Mattias Åström1,2,3, Jennifer Samuelsson4, Jonas Roothans5,6, Anders Fytagoridis4,7, Maxim Ryzhkov5,6, Rutger Nijlunsing5,6, Patric Blomstedt4. 1. Medtronic, Vasteras, Swedenmattias.astrom77@gmail.com. 2. Medtronic, Eindhoven, The Netherlandsmattias.astrom77@gmail.com. 3. Department of Biomedical Engineering, Linköping University, Linköping, Swedenmattias.astrom77@gmail.com. 4. Unit of Functional and Stereotactic Neurosurgery, Department of Pharmacology and Clinical Neuroscience, Umeå University, Umeå, Sweden. 5. Medtronic, Vasteras, Sweden. 6. Medtronic, Eindhoven, The Netherlands. 7. Neurosurgery, Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden.
Abstract
BACKGROUND/AIM: Deep brain stimulation (DBS) is an established neurosurgical treatment that can be used to alleviate symptoms in essential tremor (ET) and other movement disorders. The aim was to develop a method and software tool for the prediction of effective DBS electrode contacts based on probabilistic stimulation maps (PSMs) in patients with ET treated with caudal zona incerta (cZi) DBS. METHODS: A total of 33 patients (37 leads) treated with DBS were evaluated with the Essential Tremor Rating Scale (ETRS) 12 months after surgery. In addition, hand tremor and hand function (ETRS items 5/6 and 11-14) were evaluated for every contact during stimulation with best possible outcome without inducing side effects. Prediction of effective DBS electrode contacts was carried out in a retrospective leave-one-out manner based on PSMs, simulated stimulation fields, and a scoring function. Electrode contacts were ranked according to their likelihood of being included in the clinical setting. Ranked electrode contacts were compared to actual clinical settings. RESULTS: Predictions made by the software tool showed that electrode contacts with rank 1 matched the clinically used contacts in 60% of the cases. Contacts with a rank of 1-2 and 1-3 matched the clinical contacts in 83 and 94% of the cases, respectively. Mean improvement of hand tremor and hand function was 79 ± 21% and 77 ± 22% for the clinically used and the predicted electrode contacts, respectively. CONCLUSIONS: Effective electrode contacts can be predicted based on PSMs in patients treated with cZi DBS for ET. Predictions may in the future be used to reduce the number of clinical assessments that are carried out before a satisfying stimulation setting is defined.
BACKGROUND/AIM: Deep brain stimulation (DBS) is an established neurosurgical treatment that can be used to alleviate symptoms in essential tremor (ET) and other movement disorders. The aim was to develop a method and software tool for the prediction of effective DBS electrode contacts based on probabilistic stimulation maps (PSMs) in patients with ET treated with caudal zona incerta (cZi) DBS. METHODS: A total of 33 patients (37 leads) treated with DBS were evaluated with the Essential Tremor Rating Scale (ETRS) 12 months after surgery. In addition, hand tremor and hand function (ETRS items 5/6 and 11-14) were evaluated for every contact during stimulation with best possible outcome without inducing side effects. Prediction of effective DBS electrode contacts was carried out in a retrospective leave-one-out manner based on PSMs, simulated stimulation fields, and a scoring function. Electrode contacts were ranked according to their likelihood of being included in the clinical setting. Ranked electrode contacts were compared to actual clinical settings. RESULTS: Predictions made by the software tool showed that electrode contacts with rank 1 matched the clinically used contacts in 60% of the cases. Contacts with a rank of 1-2 and 1-3 matched the clinical contacts in 83 and 94% of the cases, respectively. Mean improvement of hand tremor and hand function was 79 ± 21% and 77 ± 22% for the clinically used and the predicted electrode contacts, respectively. CONCLUSIONS: Effective electrode contacts can be predicted based on PSMs in patients treated with cZi DBS for ET. Predictions may in the future be used to reduce the number of clinical assessments that are carried out before a satisfying stimulation setting is defined.
Authors: Joshua K Wong; Christopher W Hess; Leonardo Almeida; Erik H Middlebrooks; Evangelos A Christou; Erin E Patrick; Aparna Wagle Shukla; Kelly D Foote; Michael S Okun Journal: Expert Rev Neurother Date: 2020-03-02 Impact factor: 4.618
Authors: Jan Niklas Petry-Schmelzer; Till A Dembek; Julia K Steffen; Hannah Jergas; Haidar S Dafsari; Gereon R Fink; Veerle Visser-Vandewalle; Michael T Barbe Journal: Brain Sci Date: 2020-12-20