Deep Brain Stimulation: Emerging Tools for Simulation, Data Analysis, and Visualization

Abstract

Deep brain stimulation (DBS) is a well-established neurosurgical procedure for movement disorders that is also being explored for treatment-resistant psychiatric conditions. This review highlights important consideration for DBS simulation and data analysis. The literature on DBS has expanded considerably in recent years, and this article aims to identify important trends in the field. During DBS planning, surgery, and follow up sessions, several large data sets are created for each patient, and it becomes clear that any group analysis of such data is a big data analysis problem and has to be handled with care. The aim of this review is to provide an update and overview from a neuroengineering perspective of the current DBS techniques, technical aids, and emerging tools with the focus on patient-specific electric field (EF) simulations, group analysis, and visualization in the DBS domain. Examples are given from the state-of-the-art literature including our own research. This work reviews different analysis methods for EF simulations, tractography, deep brain anatomical templates, and group analysis. Our analysis highlights that group analysis in DBS is a complex multi-level problem and selected parameters will highly influence the result. DBS analysis can only provide clinically relevant information if the EF simulations, tractography results, and derived brain atlases are based on as much patient-specific data as possible. A trend in DBS research is creation of more advanced and intuitive visualization of the complex analysis results suitable for the clinical environment.

Modeling the volume of tissue activated in deep brain stimulation and its clinical influence: a review

“…The utility of the VTA is dependent on imaging the brain. Wårdell et al provide a detailed review of imaging and modeling technologies for DBS ( Wårdell et al, 2022 ). In short, the DBS lead location with respect to anatomical structures of the individual must be identified with pre-operative MRI for anatomy and post-operative MRI or CT scans for lead localization.…”

“…In short, the DBS lead location with respect to anatomical structures of the individual must be identified with pre-operative MRI for anatomy and post-operative MRI or CT scans for lead localization. Existing neurological atlases then need to be warped to the patient’s brain images to provide spatial reference points ( Wårdell et al, 2022 ). Additionally, pre-operative MRI scans with diffusion tensor imaging (DTI) provide extra information that can be used to define local anisotropic tissue electrical conductivity values that can inform the VTA calculation ( Tuch et al, 2001 ; Butson et al, 2007 ).…”

A structural magnetic resonance imaging review of clinical motor outcomes from deep brain stimulation in movement disorders

“…Furthermore, patient-specific dMRI is showing increasing clinical utility for optimizing intra-operative planning and targeting of DBS electrodes in relation to white matter fibres. 8 , 194 , 195 …”

Computational Models in Deep Brain Stimulation : Patient‐Specific Simulations, Tractography, and Group Analysis

“…Different spatial evaluations of DBS results can be visualized for explaining the data, but also to extract biomarkers for prediction [41]. Since the DBS programming process can be an exhausting procedure, computer models predicting the best setting can be highly beneficial.…”