Please use this identifier to cite or link to this item: https://ahro.austin.org.au/austinjspui/handle/1/33074
Title: Anatomical targeting for electrode localization in subthalamic nucleus deep brain stimulation: A comparative study.
Austin Authors: Tonroe, Thomas;McDermott, Hugh;Pearce, Patrick;Acevedo, Nicola;Thevathasan, Wesley;Xu, San San ;Bulluss, Kristian J ;Perera, Thushara
Affiliation: Bionics Institute, East Melbourne, Victoria, Australia
DBS Technologies Pty Ltd, East Melbourne, Victoria, Australia
Department of Neurosurgery, Cabrini Hospital, Malvern, Victoria, Australia
Centre for Mental Health, Swinburne University of Technology, Melbourne, Victoria, Australia.
Neurology
Medical Bionics Department, The University of Melbourne, East Melbourne, Victoria, Australia
Department of Neurosurgery, St Vincent's Hospital Melbourne, Fitzroy, Victoria, Australia
School of Engineering, RMIT University, Melbourne, Victoria, Australia
Department of Neurosurgery, Cabrini Hospital, Malvern, Victoria, Australia
Department of Neurology, The Royal Melbourne Hospital, Parkville, Victoria, Australia
Department of Medicine, The University of Melbourne, Parkville, Victoria, Australia.
Neurosurgery
Department of Surgery, The University of Melbourne, Parkville, Victoria, Australia
Issue Date: 8-Jun-2023
Date: 2023
Publication information: Journal of Neuroimaging : Official journal of the American Society of Neuroimaging 2023
Abstract: In deep brain stimulation (DBS), accurate electrode placement is essential for optimizing patient outcomes. Localizing electrodes enables insight into therapeutic outcomes and development of metrics for use in clinical trials. Methods of defining anatomical targets have been described with varying accuracy and objectivity. To assess variability in anatomical targeting, we compare four methods of defining an appropriate target for DBS of the subthalamic nucleus for Parkinson's disease. The methods compared are direct visualization, red nucleus-based indirect targeting, mid-commissural point-based indirect targeting, and automated template-based targeting. This study assessed 226 hemispheres in 113 DBS recipients (39 females, 73 males, 62.2 ± 7.7 years). We utilized the electrode placement error (the Euclidean distance between the defined target and closest DBS electrode) as a metric for comparative analysis. Pairwise differences in electrode placement error across the four methods were compared using the Kruskal-Wallis H-test and Wilcoxon signed-rank tests. Interquartile ranges of the differences in electrode placement error spanned 1.18-1.56 mm. A Kruskal-Wallis H-test reported a statistically significant difference in the median of at least two groups (H(5) = 41.052, p < .001). Wilcoxon signed-rank tests reported statistically significant difference in two comparisons: direct visualization versus red nucleus-based indirect, and direct visualization versus automated template-based methods (T < 9215, p < .001). All methods were similarly discordant in their relative accuracy, despite having significant technical differences in their application. The differing protocols and technical aspects of each method, however, have the implication that one may be more practical depending on the clinical or research application at hand.
URI: https://ahro.austin.org.au/austinjspui/handle/1/33074
DOI: 10.1111/jon.13133
ORCID: 0000-0003-4341-6033
0000-0002-4237-8373
Journal: Journal of Neuroimaging : Official journal of the American Society of Neuroimaging
PubMed URL: 37288952
ISSN: 1552-6569
Type: Journal Article
Subjects: Parkinson's disease
anatomical targeting
automation
deep brain stimulation
electrode localization
neuroimaging
subthalamic nucleus
Appears in Collections:Journal articles

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