The effect of cystic cavities on deep brain stimulation in the basal ganglia:: a simulation-based study
The effect of cystic cavities on deep brain stimulation in the basal ganglia:: a simulation-based study
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DOI：
10.1088/1741-2560/3/2/007
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发表时间：
2006-06-01
影响因子：
4
通讯作者：
Wardell, Karin
中科院分区：
文献类型：
--
作者：
Astrom, Mattias;Johansson, Johannes D.;Wardell, Karin
尽管深部脑刺激（DBS）的治疗效果已得到公认，但对其机制的基本理解仍不清楚。本文采用有限元建模和仿真的方法，研究了灰质中单极DBS电极周围电场扩展的相对变化。由于dbs靶点苍白球内经常出现囊性空洞，因此我们建立了有或没有脑脊液填充囊性空洞的灰质核模型。囊肿的位置、大小和形状随电极的变化而改变。模拟结果表明，在有源元件周围存在一个沿径向逐渐减小的电场。在灰质和白质之间的边缘存在逐步变化。囊肿增加了径向延伸，并大大改变了电场的形状。囊肿的位置、大小和形状是主要影响因素。我们认为dbs靶点的囊性空腔可能导致密切相关的意外结构或神经纤维束受到刺激，这可能是导致临床效果不佳或刺激引起副作用的原因之一。
Although the therapeutic effect of deep brain stimulation (DBS) is well recognized, a fundamental understanding of the mechanisms responsible is still not known. In this study finite element method (FEM) modelling and simulation was used in order to study relative changes of the electrical field extension surrounding a monopolar DBS electrode positioned in grey matter. Due to the frequently appearing cystic cavities in the DBS-target globus pallidus intemus, a nucleus of grey matter with and without a cerebrospinal fluid filled cystic cavity was modelled. The position, size and shape of the cyst were altered in relation to the electrode. The simulations demonstrated an electrical field around the active element with decreasing values in the radial direction. A stepwise change was present at the edge between grey and white matters. The cyst increased the radial extension and changed the shape of the electrical field substantially. The position, size and shape of the cyst were the main influencing factors. We suggest that cystic cavities in the DBS-target may result in closely related unexpected structures or neural fibre bundles being stimulated and could be one of the reasons for suboptimal clinical effects or stimulation-induced side effects.