Daniel E Lumsden1, Jonathan Ashmore2, Geoffrey Charles-Edwards2, Richard Selway3, Jean-Pierre Lin4, Keyoumars Ashkan5. 1. Complex Motor Disorder Service, Evelina Children's Hospital, Guy's and St. Thomas' NHS Foundation Trust, London, United Kingdom; King's College London, London, United Kingdom. Electronic address: Daniel.lumsden@nhs.net. 2. King's College London, London, United Kingdom. 3. Functional Neurosurgery, King's College Hospital, King's College Hospital NHS Foundation Trust, London, United Kingdom. 4. Complex Motor Disorder Service, Evelina Children's Hospital, Guy's and St. Thomas' NHS Foundation Trust, London, United Kingdom. 5. Clinical Neurosciences, Institute of Psychiatry, King's College London, London, United Kingdom; Functional Neurosurgery, King's College Hospital, King's College Hospital NHS Foundation Trust, London, United Kingdom.
Abstract
OBJECTIVE: It is unclear how brain growth with age affects electrode position in relation to target for children undergoing deep brain stimulation surgery. We aimed to model projected change in the distance between the entry point of the electrode into the brain and target during growth to adulthood. METHODS: Modeling was performed using a neurodevelopmental magnetic resonance imaging database of age-specific templates in 6-month increments from 4 to 18 years of age. Coordinates were chosen for a set of entry points into both cerebral hemispheres and target positions within the globus pallidus internus on the youngest magnetic resonance imaging template. The youngest template was nonlinearly registered to the older templates, and the transformations generated by these registrations were applied to the original coordinates of entry and target positions, mapping these positions with increasing age. Euclidean geometry was used to calculate the distance between projected electrode entry and target with increasing age. RESULTS: A projected increase in distance between entry point and target of 5-10 mm was found from age 4 to 18 years. Most change appeared to occur before 7 years of age, after which minimal change in distance was found. CONCLUSIONS: Electrodes inserted during deep brain stimulation surgery are tethered at the point of entry to the skull. Brain growth, which could result in a relative retraction with respect to the original target position, appears to occur before 7 years of age, suggesting careful monitoring is needed for children undergoing implantation before this age. Reengineering of electrode design could avoid reimplantation surgery in young children undergoing deep brain stimulation.
OBJECTIVE: It is unclear how brain growth with age affects electrode position in relation to target for children undergoing deep brain stimulation surgery. We aimed to model projected change in the distance between the entry point of the electrode into the brain and target during growth to adulthood. METHODS: Modeling was performed using a neurodevelopmental magnetic resonance imaging database of age-specific templates in 6-month increments from 4 to 18 years of age. Coordinates were chosen for a set of entry points into both cerebral hemispheres and target positions within the globus pallidus internus on the youngest magnetic resonance imaging template. The youngest template was nonlinearly registered to the older templates, and the transformations generated by these registrations were applied to the original coordinates of entry and target positions, mapping these positions with increasing age. Euclidean geometry was used to calculate the distance between projected electrode entry and target with increasing age. RESULTS: A projected increase in distance between entry point and target of 5-10 mm was found from age 4 to 18 years. Most change appeared to occur before 7 years of age, after which minimal change in distance was found. CONCLUSIONS: Electrodes inserted during deep brain stimulation surgery are tethered at the point of entry to the skull. Brain growth, which could result in a relative retraction with respect to the original target position, appears to occur before 7 years of age, suggesting careful monitoring is needed for children undergoing implantation before this age. Reengineering of electrode design could avoid reimplantation surgery in young children undergoing deep brain stimulation.
Authors: Harith Akram; Stamatios N Sotiropoulos; Saad Jbabdi; Dejan Georgiev; Philipp Mahlknecht; Jonathan Hyam; Thomas Foltynie; Patricia Limousin; Enrico De Vita; Marjan Jahanshahi; Marwan Hariz; John Ashburner; Tim Behrens; Ludvic Zrinzo Journal: Neuroimage Date: 2017-07-12 Impact factor: 6.556
Authors: Yasemin Gulcan Kurt; Jorida Çoku; H Orhan Akman; Ali Naini; Jesheng Lu; Kristin Engelstad; Michio Hirano; Darryl C De Vivo; Salvatore DiMauro Journal: Child Neurol Open Date: 2016-04-04