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Comparative Study
. 2014 Jan;9(1):107-17.
doi: 10.1007/s11548-013-0911-x. Epub 2013 Jun 19.

Analysis of electrode deformations in deep brain stimulation surgery

Florent Lalys  1 , Claire Haegelen, Tiziano D'albis, Pierre Jannin
Affiliations
Free PMC article
Comparative Study

Analysis of electrode deformations in deep brain stimulation surgery

Florent Lalys et al. Int J Comput Assist Radiol Surg. 2014 Jan.
Free PMC article

Abstract

Purpose: Deep brain stimulation (DBS) surgery is used to reduce motor symptoms when movement disorders are refractory to medical treatment. Post-operative brain morphology can induce electrode deformations as the brain recovers from an intervention. The inverse brain shift has a direct impact on accuracy of the targeting stage, so analysis of electrode deformations is needed to predict final positions.

Methods: DBS electrode curvature was evaluated in 76 adults with movement disorders who underwent bilateral stimulation, and the key variables that affect electrode deformations were identified. Non-linear modelling of the electrode axis was performed using post-operative computed tomography (CT) images. A mean curvature index was estimated for each patient electrode. Multivariate analysis was performed using a regression decision tree to create a hierarchy of predictive variables. The identification and classification of key variables that determine electrode curvature were validated with statistical analysis.

Results: The principal variables affecting electrode deformations were found to be the date of the post-operative CT scan and the stimulation target location. The main pathology, patient's gender, and disease duration had a smaller although important impact on brain shift.

Conclusions: The principal determinants of electrode location accuracy during DBS procedures were identified and validated. These results may be useful for improved electrode targeting with the help of mathematical models.

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Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

Figure 1
Figure 1
20 segmented electrodes from 10 STN DBS patients warped into a template. In red: segmented contacts. Structures: Green: GPm, Yellow: STN, pink: red nucleus.
Figure 2
Figure 2
Distributions of predictive variables: Above: post-operative delay of the CT acquisition. Middle: disease duration. Below: Main pathology (left) and form of the disease (right) only for Parkinsonian patients.
Figure 3
Figure 3
Subdivision of MRI in three zones according to AC-PC coordinates.
Figure 4
Figure 4
Regression decision tree, with the number of electrodes used at each parent node and the mean MCI calculated at each leaf node.
Figure 5
Figure 5
MCI evolution for the subgroup of STN patients and the subgroup of GPm patients.
Figure 6
Figure 6
Statistical comparisons performed using results of the regression decision tree (one line per level). The y axis represents the MCI of electrodes.
Figure 7
Figure 7
Statistical comparisons per electrode zones, given the predictive variables of level 2 of the tree. The y axis represents the MCI of electrodes.
See this image and copyright information in PMC

References

    1. Benabid AL, Krack P, Benazzouz A, Limousin P, Koudsie A, Pollak P. Deep brain stimulation of the subthalamic nucleus for Parkinson’s disease: methodologic aspects and clinical criteria. Neurology. 2000;55:40–44. - PubMed
    1. Mink JW, Walkup J, Frey KA, et al. Patient selection and assessment recommendations for deep brain stimulation in Tourette syndrome. Mov Disord. 2006;21(11):1831–8. - PubMed
    1. Lakhan SE, Callaway H. Deep brain stimulation for obsessive-compulsive disorder treatment-resistant depression : systematic review. MBM research notes. 2010;3(1):60. - PMC - PubMed
    1. Biseul M, Sauleau P, Haegelen C, Trebon P, Drapier D, Raoul S, Drapier S, Lallement F, Rivier I, Lajat Y, Verin M. Fear recognition is impaired by subthalamic nucleus stimulation in parkinson’s disease. Neuropsychologia. 2005;43:1054–059. - PubMed
    1. Alegret M, Junque C, Valldeoriola F, Vendrell P, Pilleri M, Rumia J, Tolosa E. Effects of bilateral subthalamic stimulation on cognitive function in Parkinson disease. Arch Neurol. 2001;58:1223–1227. - PubMed

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