Review on Factors Affecting Targeting Accuracy of Deep Brain Stimulation Electrode Implantation between 2001 and 2015

Background: Accurate implantation of a depth electrode into the brain is of the greatest importance in deep brain stimulation (DBS), and various stereotactic systems have been developed for electrode implantation. However, an updated analysis of depth electrode implantation in the modern era of DBS is lacking. Objective: This study aims at providing an updated review on targeting accuracy of DBS electrode implantation by analyzing contemporary DBS electrode implantation operations from the perspective of precision engineering. Methods: Eligible articles with information on targeting accuracy of DBS electrode implantation were searched in the PubMed database. Results: An average targeting error of DBS electrode implantation is reported to decrease toward 1 mm; the standard deviation of targeting error is decreasing toward 0.5 mm. Targeting accuracy is not only found to be affected by individual surgical steps, but also systematically affected by the architecture of the implantation operation. Conclusion: A systematic strategy should be adopted to further improve the targeting accuracy of depth electrode implantation. Attention should be paid to optimizing the whole electrode implantation operation, which can help minimize error accumulation or amplification throughout the serially connected procedures for DBS electrode implantation.