Modeling of Electric Fields in Individual Imaging Atlas for Capsular Threshold Prediction of Deep Brain Stimulation in Parkinson's Disease: A Pilot Study.

Béreau, Matthieu; Kibleur, Astrid; Bouthour, Walid; Tomkova Chaoui, Emilie; Maling, Nicholas; Nguyen, T. A. Khoa; Momjian, Shahan; Vargas Gomez, Maria Isabel; Zacharia, André; Bally, Julien F.; Fleury, Vanessa; Tatu, Laurent; Burkhard, Pierre R.; Krack, Paul (2020). Modeling of Electric Fields in Individual Imaging Atlas for Capsular Threshold Prediction of Deep Brain Stimulation in Parkinson's Disease: A Pilot Study. Frontiers in neurology, 11(532), p. 532. Frontiers Media S.A. 10.3389/fneur.2020.00532

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Background: Modeling of deep brain stimulation electric fields and anatomy-based software might improve post-operative management of patients with Parkinson's disease (PD) who have benefitted from subthalamic nucleus deep brain stimulation (STN-DBS). Objective: We compared clinical and software-guided determination of the thresholds for current diffusion to the pyramidal tract, the most frequent limiting side effect in post-operative management of STN-DBS PD patients. Methods: We assessed monopolar reviews in 16 consecutive STN-DBS PD patients and retrospectively compared clinical capsular thresholds, which had been assessed according to standard clinical practice, to those predicted by volume of tissue activated (VTA) model software. All the modeling steps were performed blinded from patients' clinical evaluations. Results: At the group level, we found a significant correlation (p = 0.0001) when performing statistical analysis on the z-scored capsular thresholds, but with a low regression coefficient (r = 0.2445). When considering intra-patient analysis, we found significant correlations (p < 0.05) between capsular threshold as modeled with the software and capsular threshold as determined clinically in five patients (31.2%). Conclusions: In this pilot study, the VTA model software was of limited assistance in identifying capsular thresholds for the whole cohort due to a large inter-patient variability. Clinical testing remains the gold standard in selecting stimulation parameters for STN-DBS in PD.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Neurology

UniBE Contributor:

Krack, Paul

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1664-2295

Publisher:

Frontiers Media S.A.

Language:

English

Submitter:

Chantal Kottler

Date Deposited:

10 Nov 2020 08:12

Last Modified:

15 Mar 2021 16:42

Publisher DOI:

10.3389/fneur.2020.00532

PubMed ID:

32714264

Uncontrolled Keywords:

Parkinson's disease capsular prediction deep brain stimulation subthalamic nucleus volume of tissue activated

BORIS DOI:

10.7892/boris.147363

URI:

https://boris.unibe.ch/id/eprint/147363

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