Electrode Reconstruction Assists Post-operative Contact Selection in Deep Brain Stimulation.

Electrode Reconstruction Assists Post-operative Contact Selection in Deep Brain Stimulation.

World Neurosurg. 2019 Jan 29;:

Authors: Zhang D, Lin H, Liu J, Liu Z, Yan J, Cai X

Abstract
BACKGROUND: Post-operative contact selection of deep brain stimulation (DBS), testing one contact at a time, is a clinically time-consuming procedure being challenged by incoming applications of more complex DBS leads. The objective of this study is to guide clinicians to select the optimal contact by neuroanatomical information derived from electrode reconstruction.
METHODS: We reviewed 33 Parkinson's disease patients who underwent bilateral subthalamic nucleus (STN) DBS with pre-operative MRI and post-operative CT. All electrodes were reconstructed in standardized MNI space and the volume of tissue activated (VTA) was estimated for each contact. According to the DISTAL atlas, we calculated six neuroanatomical parameters: the distances of each contact to the STN and the motor part of STN (M-STN), the volumes of the overlapping areas of VTA and STN/M-STN, the number and ratio of fiber tracts through both VTA and motor areas (primary motor cortex and supplementary motor area).
RESULTS: All these six parameters showed significant group differences between clinical optimal and non-optimal contacts by permutation test. Moreover, the possibilities to be the optimal contacts were estimated for all contacts under the combination of these six parameters using a generalized linear model, which resulted in accuracy of 72.7% for prediction of contact selection.
CONCLUSIONS: Electrode reconstruction could assist in selecting the clinical optimal contact and improve its efficiency.

PMID: 30708078 [PubMed - as supplied by publisher]

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