Early Deformation of Deep Brain Stimulation Electrodes Following Surgical Implantation: Intracranial, Brain, and Electrode Mechanics.
Early Deformation of Deep Brain Stimulation Electrodes Following Surgical Implantation: Intracranial, Brain, and Electrode Mechanics.
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DOI：
10.3389/fbioe.2021.657875
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发表时间：
2021
影响因子：
5.7
通讯作者：
Lemaire JJ
中科院分区：
文献类型：
--
作者：
Chapelle F;Manciet L;Pereira B;Sontheimer A;Coste J;El Ouadih Y;Cimpeanu R;Gouot D;Lapusta Y;Claise B;Sautou V;Bouattour Y;Marques A;Wohrer A;Lemaire JJ
尽管深部脑刺激目前在世界各地都在进行，但电极植入的生物力学方面却很少受到关注，主要是因为医生们主要关注外科手术的最佳适应证、积极和不良反应以及长期随访等医学方面。我们的目的是描述电极在植入后立即的变形和脑移位，因为这可能会突出我们对颅内和脑内力学的理解。对30例帕金森病严重症状伴特发性震颤患者的60个电极进行了研究。它们包括30个非定向电极和30个定向电极，分别植入42次丘脑和18次丘脑腹外侧部。我们计算了x(横向)，y(前后)，z(深度)，扭转和曲率变形，沿着电极从脑壳的入口点开始。电极从术后即刻的CT扫描开始，使用自动体素阈值分割、人工减影和自动骨架化来建模。用三次多项式回归从电极曲线计算变形参数。我们根据电极的类型、临床参数、手术相关的准确性、脑移位、半球和三个组织层、回转层、白质干层和脑深层(I类误差设为5%)来研究这些变形。我们发现，植入的第一半球耦合到大脑的位移和电极类型的刚性对电极变形产生影响。不同的组织层、不同的电极类型、不同的第一半球脑移位效应，其变形程度也不同。我们的发现提供了有关颅内和大脑生物力学的信息，并应有助于进一步发展脑内电极设计和手术问题。
Although deep brain stimulation is nowadays performed worldwide, the biomechanical aspects of electrode implantation received little attention, mainly as physicians focused on the medical aspects, such as the optimal indication of the surgical procedure, the positive and adverse effects, and the long-term follow-up. We aimed to describe electrode deformations and brain shift immediately after implantation, as it may highlight our comprehension of intracranial and intracerebral mechanics. Sixty electrodes of 30 patients suffering from severe symptoms of Parkinson’s disease and essential tremor were studied. They consisted of 30 non-directional electrodes and 30 directional electrodes, implanted 42 times in the subthalamus and 18 times in the ventrolateral thalamus. We computed the x (transversal), y (anteroposterior), z (depth), torsion, and curvature deformations, along the electrodes from the entrance point in the braincase. The electrodes were modelized from the immediate postoperative CT scan using automatic voxel thresholding segmentation, manual subtraction of artifacts, and automatic skeletonization. The deformation parameters were computed from the curve of electrodes using a third-order polynomial regression. We studied these deformations according to the type of electrodes, the clinical parameters, the surgical-related accuracy, the brain shift, the hemisphere and three tissue layers, the gyration layer, the white matter stem layer, and the deep brain layer (type I error set at 5%). We found that the implanted first hemisphere coupled to the brain shift and the stiffness of the type of electrode impacted on the electrode deformations. The deformations were also different according to the tissue layers, to the electrode type, and to the first-hemisphere-brain-shift effect. Our findings provide information on the intracranial and brain biomechanics and should help further developments on intracerebral electrode design and surgical issues.
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影响因子：
7.7
作者：
Choi KS;Noecker AM;Riva-Posse P;Rajendra JK;Gross RE;Mayberg HS;McIntyre CC
通讯作者：
McIntyre CC
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Morrison, Barclay, III
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影响因子：
3.7
作者：
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通讯作者：
Hamel W