P38 Postoperative electrode localization in deep brain stimulation (DBS) using thalamic probability maps

Basal Ganglia ◽  
2011 ◽  
Vol 1 (2) ◽  
pp. 118-119
Author(s):  
C. Bartsch ◽  
P. Pieperhoff ◽  
K. Amunts ◽  
H.B.M. Uylings ◽  
D. Lenartz ◽  
...  
2017 ◽  
Vol 14 (6) ◽  
pp. 661-667
Author(s):  
Sunjay S Dodani ◽  
Charles W Lu ◽  
J Wayne Aldridge ◽  
Kelvin L Chou ◽  
Parag G Patil

Abstract BACKGROUND Accurate electrode placement is critical to the success of deep brain stimulation (DBS) surgery. Suboptimal targeting may arise from poor initial target localization, frame-based targeting error, or intraoperative brain shift. These uncertainties can make DBS surgery challenging. OBJECTIVE To develop a computerized system to guide subthalamic nucleus (STN) DBS electrode localization and to estimate the trajectory of intraoperative microelectrode recording (MER) on magnetic resonance (MR) images algorithmically during DBS surgery. METHODS Our method is based upon the relationship between the high-frequency band (HFB; 500-2000 Hz) signal from MER and voxel intensity on MR images. The HFB profile along an MER trajectory recorded during surgery is compared to voxel intensity profiles along many potential trajectories in the region of the surgically planned trajectory. From these comparisons of HFB recordings and potential trajectories, an estimate of the MER trajectory is calculated. This calculated trajectory is then compared to actual trajectory, as estimated by postoperative high-resolution computed tomography. RESULTS We compared 20 planned, calculated, and actual trajectories in 13 patients who underwent STN DBS surgery. Targeting errors for our calculated trajectories (2.33 mm ± 0.2 mm) were significantly less than errors for surgically planned trajectories (2.83 mm ± 0.2 mm; P = .01), improving targeting prediction in 70% of individual cases (14/20). Moreover, in 4 of 4 initial MER trajectories that missed the STN, our method correctly indicated the required direction of targeting adjustment for the DBS lead to intersect the STN. CONCLUSION A computer-based algorithm simultaneously utilizing MER and MR information potentially eases electrode localization during STN DBS surgery.


2014 ◽  
Vol 20 (12) ◽  
pp. 1341-1344 ◽  
Author(s):  
Fenna T. Phibbs ◽  
Srivatsan Pallavaram ◽  
Christopher Tolleson ◽  
Pierre-François D'Haese ◽  
Benoit M. Dawant

2019 ◽  
Vol 9 ◽  
Author(s):  
Maria Ida Iacono ◽  
Seyed Reza Atefi ◽  
Luca Mainardi ◽  
Harrison C. Walker ◽  
Leonardo M. Angelone ◽  
...  

2016 ◽  
Author(s):  
Siobhan Ewert ◽  
Philip Plettig ◽  
M. Mallar Chakravarty ◽  
Andrea Kühn ◽  
Andreas Horn

AbstractThree-dimensional atlases of subcortical brain structures are valuable tools to reference anatomy in neuroscience and neurology. In the special case of deep brain stimulation (DBS), the three most common targets are the subthalamic nucleus (STN), the internal part of the pallidum (GPi) and the ventral intermediate nucleus of the thalamus (VIM). With the help of atlases that define the position and shape of these target regions within a well-defined stereotactic space, their spatial relationship to implanted deep brain stimulation (DBS) electrodes may be determined.Here we present a composite atlas based on manual segmentations of a multi-modal high-resolution MNI template series, histology and structural connectivity. To attain exact congruence to the template anatomy, key structures were defined using all four modalities of the template simultaneously. In a first step tissue probability maps were defined based on the multimodal intensity profile of each structure. These observer-independent probability maps provided an excellent basis for the subsequent manual segmentation particularly when defining the outline of the target regions.Second, the key structures were used as an anchor point to coregister a histology based atlas into standard space. Finally, a sub-segmentation of the subthalamic nucleus into three functional zones was estimated based on structural connectivity. The resulting composite atlas uses the spatial information of the MNI template for DBS key structures that are visible on the template itself. For remaining structures, it relies on histology or structural connectivity. In this way the final atlas combines the anatomical detail of a histology based atlas with the spatial accuracy of key structures in relationship to the template anatomy. Thus, the atlas provides an ideal tool for the analysis of DBS electrode placement.Highlights:Composite subcortical atlas based on a multimodal, high definition MNI template series, histology and tractographyHigh definition atlas of DBS targets exactly matching MNI 152 NLIN 2009b spaceMultimodal subcortical segmentation algorithm applied to MNI template


2018 ◽  
Vol 75 (7) ◽  
pp. 448-454
Author(s):  
Thomas Grunwald ◽  
Judith Kröll

Zusammenfassung. Wenn mit den ersten beiden anfallspräventiven Medikamenten keine Anfallsfreiheit erzielt werden konnte, so ist die Wahrscheinlichkeit, dies mit anderen Medikamenten zu erreichen, nur noch ca. 10 %. Es sollte dann geprüft werden, warum eine Pharmakoresistenz besteht und ob ein epilepsiechirurgischer Eingriff zur Anfallsfreiheit führen kann. Ist eine solche Operation nicht möglich, so können palliative Verfahren wie die Vagus-Nerv-Stimulation (VNS) und die tiefe Hirnstimulation (Deep Brain Stimulation) in eine bessere Anfallskontrolle ermöglichen. Insbesondere bei schweren kindlichen Epilepsien stellt auch die ketogene Diät eine zu erwägende Option dar.


2008 ◽  
Author(s):  
Jonathan D. Richards ◽  
Paul M. Wilson ◽  
Pennie S. Seibert ◽  
Carin M. Patterson ◽  
Caitlin C. Otto ◽  
...  

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