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Related Experiment Video

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Analysis of Gene Expression Changes in the Rat Hippocampus After Deep Brain Stimulation of the Anterior Thalamic Nucleus
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Impact of brain shift on subcallosal cingulate deep brain stimulation.

Ki Sueng Choi1, Angela M Noecker2, Patricio Riva-Posse1

  • 1Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA, United States.

Brain Stimulation
|December 17, 2017
PubMed
Summary

Brain shift after surgery for deep brain stimulation (DBS) of the subcallosal cingulate can alter targeted pathways. Electrode placement accuracy is crucial for effective treatment of depression, impacting patient outcomes.

Keywords:
ConnectomicElectrodeNeurosurgeryStereotacticTractography

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Area of Science:

  • Neurosurgery
  • Neurology
  • Medical Imaging

Background:

  • Deep brain stimulation (DBS) of the subcallosal cingulate (SCC) is an experimental therapy for treatment-resistant depression.
  • Accurate surgical targeting of axonal pathways is essential for SCC DBS efficacy.
  • Brain shift following skull opening can displace these target pathways.

Purpose of the Study:

  • To quantify the impact of electrode location deviations on tractographic representations for SCC DBS.
  • To analyze the effects of brain shift on stimulating target pathways using longitudinal imaging data.

Main Methods:

  • Coregistered preoperative MRI/DWI with postoperative MRI and CT scans from 15 patients.
  • Measured brain shift using anatomical control points.
  • Defined electrode models at planned, near-term, and long-term positions for tractography analysis.

Main Results:

  • Observed mean brain shift of 2.2 mm near-term, resolving long-term.
  • Found significant electrode displacements (up to 1.47 mm) from the planned target, particularly in the right hemisphere.
  • Displacements altered pathway activation patterns, with less variance in remitters.

Conclusions:

  • Brain shift is a significant factor affecting surgical targeting accuracy in SCC DBS.
  • Deviations in electrode placement can impact connectomic analyses and treatment outcomes.
  • Accurate targeting and accounting for brain shift are critical for optimizing SCC DBS therapy.