Image Guidance in Deep Brain Stimulation Surgery to Treat Parkinson's Disease: A Comprehensive Review

Xiao, Yiming; Lau, Jonathan C.; Hemachandra, Dimuthu; Gilmore, Greydon; Khan, Ali Raza; Peters, T. M.

doi:10.1109/tbme.2020.3006765

Cited by 26 publications

(17 citation statements)

References 111 publications

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“…El ejercicio de resistencia muscular es la medida más eficaz para la prevención y tratamiento de la sarcopenia ya que mejora la funcionalidad para levantarse, subir escaleras, evitar caídas, también se ha visto que mejora la resistencia a la insulina y el perfil lipídico, además de prevenir el deterioro cognitivo (65). La Sociedad de Sarcopenia, Caquexia y Desórdenes de Desgaste recomienda ejercicio aeróbico y de resistencia muscular, durante 20 a 30 minutos, 3 veces por semana (66).…”

Section: Prevención Terciariaunclassified

Prevención de la sarcopenia en pacientes con enfermedad de Parkinson: Revisión descriptiva desde la medicina preventiva

2021

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Resumen: La enfermedad de Parkinson ocupa el segundo lugar de las enfermedades neurodegenerativas más comunes en el mundo. La sarcopenia se caracteriza por dinapenia y en los adultos mayores con diagnóstico de enfermedad de Parkinson acelera su progresión. El objetivo de la presente revisión es describir el estado sarcopénico y la importancia de su prevención en los adultos mayores con enfermedad de Parkinson, así como ofrecer una revisión de las medidas de prevención primaria, secundaria y terciaria pertinentes para su abordaje. Si bien el deterioro y la gravedad de la enfermedad de Parkinson se relaciona directamente con el estado sarcopénico del paciente mediante el abordaje disciplinario, la medicina preventiva puede favorecer la calidad de vida de los pacientes mediante medidas de promoción, diagnóstico oportuno, tratamiento farmacológico y no farmacológico y limitación de la progresión de la sarcopenia.Abstract: Parkinson's disease ranks second among the most common neurodegenerative diseases in the world. Sarcopenia is characterized by dynapenia and in older adults diagnosed with Parkinson's disease accelerates its progression. The objective of the present review is to describe the sarcopenic state and the importance of its prevention in older adults with Parkinson's disease, as well as to offer a review of primary prevention measures, secondary and tertiary relevant to its approach. Although the deterioration and severity of Parkinson's disease is directly related to the sarcopenic state of the patient through the disciplinary approach, preventive medicine can favor the quality of life of patients through promotional measures, timely diagnosis, pharmacological treatment and not pharmacological and limiting the progression of sarcopenia.

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Section: Prevención Terciariaunclassified

Prevención de la sarcopenia en pacientes con enfermedad de Parkinson: Revisión descriptiva desde la medicina preventiva

2021

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“…Lastly, we would like to mention that while this paper specifically refers to suboptimal placement of DBS leads due to the limitations of neuroimaging, negative outcomes of DBS application can arise independently of planning procedures and surgical expertise. For example, neurosurgery has been linked to brain deformation and shift, changes in cerebral spinal fluid volume, and intracranial pressure, which may induce spatial variability both during the surgery and cause a shift in the implanted lead location during recovery [ 27 , 234 ]. Similarly, DBS surgeries are associated with infection (mostly found in the chest and connector) [ 235 ]; reactive gliosis and gliotic scarring [ 236 ]; hemorrhage either during the surgery or delayed (in less than 5%) [ 237 ]; and, although rare, cerebral pneumocephalus [ 238 ].…”

Section: Complications Unrelated To Pre-operative Planningmentioning

confidence: 99%

Methodological Considerations for Neuroimaging in Deep Brain Stimulation of the Subthalamic Nucleus in Parkinson’s Disease Patients

Isaacs

Keuken

Alkemade

et al. 2020

JCM

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Deep brain stimulation (DBS) of the subthalamic nucleus is a neurosurgical intervention for Parkinson’s disease patients who no longer appropriately respond to drug treatments. A small fraction of patients will fail to respond to DBS, develop psychiatric and cognitive side-effects, or incur surgery-related complications such as infections and hemorrhagic events. In these cases, DBS may require recalibration, reimplantation, or removal. These negative responses to treatment can partly be attributed to suboptimal pre-operative planning procedures via direct targeting through low-field and low-resolution magnetic resonance imaging (MRI). One solution for increasing the success and efficacy of DBS is to optimize preoperative planning procedures via sophisticated neuroimaging techniques such as high-resolution MRI and higher field strengths to improve visualization of DBS targets and vasculature. We discuss targeting approaches, MRI acquisition, parameters, and post-acquisition analyses. Additionally, we highlight a number of approaches including the use of ultra-high field (UHF) MRI to overcome limitations of standard settings. There is a trade-off between spatial resolution, motion artifacts, and acquisition time, which could potentially be dissolved through the use of UHF-MRI. Image registration, correction, and post-processing techniques may require combined expertise of traditional radiologists, clinicians, and fundamental researchers. The optimization of pre-operative planning with MRI can therefore be best achieved through direct collaboration between researchers and clinicians.

