scholarly journals Towards Tracking of Deep Brain Stimulation Electrodes Using an Integrated Magnetometer

Sensors ◽  
2021 ◽  
Vol 21 (8) ◽  
pp. 2670
Author(s):  
Thomas Quirin ◽  
Corentin Féry ◽  
Dorian Vogel ◽  
Céline Vergne ◽  
Mathieu Sarracanie ◽  
...  

This paper presents a tracking system using magnetometers, possibly integrable in a deep brain stimulation (DBS) electrode. DBS is a treatment for movement disorders where the position of the implant is of prime importance. Positioning challenges during the surgery could be addressed thanks to a magnetic tracking. The system proposed in this paper, complementary to existing procedures, has been designed to bridge preoperative clinical imaging with DBS surgery, allowing the surgeon to increase his/her control on the implantation trajectory. Here the magnetic source required for tracking consists of three coils, and is experimentally mapped. This mapping has been performed with an in-house three-dimensional magnetic camera. The system demonstrates how magnetometers integrated directly at the tip of a DBS electrode, might improve treatment by monitoring the position during and after the surgery. The three-dimensional operation without line of sight has been demonstrated using a reference obtained with magnetic resonance imaging (MRI) of a simplified brain model. We observed experimentally a mean absolute error of 1.35 mm and an Euclidean error of 3.07 mm. Several areas of improvement to target errors below 1 mm are also discussed.

2011 ◽  
Vol 26 (S2) ◽  
pp. 1149-1149
Author(s):  
U. Moser ◽  
M. Savli ◽  
R. Lanzenberger ◽  
S. Kasper

IntroductionDeep brain stimulation (DBS) is a promising therapy option for otherwise treatment-resistant neuropsychiatrie disorders, especially in obsessive-compulsive disorder (OCD), major depression (TRD) and Tourette's Syndrome (TS).ObjectiveThe brain coordinates of the DBS targets are mainly reported using measurements in original, unnormalized brains. In the neuroimaging community stereotactic data are mainly indicated in the standardized Montreal Neurological Institute (MNI) space, i.e. a three-dimensional proportional grid system.AimsImproved comparability between targets in DBS studies and molecular and functional neuroimaging data from PET, SPECT, MRI, fMRI, mostly published with stereotactic data.MethodsA comprehensive and systematic literature search for published DBS case reports or studies in TRD, OCD and TS was performed. We extracted the tip positions of electrode leads as provided in the publications or by the authors, and transferred individual coordinates to the standard brain in the MNI space.Results46 publications fulfilled the inclusion criteria. The main targets for the specific disorders and one or two examples of their calculated MNI coordinates are indicated in the table:[MNI coordinates of the main DBS targets]ConclusionsWe provide DBS data of neuropsychiatrie disorders in the MNI space, improving the comparability to molecular, functional and structural neuroimaging data.


2018 ◽  
Author(s):  
Laleh Golestanirad ◽  
Boris Keil ◽  
Sean Downs ◽  
John Kirsch ◽  
Behzad Elahi ◽  
...  

AbstractPatients with deep brain stimulation (DBS) implants can significantly benefit from magnetic resonance imaging (MRI) examination, however, access to MRI is restricted in this patients because of safety concerns due to RF heating of the leads. Recently we introduced a patient-adjustable reconfigurable MRI coil system to reduce the SAR at the tip of deep brain stimulation implants during MRI at 1.5T. A simulation study with realistic models of single (unilateral) DBS leads demonstrated a substantial reduction in the local SAR up to 500-fold could be achieved using the coil system compared to quadrature birdcage coils. Many patients however, have bilateral DBS implants and the question arises whether the rotating coil system can be used in for them. This work reports the results of phantom experiments measuring the temperature rise at the tips of bilateral DBS implants with realistic trajectories extracted from postoperative CT images of 10 patients (20 leads in total). A total of 200 measurements were performed to record temperature rise at the tips of the leads during 2 minutes of scanning with the coil rotated to cover all accessible rotation angles. In all patients, we were able to find an optimum coil rotation angle and reduced the heating of both left and right leads to a level below the heating produced by the body coil. An average heat reduction of 65% was achieved for bilateral leads. Reconfigurable coil technology introduces a promising approach for imaging of patients with DBS implants.


