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Influence of Virchow-Robin spaces in the Electric Field Distribution in Subthalamic Nucleus Deep Brain Stimulation
Linköping University, Department of Biomedical Engineering, Division of Biomedical Engineering. Linköping University, Faculty of Science & Engineering. (Neuroengineering)ORCID iD: 0000-0002-6896-1452
Region Östergötland, Center for Surgery, Orthopaedics and Cancer Treatment, Department of Surgery in Linköping. Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Neurosurgery.
Linköping University, Department of Biomedical Engineering, Division of Biomedical Engineering. Linköping University, Faculty of Science & Engineering.ORCID iD: 0000-0002-0012-7867
2019 (English)Conference paper, Poster (with or without abstract) (Refereed)
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.

Place, publisher, year, edition, pages
S. Karger, 2019.
Series
Stereotact Funct Neurosurg 2019;97:1–560, ISSN 1011-6125, E-ISSN 1423-0372
National Category
Other Medical Engineering
Identifiers
URN: urn:nbn:se:liu:diva-160751OAI: oai:DiVA.org:liu-160751DiVA, id: diva2:1358062
Conference
18th Biennial meeting of the World Society for Stereotactic and Functional Neurosurgery
Funder
Swedish Foundation for Strategic Research , BD15-0032Available from: 2019-10-07 Created: 2019-10-07 Last updated: 2019-10-07

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Alonso, FabiolaZsigmond, PeterWårdell, Karin

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Division of Biomedical EngineeringFaculty of Science & EngineeringDepartment of Surgery in LinköpingDivision of Neuro and Inflammation ScienceFaculty of Medicine and Health SciencesDepartment of Neurosurgery
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