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“…Deep brain stimulation (DBS) of the subthalamic nucleus (STN) is a well-accepted therapeutic approach for controlling the motor symptoms of Parkinson's disease (PD) ( 1 , 2 ). The efficacy of STN-DBS heavily relies on the influence by the appropriate placement of DBS electrodes relative to STN ( 3 , 4 ). Previous studies suggested an optimal lead placement trajectory that travels through the entire dorsolateral portion of STN, with the tip of the distal contacts placed near the deep boundary of STN ( 3 , 5 , 6 ), which will enhance clinical outcomes ( 1 , 2 , 7 , 8 ).…”

Section: Introductionmentioning

confidence: 99%

“…The efficacy of STN-DBS heavily relies on the influence by the appropriate placement of DBS electrodes relative to STN ( 3 , 4 ). Previous studies suggested an optimal lead placement trajectory that travels through the entire dorsolateral portion of STN, with the tip of the distal contacts placed near the deep boundary of STN ( 3 , 5 , 6 ), which will enhance clinical outcomes ( 1 , 2 , 7 , 8 ). However, the major challenge of this optimal lead placement is how to precisely localize STN, especially the ventral boundary ( 6 , 9 ) of STN that is an almond-shaped nucleus embedded deeply in between the diencephalon and the midbrain and surrounded by multiple brain structures.…”

Section: Introductionmentioning

confidence: 99%

“…Electrophysiological recording technique is often used to help distinguish the anatomical borders between the STN and SNr. Compared to the STN, SNr tends to have a neuronal activity featured by a higher and more regular firing frequency with a lower background noise level (3,6,10). Besides this, the appearance of the small inactive area (silent area) at the boundary between the STN and SNr (SSB) can also help identify the ventral border of the STN (5,12).…”

Section: Introductionmentioning

confidence: 99%

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Microstimulation Is a Promising Approach in Achieving Better Lead Placement in Subthalamic Nucleus Deep Brain Stimulation Surgery

et al. 2021

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Background: The successful application of subthalamic nucleus (STN) deep brain stimulation (DBS) surgery relies mostly on optimal lead placement, whereas the major challenge is how to precisely localize STN. Microstimulation, which can induce differentiating inhibitory responses between STN and substantia nigra pars reticulata (SNr) near the ventral border of STN, has indicated a great potential of breaking through this barrier.Objective: This study aims to investigate the feasibility of localizing the boundary between STN and SNr (SSB) using microstimulation and promote better lead placement.Methods: We recorded neurophysiological data from 41 patients undergoing STN-DBS surgery with microstimulation in our hospital. Trajectories with typical STN signal were included. Microstimulation was applied near the bottom of STN to determine SSB, which was validated by the imaging reconstruction of DBS leads.Results: In most trajectories with microstimulation (84.4%), neuronal firing in STN could not be inhibited by microstimulation, whereas in SNr long inhibition was observed following microstimulation. The success rate of localizing SSB was significantly higher in trajectories with microstimulation than those without. Moreover, results from imaging reconstruction and intraoperative neurological assessments demonstrated better lead location and higher therapeutic effectiveness in trajectories with microstimulation and accurately identified SSB.Conclusion: Microstimulation on microelectrode recording is an effective approach to localize the SSB. Our data provide clinical evidence that microstimulation can be routinely employed to achieve better lead placement.

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Image Guidance in Deep Brain Stimulation Surgery to Treat Parkinson's Disease: A Comprehensive Review

Cited by 26 publications

References 111 publications

Prevención de la sarcopenia en pacientes con enfermedad de Parkinson: Revisión descriptiva desde la medicina preventiva

Prevención de la sarcopenia en pacientes con enfermedad de Parkinson: Revisión descriptiva desde la medicina preventiva

Methodological Considerations for Neuroimaging in Deep Brain Stimulation of the Subthalamic Nucleus in Parkinson’s Disease Patients

Microstimulation Is a Promising Approach in Achieving Better Lead Placement in Subthalamic Nucleus Deep Brain Stimulation Surgery

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