Probabilistic stimulation mapping from intra-operative thalamic deep brain stimulation data in essential tremor
Résumé
Abstract Deep brain stimulation (DBS) is a therapy for Parkinson’s disease (PD) and essential tremor (ET). The mechanism of action of DBS is still incompletely understood. Retrospective group analysis of intra-operative data recorded from ET patients implanted in the ventral intermediate nucleus of the thalamus (Vim) is rare. Intra-operative stimulation tests generate rich data and their use in group analysis has not yet been explored. Objective: To implement, evaluate, and apply a group analysis workflow to generate probabilistic stimulation maps (PSM) using intra-operative stimulation data from ET patients implanted in Vim. A group-specific anatomical template was constructed based on the Magnetic Resonance Imaging (MRI) scans of 6 ET patients and 13 PD patients. Intra-operative test data (total: n=1821) from the 6 ET patients was analyzed: patient-specific electric field simulations together with tremor assessments obtained by a wrist-based acceleration sensor were transferred to this template. Occurrence and weighted mean maps were generated. Voxels associated with symptomatic response were identified through a linear mixed model approach to form a PSM. Improvements predicted by the PSM were compared to those clinically assessed. Finally, the PSM clusters were compared to those obtained in a multicenter study using data from chronic stimulation effects in ET. Regions responsible for improvement identified on the PSM were in the posterior sub-thalamic area (PSA) and at the border between the Vim and ventro-oral nucleus of the thalamus (VO). The comparison with literature revealed a center-to-center distance of less than 5mm and an overlap score (Dice) of 0.4 between the significant clusters. Our workflow and intra-operative test data from 6 ET-Vim patients identified effective stimulation areas in PSA and around Vim and VO, affirming existing medical literature. This study supports the potential of probabilistic analysis of intra-operative stimulation test data to reveal DBS's action mechanisms and to assist surgical planning.
Mots clés
- Deep Brain Stimulation (DBS)
- Probabilistic Stimulation Map
- Atlas
- Essential Tremor
- IntraOperative Stimulation
- Vim
- Quantitative Symptoms Assessment
- Deep Brain Stimulation (DBS) Probabilistic Stimulation Map Atlas Essential Tremor Intra-25 Operative Stimulation Vim Quantitative Symptoms Assessment. 26 Corpus geniculatum Medial CT: Computed Tomography DL: Dorsolateral Thalamus DM: 28 Dorsomedial Thalamus DRTT: Denta-Rubo Thalamic Tract EF: electric field ET: essential tremor 29 ETRS: Essential Tremor Rating Scale FF: fields of Forel FEM: finite element method GPi: Globus 30 Pallidus Internus InL: intermediolateral thalamus LaPf: Parafascicular Thalamus LMM: Linear 31 Mixed Model Med: Medial Thalmus MER: micro-electrode recording MNI: Montreal Neurological 32 Institute MR: Magnetic resonance MRI: Magnetic Resonance Imaging PD: Parkinson's disease 33 PPn: Peripeduncular Nucleus PSA: posterior subthalamic area PSM: probabilistic stimulation map 34 Pulvinar Thalamus SN: Substancia Nigra STN: subthalamic nucleus UPDRS: Universal 35 Parkinson's Disease Rating Scale VCL: ventrocaudal-lateral thalamus VO: ventro-oral thalamus 36 VCM: ventrocaudal-medial thalamus Vc: ventrocaudal thalamus (VCM+VCL) Vim: ventral 37 intermediate nucleus
- Intra-25 Operative Stimulation
- Quantitative Symptoms Assessment. 26 Corpus geniculatum Medial
- CT: Computed Tomography
- DL: Dorsolateral Thalamus
- DM: 28 Dorsomedial Thalamus
- DRTT: Denta-Rubo Thalamic Tract
- EF: electric field
- ET: essential tremor
- 29 ETRS: Essential Tremor Rating Scale
- FF: fields of Forel
- FEM: finite element method
- GPi: Globus 30 Pallidus Internus
- InL: intermediolateral thalamus
- LaPf: Parafascicular Thalamus
- LMM: Linear 31 Mixed Model
- Med: Medial Thalmus
- MER: micro-electrode recording
- MNI: Montreal Neurological 32 Institute
- MR: Magnetic resonance
- MRI: Magnetic Resonance Imaging
- PD: Parkinson's disease
- 33 PPn: Peripeduncular Nucleus
- PSA: posterior subthalamic area
- PSM: probabilistic stimulation map
- 34 Pulvinar Thalamus
- SN: Substancia Nigra
- STN: subthalamic nucleus
- UPDRS: Universal 35 Parkinson's Disease Rating Scale
- VCL: ventrocaudal-lateral thalamus
- VO: ventro-oral thalamus
- 36 VCM: ventrocaudal-medial thalamus
- Vc: ventrocaudal thalamus (VCM+VCL)
- Vim: ventral 37 intermediate nucleus
- Deep Brain Stimulation (DBS)
| Origine | Fichiers produits par l'(les) auteur(s) |
|---|---|
| Licence |