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Influence of Virchow-Robin spaces in the Electric Field Distribution in Subthalamic Nucleus Deep Brain Stimulation
Linköpings universitet, Institutionen för medicinsk teknik, Avdelningen för medicinsk teknik. Linköpings universitet, Tekniska fakulteten. (Neuroengineering)ORCID-id: 0000-0002-6896-1452
Region Östergötland, Centrum för kirurgi, ortopedi och cancervård, Kirurgiska kliniken US. Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för neuro- och inflammationsvetenskap. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Sinnescentrum, Neurokirurgiska kliniken US.
Linköpings universitet, Institutionen för medicinsk teknik, Avdelningen för medicinsk teknik. Linköpings universitet, Tekniska fakulteten.ORCID-id: 0000-0002-0012-7867
2019 (Engelska)Konferensbidrag, Poster (med eller utan abstract) (Refereegranskat)
Abstract [en]

Objectives: Previous investigations have shown the appearance of cysts i.e. Virchow-Robin spaces (VR) in the basal ganglia and their relationship with parkinsonian symptoms [1-3]. Simulations [4]using the finite element method (FEM) suggests that VR affects the electric field around deep brain stimulation (DBS) electrodes. The aim of the study was to evaluate how the electric field is modified by the presence of cysts in the STN. Methods: The effect of cysts on the electric field around the DBS lead placed in the STN was evaluated using FEM. 3D patient-specific brain models were built with COMSOL 5.2 (COMSOL AB, Sweden) and an in-house developed software [5] to convert a T2 weighted MRI of Parkinsonian patients (ethics approval no: 2012/434-3) into electrical conductivity matrix readable by FEM software. VR was classified as CSF [6]assigning a high electrical conductivity (2.0 S/m). The stimulation amplitudes were set to the clinically programmed values. Depending on the lead used, the stimulation was set to voltage control (3389) or current control (6180, ring mode). The coordinates corresponding to the lowest (first) electrode and the third higher up in the lead, taken from the postoperative CT electrode artefact, were used to localize the leads in the brain model [7]. The electric field was visualized with a 0.2V/mm isosurface. Results: Simulations showed that the electric field distribution is affected by the cysts. The higher conductivity at these regions in the vicinity of the electrode redistributes the electric field pushing it away from the cyst. The same effect occurs regardless of the operating mode or the lead design as long as the directional lead is configured in ring mode. Conclusions: The use of patient-specific models has shown the importance of considering nuances of the patients’ anatomy in the STN. This information can be used to determine the stimulation parameter and to support the analysis of side effects induced by the stimulation. The potential advantage of directional leads can also be assessed by including in the model patient-specific data.

Ort, förlag, år, upplaga, sidor
S. Karger, 2019.
Serie
Stereotact Funct Neurosurg 2019;97:1–560, ISSN 1011-6125, E-ISSN 1423-0372
Nationell ämneskategori
Annan medicinteknik
Identifikatorer
URN: urn:nbn:se:liu:diva-160751OAI: oai:DiVA.org:liu-160751DiVA, id: diva2:1358062
Konferens
18th Biennial meeting of the World Society for Stereotactic and Functional Neurosurgery
Forskningsfinansiär
Stiftelsen för strategisk forskning (SSF), BD15-0032Tillgänglig från: 2019-10-07 Skapad: 2019-10-07 Senast uppdaterad: 2019-10-07

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Alonso, FabiolaZsigmond, PeterWårdell, Karin

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Alonso, FabiolaZsigmond, PeterWårdell, Karin
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Avdelningen för medicinsk teknikTekniska fakultetenKirurgiska kliniken USAvdelningen för neuro- och inflammationsvetenskapMedicinska fakultetenNeurokirurgiska kliniken US
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