" "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "Nct. MER versus MRI guidance DBS in Parkinson's disease. <a target="_blank" href="https://clinicaltrialsgov/show/NCT01883973%202013">https://clinicaltrialsgov/show/NCT01883973 2013</a>." ] ] ] 24 => array:3 [ "identificador" => "bib0305" "etiqueta" => "25" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "ROBINS-I: a tool for assessing risk of bias in non-randomised studies of interventions" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "J.A. Sterne" 1 => "M.A. Hernán" 2 => "B.C. Reeves" 3 => "J. Savović" 4 => "N.D. Berkman" 5 => "M. Viswanathan" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1136/bmj.i4919" "Revista" => array:5 [ "tituloSerie" => "BMJ" "fecha" => "2016" "volumen" => "355" "paginaInicial" => "i4919" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27733354" "web" => "Medline" ] ] ] ] ] ] ] ] 25 => array:3 [ "identificador" => "bib0310" "etiqueta" => "26" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Targeting the subthalamic nucleus for deep brain stimulation: technical approach and fusion of pre- and postoperative MR images to define accuracy of lead placement" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "N.A. Hamid" 1 => "R.D. Mitchell" 2 => "P. Mocroft" 3 => "G.W. Westby" 4 => "J. Milner" 5 => "H. Pall" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1136/jnnp.2003.032029" "Revista" => array:7 [ "tituloSerie" => "J Neurol Neurosurg Psychiatry" "fecha" => "2005" "volumen" => "76" "paginaInicial" => "409" "paginaFinal" => "414" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15716537" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S0161642014009336" "estado" => "S300" "issn" => "01616420" ] ] ] ] ] ] ] 26 => array:3 [ "identificador" => "bib0315" "etiqueta" => "27" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Implantation of deep brain stimulators into the subthalamic nucleus: technical approach and magnetic resonance imaging-verified lead locations" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "P.A. Starr" 1 => "C.W. Christine" 2 => "P.V. Theodosopoulos" 3 => "N. Lindsey" 4 => "D. Byrd" 5 => "A. Mosley" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.3171/jns.2002.97.2.0370" "Revista" => array:7 [ "tituloSerie" => "J Neurosurg" "fecha" => "2002" "volumen" => "97" "paginaInicial" => "370" "paginaFinal" => "387" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12186466" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S2213858718301281" "estado" => "S300" "issn" => "22138587" ] ] ] ] ] ] ] 27 => array:3 [ "identificador" => "bib0320" "etiqueta" => "28" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "An optimized system for interventional magnetic resonance imaging-guided stereotactic surgery: preliminary evaluation of targeting accuracy" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "P.S. Larson" 1 => "P.A. Starr" 2 => "G. Bates" 3 => "L. Tansey" 4 => "R.M. Richardson" 5 => "A.J. Martin" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1227/NEU.0b013e31822f4a91" "Revista" => array:6 [ "tituloSerie" => "Neurosurgery" "fecha" => "2012" "volumen" => "70" "paginaInicial" => "95" "paginaFinal" => "103" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21796000" "web" => "Medline" ] ] ] ] ] ] ] ] 28 => array:3 [ "identificador" => "bib0325" "etiqueta" => "29" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Parkinson's disease outcomes after intraoperative CT-guided “asleep” deep brain stimulation in the globus pallidus internus" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "Z. Mirzadeh" 1 => "K. Chapple" 2 => "M. Lambert" 3 => "V.G. Evidente" 4 => "P. Mahant" 5 => "M.C. Ospina" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.3171/2015.4.JNS1550" "Revista" => array:7 [ "tituloSerie" => "J Neurosurg" "fecha" => "2016" "volumen" => "124" "paginaInicial" => "902" "paginaFinal" => "907" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26452116" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S0140673609621243" "estado" => "S300" "issn" => "01406736" ] ] ] ] ] ] ] 29 => array:3 [ "identificador" => "bib0330" "etiqueta" => "30" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Accuracy of frame-based stereotactic magnetic resonance imaging vs frame-based stereotactic head computed tomography fused with recent magnetic resonance imaging for postimplantation deep brain stimulator lead localization" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "P. Pezeshkian" 1 => "A.A. DeSalles" 2 => "A. Gorgulho" 3 => "E. Behnke" 4 => "D. McArthur" 5 => "A. Bari" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1227/NEU.0b013e31822b7069" "Revista" => array:7 [ "tituloSerie" => "Neurosurgery" "fecha" => "2011" "volumen" => "69" "paginaInicial" => "1299" "paginaFinal" => "1306" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21725253" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S0161642014000621" "estado" => "S300" "issn" => "01616420" ] ] ] ] ] ] ] 30 => array:3 [ "identificador" => "bib0335" "etiqueta" => "31" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Techniques for pneumocephalus and brain shift reduction in DBS surgery: a review of the literature" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "G. Beggio" 1 => "F. Raneri" 2 => "O. Rustemi" 3 => "A. Scerrati" 4 => "G. Zambon" 5 => "M. Piacentino" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Neurosurg Rev" "fecha" => "2020" "volumen" => "43" "paginaInicial" => "95" "paginaFinal" => "99" ] ] ] ] ] ] 31 => array:3 [ "identificador" => "bib0340" "etiqueta" => "32" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Deep-brain stimulation of the subthalamic nucleus or the pars interna of the globus pallidus in Parkinson's disease" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "J.A. Obeso" 1 => "C.W. Olanow" 2 => "M.C. Rodriguez-Oroz" 3 => "P. Krack" 4 => "R. Kumar" 5 => "A.E. Lang" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1056/NEJMoa000827" "Revista" => array:6 [ "tituloSerie" => "N Engl J Med" "fecha" => "2001" "volumen" => "345" "paginaInicial" => "956" "paginaFinal" => "963" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11575287" "web" => "Medline" ] ] ] ] ] ] ] ] 32 => array:3 [ "identificador" => "bib0345" "etiqueta" => "33" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Reducing hemorrhagic complications in functional neurosurgery: a large case series and systematic literature review" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "L. Zrinzo" 1 => "T. Foltynie" 2 => "P. Limousin" 3 => "M.I. Hariz" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.3171/2011.8.JNS101407" "Revista" => array:7 [ "tituloSerie" => "J Neurosurg" "fecha" => "2012" "volumen" => "116" "paginaInicial" => "84" "paginaFinal" => "94" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21905798" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S0161642021003213" "estado" => "S300" "issn" => "01616420" ] ] ] ] ] ] ] 33 => array:3 [ "identificador" => "bib0350" "etiqueta" => "34" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Procedural variables influencing stereotactic accuracy and efficiency in deep brain stimulation surgery" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "Z. Mirzadeh" 1 => "T. Chen" 2 => "K.M. Chapple" 3 => "M. Lambert" 4 => "J.P. Karis" 5 => "R. Dhall" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1093/ons/opy291" "Revista" => array:6 [ "tituloSerie" => "Oper Neurosurg (Hagerstown)" "fecha" => "2019" "volumen" => "17" "paginaInicial" => "70" "paginaFinal" => "78" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30339204" "web" => "Medline" ] ] ] ] ] ] ] ] 34 => array:3 [ "identificador" => "bib0355" "etiqueta" => "35" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Subthalamic nucleus versus globus pallidus bilateral deep brain stimulation for advanced Parkinson's disease (NSTAPS study): a randomised controlled trial" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "V.J. Odekerken" 1 => "T. van Laar" 2 => "M.J. Staal" 3 => "A. Mosch" 4 => "C.F. Hoffmann" 5 => "P.C. Nijssen" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/S1474-4422(12)70264-8" "Revista" => array:6 [ "tituloSerie" => "Lancet Neurol" "fecha" => "2013" "volumen" => "12" "paginaInicial" => "37" "paginaFinal" => "44" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23168021" "web" => "Medline" ] ] ] ] ] ] ] ] 35 => array:3 [ "identificador" => "bib0360" "etiqueta" => "36" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Meta-analysis comparing deep brain stimulation of the globus pallidus and subthalamic nucleus to treat advanced Parkinson disease" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "Y. Liu" 1 => "W. Li" 2 => "C. Tan" 3 => "X. Liu" 4 => "X. Wang" 5 => "Y. Gui" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.3171/2014.4.JNS131711" "Revista" => array:6 [ "tituloSerie" => "J Neurosurg" "fecha" => "2014" "volumen" => "121" "paginaInicial" => "709" "paginaFinal" => "718" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24905564" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/25298496/0000003400000005/v1_202309042000/S2529849622001046/v1_202309042000/en/main.assets" "Apartado" => array:4 [ "identificador" => "65581" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Clinical research" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/25298496/0000003400000005/v1_202309042000/S2529849622001046/v1_202309042000/en/main.pdf?idApp=UINPBA00004B&text.app=https://revistaneurocirugia.com/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2529849622001046?idApp=UINPBA00004B" ]
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