Evaluation of Automatic Segmentation of Thalamic Nuclei through Clinical Effects Using Directional Deep Brain Stimulation Leads: A Technical Note

Krüger, Marie T.; Kurtev-Rittstieg, Rebecca; Kägi, Georg; Naseri, Yashar; Hägele-Link, Stefan; Brugger, Florian

doi:10.3390/brainsci10090642

Cited by 8 publications

(6 citation statements)

References 15 publications

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“…Surgical procedures constituted routine clinical patient management, and all patients received bilateral electrodes and impulse generators (Medtronic Inc., Minneapolis, MN or St. Jude Medical Inc., St. Paul, MN) (Klein et al, 2017). VIM targeting was performed indirectly, based on planned coordinates relative to the anterior and posterior commissures (AC, PC) (Krüger et al, 2020). Electrode placement was planned pre‐operatively based on individual patient structural MRI scans, confirmed intra‐operatively through stereotactic x‐rays and clinical response to stimulation, and re‐confirmed postoperatively by co‐registering postoperative CT scans with the pre‐operative MRI images and the intraoperative x‐rays, comparing the findings with human brain atlases.…”

Section: Methodsmentioning

confidence: 99%

Deep brain stimulation of the ventrointermediate nucleus of the thalamus to treat essential tremor improves motor sequence learning

Terzic

Voegtle

Farahat

et al. 2022

Human Brain Mapping

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The network of brain structures engaged in motor sequence learning comprises the same structures as those involved in tremor, including basal ganglia, cerebellum, thalamus, and motor cortex. Deep brain stimulation (DBS) of the ventrointermediate nucleus of the thalamus (VIM) reduces tremor, but the effects on motor sequence learning are unknown. We investigated whether VIM stimulation has an impact on motor sequence learning and hypothesized that stimulation effects depend on the laterality of electrode location. Twenty patients (age: 38–81 years; 12 female) with VIM electrodes implanted to treat essential tremor (ET) successfully performed a serial reaction time task, varying whether the stimuli followed a repeating pattern or were selected at random, during which VIM‐DBS was either on or off. Analyses of variance were applied to evaluate motor sequence learning performance according to reaction times (RTs) and accuracy. An interaction was observed between whether the sequence was repeated or random and whether VIM‐DBS was on or off (F[1,18] = 7.89, p = .012). Motor sequence learning, reflected by reduced RTs for repeated sequences, was greater with DBS on than off (T[19] = 2.34, p = .031). Stimulation location correlated with the degree of motor learning, with greater motor learning when stimulation targeted the lateral VIM (n = 23, ρ = 0.46; p = .027). These results demonstrate the beneficial effects of VIM‐DBS on motor sequence learning in ET patients, particularly with lateral VIM electrode location, and provide evidence for a role for the VIM in motor sequence learning.

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Section: Methodsmentioning

confidence: 99%

Deep brain stimulation of the ventrointermediate nucleus of the thalamus to treat essential tremor improves motor sequence learning

Terzic

Voegtle

Farahat

et al. 2022

Human Brain Mapping

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“…Notably, it is currently possible to reconstruct the location of the lead inside a patient’s brain with trustworthy and readily accessible software [ 179 , 180 , 181 ]. Such tools enable a detailed visualization of the induced electric fields around the lead and enhance our understanding of which structures are actually being stimulated.…”

Section: Cerebellar Dbs In Hereditary Ataxiasmentioning

confidence: 99%

The Therapeutic Potential of Non-Invasive and Invasive Cerebellar Stimulation Techniques in Hereditary Ataxias

Benussi

Batsikadze

França

et al. 2023

Cells

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The degenerative ataxias comprise a heterogeneous group of inherited and acquired disorders that are characterized by a progressive cerebellar syndrome, frequently in combination with one or more extracerebellar signs. Specific disease-modifying interventions are currently not available for many of these rare conditions, which underscores the necessity of finding effective symptomatic therapies. During the past five to ten years, an increasing number of randomized controlled trials have been conducted examining the potential of different non-invasive brain stimulation techniques to induce symptomatic improvement. In addition, a few smaller studies have explored deep brain stimulation (DBS) of the dentate nucleus as an invasive means to directly modulate cerebellar output, thereby aiming to alleviate ataxia severity. In this paper, we comprehensively review the clinical and neurophysiological effects of transcranial direct current stimulation (tDCS), repetitive transcranial magnetic stimulation (rTMS), and dentate nucleus DBS in patients with hereditary ataxias, as well as the presumed underlying mechanisms at the cellular and network level and perspectives for future research.

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“…The orientation of directional leads in the CT scans was evaluated using Brainlab Elements automatic lead orientation detection, as previously described. 16 Orientation in RF was defined as originally described. 15…”

Section: Determination Of Lead Orientationmentioning

confidence: 99%

Evaluation of the Rotational Stability of Directional Deep Brain Stimulation Leads: A Case Series and Systematic Review

Cavalloni,

Brugger,

Kägi

et al. 2023

J Neurol Surg A Cent Eur Neurosurg

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Background The rotational stability of directional deep brain stimulation leads is a major prerequisite for sustained clinical effects. Data on directional lead stability are limited and controversial. Methods We aimed to evaluate the long-term rotational stability of directional leads and define confounding factors in our own population and the current literature. We retrospectively evaluated the orientation of directional leads in patients with available postoperative computed tomography (CT; T1; day of surgery) and an additional postoperative image (T2; CT or rotational fluoroscopy) performed more than 7 days after the initial scan. The potential impact of intracranial air was assessed. We also reviewed the literature to define factors impacting stability. Results Thirty-six leads were evaluated. The mean follow-up between T1 and T2 was 413.3 (7–1,171) days. The difference in rotation between T1 and T2 was 2.444 ± 2.554 degrees (range: 0–9.0 degrees). The volume of intracranial air did not impact the rotation. The literature search identified one factor impacting the stability of directional leads, which is the amount of twist applied at implantation. Conclusion Directional leads for deep brain stimulation show stable long-term orientation after implantation. Based on our literature review, large amounts of twist during implantation can lead to delayed rotation and should thus be avoided.

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Evaluation of Automatic Segmentation of Thalamic Nuclei through Clinical Effects Using Directional Deep Brain Stimulation Leads: A Technical Note

Cited by 8 publications

References 15 publications

Deep brain stimulation of the ventrointermediate nucleus of the thalamus to treat essential tremor improves motor sequence learning

Deep brain stimulation of the ventrointermediate nucleus of the thalamus to treat essential tremor improves motor sequence learning

The Therapeutic Potential of Non-Invasive and Invasive Cerebellar Stimulation Techniques in Hereditary Ataxias

Evaluation of the Rotational Stability of Directional Deep Brain Stimulation Leads: A Case Series and Systematic Review

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