Intraoperative acceleration measurements to quantify improvement in tremor during deep brain stimulation surgery.

Shah, Ashesh; Coste, Jérôme; Lemaire, Jean-Jacques; Taub, Ethan; Schüpbach, Michael; Pollo, Claudio; Schkommodau, Erik; Guzman, Raphael; Hemm-Ode, Simone (2017). Intraoperative acceleration measurements to quantify improvement in tremor during deep brain stimulation surgery. Medical & biological engineering & computing, 55(5), pp. 845-858. Springer 10.1007/s11517-016-1559-9

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Deep brain stimulation (DBS) surgery is extensively used in the treatment of movement disorders. Nevertheless, methods to evaluate the clinical response during intraoperative stimulation tests to identify the optimal position for the implantation of the chronic DBS lead remain subjective. In this paper, we describe a new, versatile method for quantitative intraoperative evaluation of improvement in tremor with an acceleration sensor that is mounted on the patient's wrist during surgery. At each anatomical test position, the improvement in tremor compared to the initial tremor is estimated on the basis of extracted outcome measures. This method was tested on 15 tremor patients undergoing DBS surgery in two centers. Data from 359 stimulation tests were acquired. Our results suggest that accelerometric evaluation detects tremor changes more sensitively than subjective visual ratings. The effective stimulation current amplitudes identified from the quantitative data (1.1 ± 0.8 mA) are lower than those identified by visual evaluation (1.7 ± 0.8 mA) for similar improvement in tremor. Additionally, if these data had been used to choose the chronic implant position of the DBS lead, 15 of the 26 choices would have been different. These results show that our method of accelerometric evaluation can potentially improve DBS targeting.

Item Type:

Journal Article (Original Article)

Division/Institute:

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

UniBE Contributor:

Schüpbach, Michael and Pollo, Claudio

Subjects:

600 Technology > 610 Medicine & health

ISSN:

0140-0118

Publisher:

Springer

Language:

English

Submitter:

Nicole Söll

Date Deposited:

08 Mar 2017 09:22

Last Modified:

20 May 2017 01:30

Publisher DOI:

10.1007/s11517-016-1559-9

PubMed ID:

27631560

Uncontrolled Keywords:

Acceleration; Deep brain stimulation; Essential tremor; Intraoperative monitoring; Parkinson’s disease; Tremor

BORIS DOI:

10.7892/boris.93660

URI:

https://boris.unibe.ch/id/eprint/93660

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