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Clinician vs. imaging-based subthalamic nucleus deep brain stimulation programming.

Gurleen Vilkhu1, Clarisse Goas1, Jacob A Miller1

  • 1Department of Neurology, Wexner Medical Center, Ohio State University, 395 W. 12th Ave. Columbus, OH, 43210, USA.

Parkinsonism & Related Disorders
|December 16, 2022
PubMed
Summary
This summary is machine-generated.

Electrode visualization tools (EVTs) accurately predict optimal Deep Brain Stimulation (DBS) contacts for Parkinson's disease, significantly reducing programming time and effort. EVTs improve efficiency in identifying non-useable contacts and predicting side effects.

Keywords:
Deep brain stimulationImagingProgrammingSubthalamic nucleus

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Area of Science:

  • Neurosurgery
  • Biomedical Engineering

Background:

  • Deep Brain Stimulation (DBS) is a crucial therapy for Parkinson's disease (PD).
  • Optimizing DBS electrode contact selection is vital for therapeutic efficacy and minimizing side effects.
  • Current programming methods can be time-consuming and labor-intensive.

Purpose of the Study:

  • To evaluate the accuracy of Electrode Visualization Tools (EVTs) in predicting optimal Deep Brain Stimulation (DBS) electrode contacts.
  • To compare the efficiency of EVT-based programming with standard monopolar review for STN-DBS in Parkinson's disease patients.

Main Methods:

  • Prospective analysis of 12 Parkinson's disease patients undergoing STN-DBS.
  • Generation of 3D EVTs using the Surgical Information Sciences (SIS) system.
  • Comparison of EVT predictions with standard monopolar review for identifying usable, non-usable, and borderline contacts.

Main Results:

  • Significant concordance between EVT and standard programming for non-usable (kappa=0.65) and usable/borderline contacts (kappa=0.52).
  • Drastic reduction in programming time: 1.46 min with EVT vs. 61.25 min with standard review.
  • EVTs accurately predicted observed side effects 90% of the time.

Conclusions:

  • Next-generation EVT-based programming is a viable enhancement to STN-DBS workflows.
  • EVTs offer substantial time and effort savings, especially in identifying non-usable electrode contacts.
  • This technology streamlines the DBS programming process, potentially improving patient outcomes.