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Prediction of Electrode Contacts for Clinically Effective Deep Brain Stimulation in Essential Tremor.
Stereotact Funct Neurosurg. 2018; 96(5):281-288.SF

Abstract

BACKGROUND/AIM

Deep brain stimulation (DBS) is an established neurosurgical treatment that can be used to alleviate symptoms in essential tremor (ET) and other movement disorders. The aim was to develop a method and software tool for the prediction of effective DBS electrode contacts based on probabilistic stimulation maps (PSMs) in patients with ET treated with caudal zona incerta (cZi) DBS.

METHODS

A total of 33 patients (37 leads) treated with DBS were evaluated with the Essential Tremor Rating Scale (ETRS) 12 months after surgery. In addition, hand tremor and hand function (ETRS items 5/6 and 11-14) were evaluated for every contact during stimulation with best possible outcome without inducing side effects. Prediction of effective DBS electrode contacts was carried out in a retrospective leave-one-out manner based on PSMs, simulated stimulation fields, and a scoring function. Electrode contacts were ranked according to their likelihood of being included in the clinical setting. Ranked electrode contacts were compared to actual clinical settings.

RESULTS

Predictions made by the software tool showed that electrode contacts with rank 1 matched the clinically used contacts in 60% of the cases. Contacts with a rank of 1-2 and 1-3 matched the clinical contacts in 83 and 94% of the cases, respectively. Mean improvement of hand tremor and hand function was 79 ± 21% and 77 ± 22% for the clinically used and the predicted electrode contacts, respectively.

CONCLUSIONS

Effective electrode contacts can be predicted based on PSMs in patients treated with cZi DBS for ET. Predictions may in the future be used to reduce the number of clinical assessments that are carried out before a satisfying stimulation setting is defined.

Authors+Show Affiliations

Medtronic, Vasteras, Swedenmattias.astrom77@gmail.com. Medtronic, Eindhoven, The Netherlandsmattias.astrom77@gmail.com. Department of Biomedical Engineering, Linköping University, Linköping, Swedenmattias.astrom77@gmail.com.Unit of Functional and Stereotactic Neurosurgery, Department of Pharmacology and Clinical Neuroscience, Umeå University, Umeå, Sweden.Medtronic, Vasteras, Sweden. Medtronic, Eindhoven, The Netherlands.Unit of Functional and Stereotactic Neurosurgery, Department of Pharmacology and Clinical Neuroscience, Umeå University, Umeå, Sweden. Neurosurgery, Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden.Medtronic, Vasteras, Sweden. Medtronic, Eindhoven, The Netherlands.Medtronic, Vasteras, Sweden. Medtronic, Eindhoven, The Netherlands.Unit of Functional and Stereotactic Neurosurgery, Department of Pharmacology and Clinical Neuroscience, Umeå University, Umeå, Sweden.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

30269142

Citation

Åström, Mattias, et al. "Prediction of Electrode Contacts for Clinically Effective Deep Brain Stimulation in Essential Tremor." Stereotactic and Functional Neurosurgery, vol. 96, no. 5, 2018, pp. 281-288.
Åström M, Samuelsson J, Roothans J, et al. Prediction of Electrode Contacts for Clinically Effective Deep Brain Stimulation in Essential Tremor. Stereotact Funct Neurosurg. 2018;96(5):281-288.
Åström, M., Samuelsson, J., Roothans, J., Fytagoridis, A., Ryzhkov, M., Nijlunsing, R., & Blomstedt, P. (2018). Prediction of Electrode Contacts for Clinically Effective Deep Brain Stimulation in Essential Tremor. Stereotactic and Functional Neurosurgery, 96(5), 281-288. https://doi.org/10.1159/000492230
Åström M, et al. Prediction of Electrode Contacts for Clinically Effective Deep Brain Stimulation in Essential Tremor. Stereotact Funct Neurosurg. 2018;96(5):281-288. PubMed PMID: 30269142.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prediction of Electrode Contacts for Clinically Effective Deep Brain Stimulation in Essential Tremor. AU - Åström,Mattias, AU - Samuelsson,Jennifer, AU - Roothans,Jonas, AU - Fytagoridis,Anders, AU - Ryzhkov,Maxim, AU - Nijlunsing,Rutger, AU - Blomstedt,Patric, Y1 - 2018/09/28/ PY - 2017/12/26/received PY - 2018/07/18/accepted PY - 2018/10/1/pubmed PY - 2019/5/24/medline PY - 2018/10/1/entrez KW - Deep brain stimulation KW - Electrode contacts KW - Essential tremor KW - Prediction KW - Simulations SP - 281 EP - 288 JF - Stereotactic and functional neurosurgery JO - Stereotact Funct Neurosurg VL - 96 IS - 5 N2 - BACKGROUND/AIM: Deep brain stimulation (DBS) is an established neurosurgical treatment that can be used to alleviate symptoms in essential tremor (ET) and other movement disorders. The aim was to develop a method and software tool for the prediction of effective DBS electrode contacts based on probabilistic stimulation maps (PSMs) in patients with ET treated with caudal zona incerta (cZi) DBS. METHODS: A total of 33 patients (37 leads) treated with DBS were evaluated with the Essential Tremor Rating Scale (ETRS) 12 months after surgery. In addition, hand tremor and hand function (ETRS items 5/6 and 11-14) were evaluated for every contact during stimulation with best possible outcome without inducing side effects. Prediction of effective DBS electrode contacts was carried out in a retrospective leave-one-out manner based on PSMs, simulated stimulation fields, and a scoring function. Electrode contacts were ranked according to their likelihood of being included in the clinical setting. Ranked electrode contacts were compared to actual clinical settings. RESULTS: Predictions made by the software tool showed that electrode contacts with rank 1 matched the clinically used contacts in 60% of the cases. Contacts with a rank of 1-2 and 1-3 matched the clinical contacts in 83 and 94% of the cases, respectively. Mean improvement of hand tremor and hand function was 79 ± 21% and 77 ± 22% for the clinically used and the predicted electrode contacts, respectively. CONCLUSIONS: Effective electrode contacts can be predicted based on PSMs in patients treated with cZi DBS for ET. Predictions may in the future be used to reduce the number of clinical assessments that are carried out before a satisfying stimulation setting is defined. SN - 1423-0372 UR - https://www.unboundmedicine.com/medline/citation/30269142/Prediction_of_Electrode_Contacts_for_Clinically_Effective_Deep_Brain_Stimulation_in_Essential_Tremor_ L2 - https://www.karger.com?DOI=10.1159/000492230 DB - PRIME DP - Unbound Medicine ER -