White matter tracing combined with electric field simulation – A patient-specific approach for deep brain stimulation

Nordin, Teresa; Zsigmond, Peter; Pujol, Sonia; Westin, Carl‐Fredrik; Wårdell, Karin

doi:10.1016/j.nicl.2019.102026

Cited by 17 publications

(17 citation statements)

References 54 publications

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“…The study is limited by the fact that it only targets a shift in axial direction and no combination of segments along the z axis is regarded. Moreover, we limited the model to equal values for gray and white matter resulting in an additional simplification [25]. Importantly, we also limited our analysis to monopolar stimulation settings.…”

Section: Discussion/conclusionmentioning

confidence: 99%

Potentials and Limitations of Directional Deep Brain Stimulation: A Simulation Approach

Kramme

Dembek

Treuer

et al. 2020

Stereotact Funct Neurosurg

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Background: Directional leads are increasingly used in deep brain stimulation. They allow shaping the electrical field in the axial plane. These new possibilities increase the complexity of programming. Thus, optimized programming approaches are needed to assist clinical testing and to obtain full clinical benefit. Objectives: This simulation study investigates to what extent the electrical field can be shaped by directional steering to compensate for lead malposition. Method: Binary volumes of tissue activated (VTA) were simulated, by using a finite element method approach, for different amplitude distributions on the three directional electrodes. VTAs were shifted from 0 to 2 mm at different shift angles with respect to the lead orientation, to determine the best compensation of a target volume. Results: Malpositions of 1 mm can be compensated with the highest gain of overlap with directional leads. For larger shifts, an improvement of overlap of 10–30% is possible, depending on the stimulation amplitude and shift angle of the lead. Lead orientation and shift determine the amplitude distribution of the electrodes. Conclusion: To get full benefit from directional leads, both the shift angle as well as the shift to target volume are required to choose the correct amplitude distribution on the electrodes. Current directional leads have limitations when compensating malpositions >1 mm; however, they still outperform conventional leads in reducing overstimulation. Further, their main advantage probably lies in the reduction of side effects. Databases like the one from this simulation could serve for optimized lead programming algorithms in the future.

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Section: Discussion/conclusionmentioning

confidence: 99%

Potentials and Limitations of Directional Deep Brain Stimulation: A Simulation Approach

Kramme

Dembek

Treuer

et al. 2020

Stereotact Funct Neurosurg

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“…An overview of the LiU approach ( Åström et al, 2009 ; Åström, 2011 ; Wårdell et al, 2011 ; Alonso et al, 2016 ; Johansson et al, 2019 ; Nordin et al, 2019 ) for patient-specific DBS simulations is presented in Figure 6 . The workflow starts by building an electrical conductivity brain model from the patients undergoing preoperative T1, T2, or PD MRI ( Figures 6A,B ).…”

Section: Patient-specific Modeling Simulation and Visualization In De...mentioning

confidence: 99%

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

et al. 2022

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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.

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“…Ongoing electrophysiologic, functional, and tractographic evaluations continue to shed some light on the physiologic differences and commonalities among these co-occurring disorders and will improve our understanding and choice of targets [25]. Furthermore, technological advancement will allow individualized maps, thus improving decision making [26]. Finally, the use of wearable sensors can help improve the characterization of the tremors and other movement signs and the effect of the different DBS targets [27].…”

Section: Expert Commentarymentioning

confidence: 99%

Deep Brain Stimulation Target Selection in Co-Morbid Essential Tremor and Parkinson’s Disease

Wadhwa

Schaefer

Gerrard

et al. 2020

Tremor and Other Hyperkinetic Movements

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A 64-year-old right-handed male with essential tremor (ET) since the age of 18 presented for management of debilitating bilateral upper extremity action tremor. As a result, he had difficulty using his hands for eating, buttoning his clothes, and shaving. One year before presentation, he had also developed left lower extremity resting tremor. He had failed propranolol due to a lack of efficacy and could not tolerate primidone due to adverse effects. In addition to bilateral upper extremity action tremor (see Figure 1 for spiral drawing), examination showed rest tremor in both upper and lower extremities, chin tremor, hypomimia, hypometric saccadic eye movements, along with reduced arm swing and stride length when walking. Bradykinesia was present bilaterally but could not be accurately quantified due to severe overlying tremor. A clinical diagnosis of ET and Parkinson's disease (PD) was made, based on the long-standing history of action tremor with onset in the upper extremities (ET), and more recent development of asymmetric rest tremor, bradykinesia and hypomimia (PD) [1]. A trial of a low dose of carbidopa-levodopa did not offer many benefits and was subsequently discontinued per patient preference. He was thus referred for deep brain stimulation (DBS) to address refractory tremor. Clinical Dilemma DBS is recommended for PD patients with medically refractory tremor or motor fluctuations. Studies have shown comparable improvement in motor symptoms with stimulation

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White matter tracing combined with electric field simulation – A patient-specific approach for deep brain stimulation

Cited by 17 publications

References 54 publications

Potentials and Limitations of Directional Deep Brain Stimulation: A Simulation Approach

Potentials and Limitations of Directional Deep Brain Stimulation: A Simulation Approach

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

Deep Brain Stimulation Target Selection in Co-Morbid Essential Tremor and Parkinson’s Disease

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