A Computerized Microelectrode Recording to Magnetic Resonance Imaging Mapping System for Subthalamic Nucleus Deep...

Area of Science:

• Neurosurgery
• Medical Imaging
• Biomedical Engineering

Background:

• Accurate electrode placement is crucial for successful deep brain stimulation (DBS) surgery.
• Suboptimal targeting in DBS can result from issues like poor initial target localization, frame-based errors, or intraoperative brain shift, complicating the procedure.

Purpose of the Study:

• To develop a computerized system for guiding subthalamic nucleus (STN) DBS electrode localization.
• To algorithmically estimate the trajectory of intraoperative microelectrode recording (MER) on magnetic resonance (MR) images during DBS surgery.

Main Methods:

• The system utilizes the relationship between high-frequency band (HFB) signals from MER and MR image voxel intensity.
• HFB profiles along MER trajectories are compared with voxel intensity profiles of potential trajectories to estimate the MER trajectory.
• The calculated trajectory is validated against the actual trajectory determined by postoperative high-resolution computed tomography.

Main Results:

• Targeting errors for calculated trajectories (2.33 mm ± 0.2 mm) were significantly lower than for planned trajectories (2.83 mm ± 0.2 mm; P = .01).
• The system improved targeting prediction accuracy in 70% of cases (14/20).
• In 4 cases where initial MER trajectories missed the STN, the method correctly indicated adjustments needed for DBS lead targeting.

Conclusions:

• A computer-based algorithm integrating MER and MR information can simplify electrode localization in STN DBS surgery.
• This approach offers a potential improvement in targeting accuracy for DBS procedures.