Impact of brain shift on neural pathways in deep brain stimulation: a preliminary analysis via multi-physics finite element models.
Impact of brain shift on neural pathways in deep brain stimulation: a preliminary analysis via multi-physics finite element models.
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DOI：
10.1088/1741-2552/abf066
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发表时间：
2021-04-06
影响因子：
4
通讯作者：
中科院分区：
文献类型：
--
作者：
脑深部电刺激（DBS）的有效性取决于电极放置的准确性，这可能会受到手术期间大脑移位的影响。虽然已经努力使用术前和术后成像数据来评估由于脑移位而导致的电极错位的影响，但是还没有通过生物物理建模使用术前和术中成像数据进行这种分析。这项工作提出了一个初步的研究，应用多物理分析框架，使用有限元生物力学和生物电模型来检查的影响，现实的术中转移神经纤维束成像确定的神经通路。该研究检查了6名接受介入磁共振引导DBS手术的患者。建模框架利用生物力学方法更新术前MR，以反映移位引起的解剖结构变化。使用该解剖学变形的图像和其未变形的对应物，可以模拟来自移动电极引线的生物电效应，并且近似神经激活差异。具体而言，对于每种配置，计算组织激活体积，随后用于纤维束成像估计。比较了总的束体积和与运动区的重叠体积以及连接概况。此外，体积重叠之间的不同的纤维束之间的配置进行了计算和相关的估计偏移。该研究发现，变形引起的差异，在道体积，运动区重叠，和连接行为，这表明的影响，转移。偏离预期靶点和预期神经通路募集之间存在强相关性（R =-0.83），其中在阈值约为2.94 mm时，预期募集完全降低。所确定的阈值与先前的观察结果和文献一致，并为先前的观察结果和文献提供了定量支持，即2-3 mm的偏差是有害的。研究结果支持和推进先前的研究和理解，以说明需要考虑DBS的转移和计算建模的潜力，以估计转移对神经激活的影响。
The effectiveness of deep brain stimulation (DBS) depends on electrode placement accuracy, which can be compromised by brain shift during surgery. While there have been efforts in assessing the impact of electrode misplacement due to brain shift using preop- and postop-imaging data, such analysis using preop- and intraop-imaging data via biophysical modeling has not been conducted. This work presents a preliminary study that applies a multi-physics analysis framework using finite element biomechanical and bioelectric models to examine the impact of realistic intraoperative shift on neural pathways determined by tractography. The study examined six patients who had undergone interventional magnetic resonance-guided DBS surgery. The modeling framework utilized a biomechanical approach to update preoperative MR to reflect shift-induced anatomical changes. Using this anatomically deformed image and its undeformed counterpart, bioelectric effects from shifting electrode leads could be simulated and neural activation differences were approximated. Specifically, for each configuration, volume of tissue activation was computed and subsequently used for tractography estimation. Total tract volume and overlapping volume with motor regions as well as connectivity profile were compared. In addition, volumetric overlap between different fiber bundles among configurations was computed and correlated to estimated shift. The study found deformation-induced differences in tract volume, motor region overlap, and connectivity behavior, suggesting the impact of shift. There is a strong correlation (R = −0.83) between shift from intended target and intended neural pathway recruitment, where at threshold of ~2.94 mm, intended recruitment completely degrades. The determined threshold is consistent with and provides quantitative support to prior observations and literature that deviations of 2–3 mm are detrimental. The findings support and advance prior studies and understanding to illustrate the need to account for shift in DBS and the potentiality of computational modeling for estimating influence of shift on neural activation.
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影响因子：
3.2
作者：
Astrom, Mattias;Lemaire, Jean-Jacques;Wardell, Karin
通讯作者：
Wardell, Karin
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
影响因子：
3.3
作者：
Alonso F;Vogel D;Johansson J;Wårdell K;Hemm S
通讯作者：
Hemm S
影响因子：
5.7
作者：
Avants BB;Tustison NJ;Song G;Cook PA;Klein A;Gee JC
通讯作者：
Gee JC
影响因子：
5.7
作者：
Fonov V;Evans AC;Botteron K;Almli CR;McKinstry RC;Collins DL;Brain Development Cooperative Group
通讯作者：
Brain Development Cooperative Group