Postoperative Displacement of Deep Brain Stimulation Electrodes Related to Lead-Anchoring Technique

Contarino, Maria Fiorella; Bot, Maarten; Speelman, Johannes D.; Bie, Rob M.A. de; Tijssen, Marina A. J.; Denys, Damiaan; Bour, L.J.; Schuurman, P. Richard; Munckhof, Pepijn van den

doi:10.1227/neu.0000000000000079

Cited by 28 publications

(29 citation statements)

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“…Brain shift refers to the movement and deformation of the brain inside the skull [63,64]. In DBS, it is mainly caused by CSF leakage after opening of the arachnoid membrane, due to which the target would move away from the preoperatively determined position [27,65]. Resorption of the subdural air after scalp closure could also incur an inverse brain shift [64,66].…”

Section: Discussionmentioning

confidence: 99%

“…The assumption that the implanted electrode does not migrate in the brain is not always valid in practice [65]. Electrode migration can occur due to inadvertent pushing-down of the DBS lead during fixation, as reflected from the relatively larger vertical error [15,16,21,38,50,65].…”

Section: Discussionmentioning

confidence: 99%

“…Electrode migration can occur due to inadvertent pushing-down of the DBS lead during fixation, as reflected from the relatively larger vertical error [15,16,21,38,50,65]. This error is thought to be affected by the force exerted by the anchoring device.…”

Section: Discussionmentioning

confidence: 99%

“…According to the principle of precision engineering, one should avoid applying the anchoring force in the direction of lead migration or the migration-sensitive direction. Currently, 3 representative devices for anchoring the DBS lead are the titanium miniplate [19,65], Medtronic burr hole ring and cap (Medtronic Inc.) supplied in the DBS lead package [68], and Stimloc cranial base and cap (Medtronic Inc., its old commercial name: Navigus; information acquired through personal communication with Medtronic Inc.) [38,42,65]. As illustrated in figure 7b, the anchoring forces exerted by the titanium miniplate, Stimloc and Medtronic cap are F mini , F S and F M , respectively.…”

Section: Discussionmentioning

confidence: 99%

“…From the perspective of anchoring force, Stimloc (or Navigus) would have the best anchoring performance. Stimloc's superiority has been verified by the smaller vertical error reported in some clinical studies [48,65,68]. The force exerted by the miniplate could cause stress concentration to the bone beneath, from which bone erosion and long-term lead migration would result [65].…”

Section: Discussionmentioning

confidence: 99%

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Review on Factors Affecting Targeting Accuracy of Deep Brain Stimulation Electrode Implantation between 2001 and 2015

Li¹,

Zhang

Yan

et al. 2016

Stereotact Funct Neurosurg

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Background: Accurate implantation of a depth electrode into the brain is of the greatest importance in deep brain stimulation (DBS), and various stereotactic systems have been developed for electrode implantation. However, an updated analysis of depth electrode implantation in the modern era of DBS is lacking. Objective: This study aims at providing an updated review on targeting accuracy of DBS electrode implantation by analyzing contemporary DBS electrode implantation operations from the perspective of precision engineering. Methods: Eligible articles with information on targeting accuracy of DBS electrode implantation were searched in the PubMed database. Results: An average targeting error of DBS electrode implantation is reported to decrease toward 1 mm; the standard deviation of targeting error is decreasing toward 0.5 mm. Targeting accuracy is not only found to be affected by individual surgical steps, but also systematically affected by the architecture of the implantation operation. Conclusion: A systematic strategy should be adopted to further improve the targeting accuracy of depth electrode implantation. Attention should be paid to optimizing the whole electrode implantation operation, which can help minimize error accumulation or amplification throughout the serially connected procedures for DBS electrode implantation.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

Review on Factors Affecting Targeting Accuracy of Deep Brain Stimulation Electrode Implantation between 2001 and 2015

Li¹,

Zhang

Yan

et al. 2016

Stereotact Funct Neurosurg

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Deep brain stimulation: Challenges at the tissue‐electrode interface and current solutions

Kolaya

Firestein

2021

Biotechnology Progress

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Deep brain stimulation (DBS) is used to treat the motor symptoms of Parkinson's disease patients by stimulating the subthalamic nucleus. However, optimization of DBS is still needed since the performance of the neural electrodes is limited by the body's response to the implant. This review discusses the issues with DBS, such as placement of electrodes, foreign body response, and electrode degradation. The current solutions to these technical issues include modifications to electrode material, coatings, and geometry.

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Long‐Term Globus Pallidus Internus Deep Brain Stimulation in Pediatric Non‐Degenerative Dystonia: A Cohort Study and a Meta‐Analysis

Duga,

Giossi,

Romito

et al. 2024

Movement Disorders

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BackgroundThe evidence in the effectiveness of deep brain stimulation in children with medication‐refractory non‐degenerative monogenic dystonia is heterogeneous and long‐term results are sparse.ObjectivesThe objective is to describe long‐term outcomes in a single‐center cohort and compare our results with a meta‐analysis cohort form literature.MethodsWe performed a retrospective single‐center cohort study including consecutive pediatric patients with non‐degenerative genetic or idiopathic dystonia treated with globus pallidus internus deep brain stimulation at our center and a systematic review and individual‐patient data meta‐analysis with the same inclusion criteria. The primary outcome was the change from baseline in the Burke‐Fahn‐Marsden Dystonia Rating Scale‐movement (BFMDRS‐M) score.ResultsThe clinical cohort included 25 patients with a mean study follow‐up of 11.4 years. The meta‐analysis cohort included 224 patients with a mean follow‐up of 3 years. Overall, the BFMDRS‐M mean improvements at 1 year and at last follow‐up were 41% and 33% in the clinical cohort and 58.9% and 57.2% in the meta‐analysis cohort, respectively. TOR1A‐dystonia showed the greatest and most stable BFMDRS‐M improvement in both cohorts at 1 year and at last follow‐up (76.3% and 74.3% in the clinical cohort; 69.6% and 67.3% in the meta‐analysis cohort), followed by SGCE‐dystonia (63% and 63.9% in the meta‐analysis cohort). THAP1‐dystonia (70.1% and 29.8% in the clinical cohort; 52.3% and 42.0% in the meta‐analysis cohort) and KMT2B‐dystonia (33.3% and 41.3% in the clinical cohort; 38.0% and 26.7% in the meta‐analysis cohort) showed a less pronounced or sustained response.ConclusionGlobus pallidus deep brain stimulation long‐term treatment seems effective with a possible gene‐specific differential effect. © 2024 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.

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Postoperative Displacement of Deep Brain Stimulation Electrodes Related to Lead-Anchoring Technique

Abstract: The commercially available plastic cap system is more efficient in preventing postoperative DBS electrode displacement than titanium microplates. A reliability analysis of the electrode fixation is warranted when alternative anchoring methods are used.

Cited by 28 publications

References 28 publications

Review on Factors Affecting Targeting Accuracy of Deep Brain Stimulation Electrode Implantation between 2001 and 2015

Review on Factors Affecting Targeting Accuracy of Deep Brain Stimulation Electrode Implantation between 2001 and 2015

Deep brain stimulation: Challenges at the tissue‐electrode interface and current solutions

Long‐Term Globus Pallidus Internus Deep Brain Stimulation in Pediatric Non‐Degenerative Dystonia: A Cohort Study and a Meta‐Analysis

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