A novel local field potential-based functional approach for targeting the centromedian-parafascicular complex for deep brain stimulation.
A novel local field potential-based functional approach for targeting the centromedian-parafascicular complex for deep brain stimulation.
复制标题
DOI：
10.1016/j.nicl.2021.102644
复制
发表时间：
2021
期刊：
影响因子：
--
通讯作者：
Gunduz A
中科院分区：
文献类型：
--
作者：
Cagle JN;Eisinger RS;Holland MT;Foote KD;Okun MS;Gunduz A
丘脑中央正中核-束旁核功能性靶向定位方法的研究。与刺激开始期间的位置相关的强局部场电位。沿丘脑中电极轨迹的可区分信号沿着。丘脑中央正中-束旁（Cm-Pf）复合体是治疗抽动秽语综合征（TS）的常见脑深部电刺激（DBS）靶点。目前，还没有标准化的功能性术中神经外科靶向方法。总的来说，这些问题导致DBS电极导线置入的可变性。因此，需要更明确的方法来提高瞄准精度。这项观察性研究的目的是开发和验证一个功能映射任务，能够区分从附近的腹中间（Vim）丘脑核区域的Cm-Pf区域。总体目标是提高Cm-Pf区域DBS靶向的可重复性。7例TS患者完成了改良的Go/NoGo任务（5例在术后环境中，2例在术中环境中）。术后神经信号从Cm-Pf区使用传感使能植入神经刺激器收集，术中神经信号从Cm-Pf区使用外部放大器收集。事件相关电位（ERP）的功能，通过使用来自术后参与者的刺激起始信号的总平均值来确定。这些特征与特定电极记录的解剖位置相关。从术中患者中提取相同的特征，以验证手术室环境中的电极位置。两个功能-一个积极的和消极的偏转-被确定在平均ERP从术后参与者。两个特征的峰值幅度与电极深度位置显著相关（正偏转p = 0.025，负偏转p = 0.039）。在最近的两名患者中，术中再现了相同的结果，与背侧电极接触相比，更多腹侧电极接触显示出更强的峰值振幅。该过程用于在生理学上确认手术室环境中电极导线的准确放置。改良的Go/NoGo任务在Cm-Pf区域中引起稳健的神经反应，然而，信号不存在于沿沿着DBS电极轨迹的丘脑的Vim核区域中。我们的结论是，ERP反应的差异可能是一个潜在的新的LFP为基础的功能性方法，为未来的目标的CM-PF复杂的TS DBS。
A functional targeting method for centromedian-parafascicular nucleus of thalamus. Strong local field potentials that correlate with position during stimuli onset. Differentiable signal along the trajectory of the electrode in thalamus. The centromedian-parafascicular (Cm-Pf) complex of the thalamus is a common deep brain stimulation (DBS) target for treatment of Tourette syndrome (TS). Currently, there are no standardized functional intraoperative neurosurgical targeting approaches. Collectively, these issues have led to variability in DBS lead placement. Therefore, more defined methods are needed to improve targeting accuracy. The objective of this observational study was to develop and to verify a functional mapping task capable of differentiating the Cm-Pf region from the nearby ventral intermediate (Vim) nucleus region of the thalamus. The overarching goal was to improve the reproducibility of DBS targeting in the Cm-Pf region. Seven TS patients completed a modified Go/NoGo task (five in the post-operative setting and two in the intra-operative setting). Post-operative neural signals from Cm-Pf region were collected using sensing-enabled implanted neural stimulators, and intraoperative neural signals from the Cm-Pf region were collected using an external amplifier. Event-related potential (ERP) features were identified by using the grand-average of stimulus onset signals derived from the postoperative participants. These features were correlated with anatomical locations for the specific electrode recordings. The same features were extracted from the intraoperative patients in order to verify electrode positions in the operating room environment. Two features – a positive and a negative deflection – were identified in the average ERP from the post-operative participants. The peak amplitudes of both features were significantly correlated with the electrode depth position (p = 0.025 for positive deflection and p = 0.039 for negative deflection). The same result was reproduced intra-operatively in the two most recent patients, where more ventral electrode contacts revealed stronger peak amplitudes in comparison to the dorsal electrode contacts. This process was used to physiologically confirm accurate lead placement in the operating room setting. The modified Go/NoGo task elicited robust neural responses in the Cm-Pf region however the signal was not present in the Vim nucleus region of thalamus along the DBS electrode trajectory. We conclude that the differences in ERP responses may be a potentially novel LFP based functional approach for future targeting of the Cm-Pf complex for TS DBS.
登录
查看更多内容
影响因子：
4.6
作者：
Schalk, G;McFarland, DJ;Wolpaw, JR
通讯作者：
Wolpaw, JR
影响因子：
1.7
作者：
Shields, Donald C.;Cheng, Ming L.;Eskandar, Emad N.
通讯作者：
Eskandar, Emad N.
影响因子：
5.7
作者：
Beck, Anne-Kathrin;Sandmann, Pascale;Krauss, Joachim K.
通讯作者：
Krauss, Joachim K.
影响因子：
5.7
作者：
Schepers, Inga M.;Beck, Anne-Kathrin;Krauss, Joachim K.
通讯作者：
Krauss, Joachim K.
影响因子：
4
作者：
Connolly AT;Muralidharan A;Hendrix C;Johnson L;Gupta R;Stanslaski S;Denison T;Baker KB;Vitek JL;Johnson MD
通讯作者：
Johnson MD