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.
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International Journal of Computer Assisted Radiology and Surgery, Springer Verlag, 2014, 9 (1), pp.107-17. 〈10.1007/s11548-013-0911-x〉
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Florent Lalys, Claire Haegelen, Tiziano D'Albis, Pierre Jannin. Analysis of electrode deformations in deep brain stimulation surgery.. International Journal of Computer Assisted Radiology and Surgery, Springer Verlag, 2014, 9 (1), pp.107-17. 〈10.1007/s11548-013-0911-x〉. 〈inserm-00836932〉

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