Computer aided subthalamic nucleus (STN) localization during deep brain stimulation (DBS) surgery in Parkinson's patients
Journal Title: Annales Academiae Medicae Silesiensis - Year 2014, Vol 68, Issue 5
Abstract
INTRODUCTION During deep brain stimulation (DBS) treatment of Parkinson’s disease, the anatomical target of the surgery is a small (9 x 7 x 4 mm) deeply located structure called the Subthalamic Nucleus (STN). It is similar morphologically to the surrounding tissue and as such, not easily distinguished in CT or MRI. The goal of the surgery is precise placement of a permanent stimulating electrode within the target nucleus. Precision is extremely important as incorrect placement of the stimulating electrode may lead to serious adverse effects such as mood disturbances. MATERIALS AND METHODS To obtain the exact location of the STN nucleus, intraoperative stereotactic supportive navigation is used. A set of 3 ~ 5 parallel microelectrodes is inserted into the brain and advanced towards the expected location of the nucleus. From a depth of 10 mm above the estimated STN, the electrodes advance at 1 mm steps. At each step, the activity of the surrounding neural tissue is recorded. Typically, the electrodes are further advanced until the ventral STN border is passed and the Substantia Nigra pars reticulata (SNr) is reached. Because the STN has distinct physiological properties, signals recorded in the vicinity of the STN display specific features. Therefore it was possible to provide an analytical method to detect specific STN characteristics. This paper presents a computer-based approach in order to discriminate between microelectrode signals coming from the STN and those outside it. RESULTS AND CONCLUSIONS When our method was used on-line during DBS neurosurgical procedure, it helped in precise identification of STN borders and shorted the surgery. Since the fall of 2013, we have developed an on-line computer-aided application for STN border localization that is used during PD DBS surgeries performed in the Institute of Psychiatry and Neurology in Warsaw, POLAND.
Authors and Affiliations
Konrad Ciecierski, Tomasz Mandat, Rafał Rola, Zbigniew Raś, Andrzej Przybyszewski
Keywords
Related Articles
- EP ID EP266932
- DOI -
- Views 90
- Downloads 0
Potential of e- and m-health tools and gender-tailored approach in modern model of education and prevention of cardiovascular disease in women
Cardiovascular disease (CVD) is a leading cause of death worldwide. Only in 2012 it accounted for 17.5 million deaths. Although it affects both sexes, every year more women die due to CVD, more than due to all cancers, t...
Tworzenie i wykorzystanie programu edukacji żywieniowej jako przykład kształtowania prawidłowych nawyków żywieniowych wśród dzieci
Edukację zdrowotną, w tym także żywieniową, definiuje się jako proces służący nauce sposobu życia, mający na celu zachowanie zdrowia oraz wzmacnianie go, a także tworzenie środowiska sprzyjającego zachowaniu dobrostanu f...
Ocena zgodności wprowadzania poszczególnych produktów do diety niemowląt w odniesieniu do schematu żywienia, z uwzględnieniem wieku, wykształcenia i miejsca zamieszkania matek
WSTĘP: Okres niemowlęcy to czas do ukończenia pierwszego roku życia. Jest to najbardziej dynamiczna faza rozwoju psychicznego i fizycznego dziecka. Jednym z najważniejszych czynników wpływających na jakość tego rozwoju j...
Usefulness of determining CA 125 and HE4 serum concentration in diagnosis of ovarian cancer
INTRODUCTION: Ovarian cancer is a malignant tumor that is the most common cause of death among women with abnormalities of the reproductive organs. CA125 plays a key role in the diagnosis of ovarian cancer. However, acco...
Diagnostic and therapeutic difficulties in 32-year-old woman with stroke, patent foramen ovale and hereditary thrombophilia – case report
Foramen ovale is a part of foetal circulation that allows blood to flow directly from the right to the left atrium. Patent foramen ovale (PFO) occurs approximately in 20% of the general population. It is suggested that...