Impact of brain shift on subcallosal cingulate deep brain stimulation.
Impact of brain shift on subcallosal cingulate deep brain stimulation.
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DOI：
10.1016/j.brs.2017.12.001
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发表时间：
2018-03
影响因子：
7.7
通讯作者：
McIntyre CC
中科院分区：
文献类型：
--
作者：
Choi KS;Noecker AM;Riva-Posse P;Rajendra JK;Gross RE;Mayberg HS;McIntyre CC
胼胝体下扣带回脑深部电刺激（DBS）是一种治疗难治性抑郁症的新兴实验性疗法。SCC DBS手术靶向的新发展集中在识别特定的轴突刺激通路，这些通路是根据术前收集的弥散加权成像（DWI）数据估计的。然而，在颅骨中打开钻孔引起的脑移位可能会改变靶通路的位置。使用纵向临床成像数据集量化电极位置偏差对用于刺激靶通路的纤维束成像表示的影响。将术前MRI和DWI数据（计划）与术后MRI（1天，近期）和CT（3周，长期）数据进行配准。用解剖学控制点测量脑移位。在15名患者的每个半球中定义了与计划、近期和长期位置相对应的电极模型。使用估计的刺激体积作为以不同电极位置为中心的种子进行纤维束成像分析。在近期观察到额极平均脑移位2.2 mm，在长期解决。然而，在近期（平均左侧电极移位：0.43 mm，平均右侧电极移位：0.99 mm）和长期（平均左侧电极移位：1.02 mm，平均右侧电极移位：1.47 mm），均观察到电极在前上方偏离计划的立体定向靶位置。植入右半球（第二侧手术）的DBS电极比植入左半球的电极偏离计划更多。与计划相比，这些位移导致电极与腹侧纹状体之间的通路激活减少3.6%，但额极连接增加2.7%。缓解者从六个月的慢性刺激有较少的变化，在通路激活模式比非缓解者。脑移位是SCC DBS手术靶向的一个重要问题，可能影响连接组学分析。
Deep brain stimulation (DBS) of the subcallosal cingulate (SCC) is an emerging experimental therapy for treatment-resistant depression. New developments in SCC DBS surgical targeting are focused on identifying specific axonal pathways for stimulation that are estimated from preoperatively collected diffusion-weighted imaging (DWI) data. However, brain shift induced by opening burr holes in the skull may alter the position of the target pathways. Quantify the effect of electrode location deviations on tractographic representations for stimulating the target pathways using longitudinal clinical imaging datasets. Preoperative MRI and DWI data (planned) were coregistered with postoperative MRI (1 day, near-term) and CT (3 weeks, long-term) data. Brain shift was measured with anatomical control points. Electrode models corresponding to the planned, near-term, and long-term locations were defined in each hemisphere of 15 patients. Tractography analyses were performed using estimated stimulation volumes as seeds centered on the different electrode positions. Mean brain shift of 2.2 mm was observed in the near-term for the frontal pole, which resolved in the long-term. However, electrode displacements from the planned stereotactic target location were observed in the anterior-superior direction in both the near-term (mean left electrode shift: 0.43 mm, mean right electrode shift: 0.99 mm) and long-term (mean left electrode shift: 1.02 mm, mean right electrode shift: 1.47 mm). DBS electrodes implanted in the right hemisphere (second-side operated) were more displaced from the plan than those in the left hemisphere. These displacements resulted in 3.6% decrease in pathway activation between the electrode and the ventral striatum, but 2.7% increase in the frontal pole connection, compared to the plan. Remitters from six-month chronic stimulation had less variance in pathway activation patterns than the non-remitters. Brain shift is an important concern for SCC DBS surgical targeting and can impact connectomic analyses.
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影响因子：
7.7
作者：
Lujan, J. Luis;Chaturvedi, Ashutosh;Choi, Ki Sueng;Holtzheimer, Paul E.;Gross, Robert E.;Mayberg, Helen S.;McIntyre, Cameron C.
通讯作者：
McIntyre, Cameron C.
影响因子：
4
作者：
Chaturvedi A;Luján JL;McIntyre CC
通讯作者：
McIntyre CC
影响因子：
10.6
作者：
Gutman, David A.;Holtzheimer, Paul E.;Behrens, Timothy E. J.;Johansen-Berg, Heidi;Mayberg, Helen S.
通讯作者：
Mayberg, Helen S.
影响因子：
16.2
作者：
Mayberg, HS;Lozano, AM;Kennedy, SH
通讯作者：
Kennedy, SH
影响因子：
10.6
作者：
Riva-Posse P;Choi KS;Holtzheimer PE;McIntyre CC;Gross RE;Chaturvedi A;Crowell AL;Garlow SJ;Rajendra JK;Mayberg HS
通讯作者：
Mayberg HS