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Article Dans Une Revue Journal of Neural Engineering Année : 2024

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
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hal-04568393 , version 1 (04-05-2024)

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Dorian Vogel, Teresa Nordin, Stefanie Feiler, Karin Wardell, Jérôme Coste, et al.. Probabilistic stimulation mapping from intra-operative thalamic deep brain stimulation data in essential tremor. Journal of Neural Engineering, 2024, 21 (3), pp.036017. ⟨10.1088/1741-2552/ad4742⟩. ⟨hal-04568393⟩
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