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Utility of Postoperative Imaging Software for Deep Brain Stimulation Targeting in Patients with Movement Disorders
Almudena Sánchez-Gómez1, Paola Camargo2, Ana Cámara1
1Institut de Neurociències, Service of Neurology, Parkinson's Disease and Movement Disorders Unit., Hospital Clinic de Barcelona, Barcelona, Catalonia, Spain; Institut de Neurociències, Maeztu Center, Universitat de Barcelona, Barcelona, Catalonia, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Catalonia, Spain.
Objective:
The objective of this study was to evaluate the accuracy of the SureTune3 postoperative imaging software in determining the location of a deep brain stimulation (DBS) electrode based on clinical outcomes and the adverse effects (AEs) observed.
Methods:
Twenty-six consecutive patients with Parkinson disease (n = 17), essential tremor (n = 8), and dystonia (n = 1) who underwent bilateral DBS surgery (52 electrodes) were included in this study. Presurgical assessments were performed in all patients prior to surgery and at 3 and 6 months after surgery, using quality-of-life and clinical scales in each case. The SureTune3 software was used to evaluate the anatomical positioning of the DBS electrodes.
Results:
Following DBS surgery, motor and quality-of-life improvement was observed in all patients. Different AEs were detected in 12 patients, in 10 of whom (83.3%) SureTune3 related the symptoms to the positioning of an electrode. A clinical association was observed with SureTune3 for 48 of 52 (92.3%) electrodes, whereas no association was found between the AEs or clinical outcomes and the SureTune3 reconstructions for 4 of 52 electrodes (7.7%) from 4 different patients. In 2 patients, the contact chosen was modified based on the SureTune3 data, and in 2 cases, the software helped determine that second electrode replacement surgery was necessary.
Conclusions:
The anatomical position of electrodes analyzed with SureTune3 software was strongly correlated with both the AEs and clinical outcomes. Thus, SureTune3 may be useful in clinical practice, and it could help improve stimulation parameters and influence decisions to undertake electrode replacement surgery.
Insights
SureTune3 software accurately assessed deep brain stimulation (DBS) electrode placement, correlating with patient outcomes and adverse effects. This imaging tool aids in optimizing DBS therapy and surgical decisions.
Area of Science:
- Neurosurgery
- Medical Imaging
- Neurology
Background:
- Deep brain stimulation (DBS) is a crucial therapy for movement disorders.
- Accurate electrode placement is vital for DBS efficacy and safety.
- Postoperative imaging software aids in verifying electrode location.
Purpose of the Study:
- To evaluate the accuracy of SureTune3 software in determining DBS electrode location.
- To correlate software-assessed electrode position with clinical outcomes and adverse effects.
Main Methods:
- Twenty-six patients with Parkinson disease, essential tremor, and dystonia undergoing DBS surgery were included.
- SureTune3 software was used to analyze the anatomical positioning of 52 electrodes.
- Clinical outcomes and adverse effects were assessed using standardized scales.
Main Results:
- SureTune3 showed a strong correlation with clinical outcomes and adverse effects for 92.3% of electrodes.
- The software accurately linked symptoms to electrode positioning in 83.3% of adverse events.
- SureTune3 influenced treatment decisions, including electrode repositioning and replacement surgery.
Conclusions:
- SureTune3 software demonstrates high accuracy in assessing DBS electrode placement.
- The software is a valuable tool for clinical practice, improving stimulation parameters.
- SureTune3 can guide decisions regarding electrode revision surgery.