2017 ◽  
Vol 2017 ◽  
pp. 1-5 ◽  
Author(s):  
Byung-chul Son ◽  
Jin-gyu Choi ◽  
Hak-cheol Ko

Unilateral hemichorea/hemiballism (HH) associated with contralateral neuroimaging abnormalities of the basal ganglia, which is characterized by T1 hyperintensity on magnetic resonance imaging (MRI) and is secondary to diabetic nonketotic hyperglycemia, is a rare and unique complication of poorly controlled diabetes mellitus (DM). Although almost all prior reports have documented rapid resolution of HH within days after normalization of blood glucose levels, medically refractory persistent HH has been noted. The experience of surgical intervention for persistent HH is limited. A 46-year-old, right-handed female patient with type 2 DM presented with refractory diabetic HH on the left side of 6 months’ duration despite DM control and neuroleptic medication usage. Image-guided deep brain stimulation (DBS) on the right globus pallidus internus (GPi) was performed. A mechanical micropallidotomy effect was observed and chronic stimulation of GPi was quite effective in symptomatic control of diabetic HH until a 16-month follow-up visit. DBS of the GPi can be an effective treatment for medically refractory diabetic HH.


2011 ◽  
Vol 58 (3,4) ◽  
pp. 264-272 ◽  
Author(s):  
Shigetaka Nakao ◽  
Koji Komatsu ◽  
Waka Sakai ◽  
Michiharu Kashihara ◽  
Yuki Masuda ◽  
...  

2019 ◽  
Vol 19 (2) ◽  
pp. 143-149
Author(s):  
Erik Bolier ◽  
Jessica A Karl ◽  
R Mark Wiet ◽  
Alireza Borghei ◽  
Leo Verhagen Metman ◽  
...  

Abstract Background Deep brain stimulation (DBS) surgery in patients with pre-existing cochlear implants (CIs) poses various challenges. We previously reported successful magnetic resonance imaging (MRI)-based, microelectrode recording (MER)-guided subthalamic DBS surgery in a patient with a pre-existing CI. Other case reports have described various DBS procedures in patients with pre-existing CIs using different techniques, leading to varying issues to address. A standardized operative technique and workflow for DBS surgery in the setting of pre-existing CIs is much needed. Objective To provide a standardized operative technique and workflow for DBS lead placement in the setting of pre-existing CIs. Methods Our operative technique is MRI-based and MER-guided, following a workflow involving coordination with a neurotology team to remove and re-implant the internal magnets of the CIs in order to safely perform DBS lead placement, altogether within a 24-h time frame. Intraoperative nonverbal communication with the patient is easily possible using a computer monitor. Results A 65-yr old woman with a 10-yr history of craniocervical dystonia and pre-existing bilateral CIs underwent successful bilateral pallidal DBS surgery at our institution. No merging errors or difficulties in targeting globus pallidus internus were experienced. Also, inactivated CIs do not interfere with MER nor with stimulation, and intraoperative communication with the patient using a computer monitor proved feasible and satisfactory. Conclusion DBS procedures are safe and feasible in patients with pre-existing CIs if precautions are taken following our workflow.


2008 ◽  
Vol 100 (5) ◽  
pp. 2549-2563 ◽  
Author(s):  
Matthew D. Johnson ◽  
Cameron C. McIntyre

Deep brain stimulation (DBS) of the globus pallidus pars interna (GPi) is an effective therapy option for controlling the motor symptoms of medication-refractory Parkinson's disease and dystonia. Despite the clinical successes of GPi DBS, the precise therapeutic mechanisms are unclear and questions remain on the optimal electrode placement and stimulation parameter selection strategies. In this study, we developed a three-dimensional computational model of GPi-DBS in nonhuman primates to investigate how membrane channel dynamics, synaptic inputs, and axonal collateralization contribute to the neural responses generated during stimulation. We focused our analysis on three general neural elements that surround GPi-DBS electrodes: GPi somatodendritic segments, GPi efferent axons, and globus pallidus pars externa (GPe) fibers of passage. During high-frequency electrical stimulation (136 Hz), somatic activity in the GPi showed interpulse excitatory phases at 1–3 and 4–5.5 ms. When including stimulation-induced GABAA and AMPA receptor dynamics into the model, the somatic firing patterns continued to be entrained to the stimulation, but the overall firing rate was reduced (78.7 to 25.0 Hz, P < 0.001). In contrast, axonal output from GPi neurons remained largely time-locked to each pulse of the stimulation train. Similar entrainment was also observed in GPe efferents, a majority of which have been shown to project through GPi en route to the subthalamic nucleus. The models suggest that pallidal DBS may have broader network effects than previously realized and the modes of therapy may depend on the relative proportion of GPi and/or GPe efferents that are directly affected by the stimulation.


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