Analysis of electrode deformations in deep brain stimulation surgery.

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.

• Authors: Florent Lalys, Claire Haegelen, Tiziano D'albis, Pierre Jannin
• Journal: International journal of computer assisted radiology and surgery (Int J Comput Assist Radiol Surg) Vol. 9 Issue 1 Pg. 107-17 (Jan 2014) ISSN: 1861-6429 [Electronic] Germany
• PMID: 23780571 (Publication Type: Comparative Study, Journal Article, Research Support, Non-U.S. Gov't)

Topics

• Adult
• Deep Brain Stimulation (instrumentation)
• Electrodes
• Female
• Humans
• Male
• Movement Disorders (diagnosis, therapy)
• Reproducibility of Results
• Tomography, X-Ray Computed (methods)