Category: Technology
Objective:
Segmented DBS microelectrode allow electric-current-steering in a point direction which comes through cumbersome yet tedious and time complexity with coding. Accurate measurement angle of electrode is key for accelerating stimulus coding. Existing techniques imply emission establishing intrinsic hazards, also cycle of electrode insertion might need repetitive measures. To avoid such hazards, this study proposes antiradiation process by postop imaging apprised EEG.
Background:
Guiding (steering)electrodes gives many merits technically, e.g., large-window plus high-threshold for dyskinesias. Yet it`s time-complexity is linked by time and space-complexity due to DBS coding. Image- guided package can accelerate but it needs the expertise of electrode direction. Existing techniques involve the process of radiation to uncover leads. Moreover, directional electrodes can rotate over time, necessitating repeated measurements in a single patient [9–11]. So, antiradiation is a must. Phantom test is one such technique using EEG advised by postop MRI can just decide electrode angle.
Method:
Phantom EEG through optimized computer (software, automated hardware) most viable for standard application in clinical settings.
Results:
Determined the electrode direction <1°error in ideal settings. Such circumstances can hypothetically be attained by as-few-as four leads plus a minute-recording (~) bilaterally which equals positively through outcome with imaging (either computed axial tomography or MR) gyratory fluoroscopy and magnetoencephalography. The procedure needs that the noisy ‘dipole-pattern’ is compellingly altered by the direction of the microelectrodes (leads) which is authentic mainly for bipolar-stimuli amid two segments over consistent and similar yet identical ring.
Conclusion:
test in Parkinson`s neurodegenerative disease and in other movement disorders, expertise of the authentic and the direction of valid lead perchance is demanded.
References: 1. Steigerwald F, Müller L, Johannes S, Matthies C, Volkmann J. Directional deep brain stimulation of the subthalamic nucleus: A pilot study using a novel neurostimulation device. Movement Disorders 2016;31:1240–3. https://doi.org/10.1002/mds.26669.
2. Pollo C, Kaelin-Lang A, Oertel MF, Stieglitz L, Taub E, Fuhr P, et al. Directional deep brain stimulation: an intraoperative double-blind pilot study. Brain 2014;137:2015–26. https://doi.org/10.1093/brain/awu102.
3. Dembek TA, Reker P, Visser-Vandewalle V, Wirths J, Treuer H, Klehr M, et al. Directional DBS increases side-effect thresholds—A prospective, double-blind trial. Movement Disorders 2017;32:1380–8. https://doi.org/10.1002/mds.27093.
4. Hunsche S, Neudorfer C, Majdoub F El, Maarouf M, Sauner D. Determining the Rotational Orientation of Directional Deep Brain Stimulation Leads Employing Flat-Panel Computed Tomography. Oper Neurosurg (Hagerstown) 2019;16:465–70. https://doi.org/10.1093/ons/opy163.
5. Reinacher PC, Krüger MT, Coenen VA, Shah M, Roelz R, Jenkner C, et al. Determining the Orientation of Directional Deep Brain Stimulation Electrodes Using 3D Rotational Fluoroscopy. American Journal of Neuroradiology 2017;38:1111–6. https://doi.org/10.3174/ajnr.A5153.
6. Sitz A, Hoevels M, Hellerbach A, Gierich A, Luyken K, Dembek TA, et al. Determining the orientation angle of directional leads for deep brain stimulation using computed tomography and digital x-ray imaging: A phantom study. Med Phys 2017;44:4463–73. https://doi.org/10.1002/mp.12424.
To cite this abstract in AMA style:
K. Balmuri, V. Rama Raju. Determining the Direction of segmented DBS Micro Electrodes through the EEG [abstract]. Mov Disord. 2024; 39 (suppl 1). https://www.mdsabstracts.org/abstract/determining-the-direction-of-segmented-dbs-micro-electrodes-through-the-eeg/. Accessed October 10, 2024.« Back to 2024 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/determining-the-direction-of-segmented-dbs-micro-electrodes-through-the-eeg/