Deep Brain Stimulation Electrode Reconstruction: Comparison between Lead-DBS and Surgical Planning System

Area of Science:

• Neurosurgery
• Medical Imaging
• Computational Neuroscience

Background:

• Accurate electrode placement is crucial for effective deep brain stimulation (DBS).
• Postoperative reconstruction of DBS electrodes is essential for assessing lead placement and optimizing stimulation parameters.
• Current methods include manual reconstruction (Surgiplan) and semi-automated software (Lead-DBS), but Lead-DBS accuracy requires thorough validation.

Purpose of the Study:

• To compare the accuracy of DBS electrode reconstruction between the Lead-DBS toolbox and the Surgiplan system.
• To evaluate the performance of Lead-DBS in capturing electrode coordinates and relative positions to the subthalamic nucleus (STN).

Main Methods:

• Compared Lead-DBS and Surgiplan reconstructions in 26 patients (Parkinson's disease, dystonia) undergoing STN-DBS.
• Analyzed electrode contact coordinates and relative positions to the STN using postoperative CT and MRI.
• Mapped optimal stimulation contacts onto Lead-DBS reconstructions to assess STN overlap.

Main Results:

• Significant differences in X, Y, and Z coordinates were observed between Lead-DBS and Surgiplan using postoperative CT.
• Y and Z coordinates showed significant differences with both CT and MRI.
• No significant difference was found in the relative distance between the electrode and the STN.
• 70% of optimal contacts in Lead-DBS reconstructions were within the STN's dorsolateral region.

Conclusions:

• Despite coordinate discrepancies of approximately 1 mm, Lead-DBS demonstrates reasonable accuracy for postoperative DBS electrode reconstruction.
• Lead-DBS effectively maintains the relative spatial relationship between the electrode and the DBS target (STN).
• The findings support the utility of Lead-DBS for clinical applications in DBS surgery.