Ermittlung der tatsächlich erzielten Elektrodenpositionen nach tiefer Hirnstimulation mittels frühem postoperativem 3D CT

Neurodegenerative disorders like Parkinson’s disease (PD) and essential tremor (ET) can in part be treated with deep brain stimulation (DBS). The aim of the present study was to show whether it is possible to locate DBS electrodes implanted into the human brain accurately in an early postoperative 3D-CT that was fused to preoperative planning data. Preoperative targeting was performed statistically with respect to the midcommissural point (MCP) and (in subthalamic nucleus DBS) directly in a high-resolution MRI data set. Intra-operative targeting was performed with 5 simultaneous micro-electrodes and 1 macro-stimulating electrode (PD). In ET cases only 2 macro-electrodes where lowered to the target area and tested. The patient-collective included 11 patients with PD and 7 patients with ET. Fusion of the imaging data and localizing the electrode position in the postoperative 3D-CT were performed using the Frame-LinkTM Software on the Stealth Station® Gen2 or the Treon system (Medtronic SNT, USA). With the help of a Matlab 7.0 based software program, developed for this study, it was possible to compare the electrode positions as found in the 3D-CT with their theoretical position as calculated from the planning data and the intraoperative protocol. The deviations were about 1mm per axis. The active contact was found at an average position 11.9mm lateral, 0.5mm posterior and 2.6mm caudal to the MCP. The distance between the activated contact and the planned target was about 1mm per axis. The findings concerning the distance between the active contact and the MCP are in accordance with those found in the literature. The authors hold mistakes in the fusion process, distortion during the tomography and brain shift responsible for the distance between the activated contact and the planned target. Overall, locating electrode positions in a postoperative 3D-CT seems to be a simple and accurate procedure.

Grantor dc:publisher

Publikationsserver der RWTH Aachen University

Year dc:date

2008

Author dc:creator

• Marks, Benjamin

Contributors dc:contributor

• Gilsbach, Joachim M.

• info:eu-repo/classification/ddc/610
• Parkinson-Krankheit
• Essentieller Tremor
• Hirnstimulation
• Computertomographie
• Elektrode
• Medizin
• parkinson s disease
• essential tremor
• deep brain stimulation
• electrode position
• CT

Statement dc:rights

• info:eu-repo/semantics/openAccess

Language dc:language

ger

Identifier

https://publications.rwth-aachen.de/search?p=id:%22RWTH-CONV-112877%22

OAI record oai:identifier

https://publications.rwth-aachen.de/oai2d?verb=GetRecord&metadataPrefix=oai_dc&identifier=oai%3Apublications.rwth-aachen.de%3A50328