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Directional DBS leads show large deviations from their intended implantation orientation
T A Dembek1, M Hoevels2, A Hellerbach2
1Department of Neurology, University Hospital of Cologne, Germany.
Parkinsonism & Related Disorders
|September 10, 2019
Summary
Large deviations in directional deep brain stimulation (DBS) lead placement are common, occurring in 42% of leads. Postoperative analysis is crucial for accurate directional DBS therapy.
Area of Science:
- Neurosurgery
- Biomedical Engineering
- Medical Imaging
Background:
- Directional deep brain stimulation (DBS) offers a new degree of freedom through lead orientation.
- Understanding lead placement accuracy is critical for optimizing DBS therapy.
Purpose of the Study:
- To investigate the prevalence of deviations in the implantation direction of directional DBS leads.
- To analyze factors influencing lead orientation accuracy.
Main Methods:
- Implemented the Directional Orientation Detection (DiODe) algorithm using postoperative CT scans.
- Analyzed lead orientation in 198 leads from 100 consecutive patients.
- Compared outcomes across different anatomical targets and intraoperative setups.
Main Results:
- Observed deviations up to 90° from the intended implantation direction.
- 42% of leads showed deviations >30°, and 11% showed deviations >60°.
- Deviations were independent of target/frame but varied with microdrive type.
Conclusions:
- Significant deviations in directional DBS lead orientation are common.
- Postoperative determination of lead orientation is essential for effective directional DBS research and application.
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