Semi-automated application for estimating subthalamic nucleus boundaries and optimal target selection for deep brain stimulation implantation surgery
Semi-automated application for estimating subthalamic nucleus boundaries and optimal target selection for deep brain stimulation implantation surgery
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DOI：
10.3171/2017.12.jns171964
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发表时间：
2019-04-01
影响因子：
4.1
通讯作者：
Abosch, Aviva
中科院分区：
文献类型：
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作者：
Thompson, John A.;Oukal, Salam;Abosch, Aviva
目的丘脑底核脑深部电刺激术（DBS）已成为帕金森病（PD）外科治疗的标准治疗方法。用于指导DBS植入手术的微电极记录（MER）数据的可靠解释需要专家进行电生理评估。最近的努力已经endeavenly使用电生理信号自动检测相关的大脑结构和最佳的植入物的目标location.The作者进行了一项观察性病例对照研究，以评估一个软件包上实现的电生理记录系统，提供在线的客观估计，进入和退出的神经元。此外，他们还评估了该软件在选择DBS植入颅内的电极轨迹和深度方面的准确性，这依赖于检测频谱活动的变化。（4名经验丰富的神经外科医生; 3个站点），其中估计进入和退出DBS，DBS轨道选择，在手术过程中，将软件确定的和植入神经外科医生/神经生理学家确定的植入深度进行事后比较。神经生理学家和软件的进入和退出的DBS以及最佳的DBS植入depth.CONCLUSIONS本研究的结果表明，该软件可以可靠和准确地估计进入和退出的DBS，并选择相应的最终DBS植入的轨道。
OBJECTIVE Deep brain stimulation (DBS) of the subthalamic nucleus (STN) has become standard care for the surgical treatment of Parkinson's disease (PD). Reliable interpretation of microelectrode recording (MER) data, used to guide DBS implantation surgery, requires expert electrophysiological evaluation. Recent efforts have endeavored to use electrophysiological signals for automatic detection of relevant brain structures and optimal implant target location.The authors conducted an observational case-control study to evaluate a software package implemented on an electrophysiological recording system to provide online objective estimates for entry into and exit from the STN. In addition, they evaluated the accuracy of the software in selecting electrode track and depth for DBS implantation into STN, which relied on detecting changes in spectrum activity.METHODS Data were retrospectively collected from 105 MER-guided STN-DBS surgeries (4 experienced neurosurgeons; 3 sites), in which estimates for entry into and exit from the STN, DBS track selection, and implant depth were compared post hoc between those determined by the software and those determined by the implanting neurosurgeon/neurophysiologist during surgery.RESULTS This multicenter study revealed submillimetric agreement between surgeon/neurophysiologist and software for entry into and exit out of the STN as well as optimal DBS implant depth.CONCLUSIONS The results of this study demonstrate that the software can reliably and accurately estimate entry into and exit from the STN and select the track corresponding to ultimate DBS implantation.