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The effect of cystic cavities on deep brain stimulation in the basal ganglia: A simulation-based study
Linköping University, The Institute of Technology. Linköping University, Department of Biomedical Engineering, Biomedical Instrumentation. (MINT)
Linköping University, The Institute of Technology. Linköping University, Department of Biomedical Engineering, Biomedical Instrumentation. (NT)
Institute of Neurology London.
Linköping University, The Institute of Technology. Linköping University, Department of Biomedical Engineering, Biomedical Instrumentation.
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2006 (English)In: Journal of Neural Engineering, ISSN 1741-2560, E-ISSN 1741-2552, Vol. 3, no 2, 132-138 p.Article in journal (Refereed) Published
Abstract [en]

Although the therapeutic effect of deep brain stimulation (DBS) is well recognized, a fundamental understanding of the mechanisms responsible is still not known. In this study finite element method (FEM) modelling and simulation was used in order to study relative changes of the electrical field extension surrounding a monopolar DBS electrode positioned in grey matter. Due to the frequently appearing cystic cavities in the DBS-target globus pallidus internus, a nucleus of grey matter with and without a cerebrospinal fluid filled cystic cavity was modelled. The position, size and shape of the cyst were altered in relation to the electrode. The simulations demonstrated an electrical field around the active element with decreasing values in the radial direction. A stepwise change was present at the edge between grey and white matters. The cyst increased the radial extension and changed the shape of the electrical field substantially. The position, size and shape of the cyst were the main influencing factors. We suggest that cystic cavities in the DBS-target may result in closely related unexpected structures or neural fibre bundles being stimulated and could be one of the reasons for suboptimal clinical effects or stimulation-induced side effects. © 2006 IOP Publishing Ltd.

Place, publisher, year, edition, pages
Institute of Physics Publishing (IOPP), 2006. Vol. 3, no 2, 132-138 p.
National Category
Biomedical Laboratory Science/Technology
Identifiers
URN: urn:nbn:se:liu:diva-34125DOI: 10.1088/1741-2560/3/2/007ISI: 000239673500007PubMedID: 16705269Scopus ID: 2-s2.0-33744911364Local ID: 20869OAI: oai:DiVA.org:liu-34125DiVA: diva2:254973
Available from: 2009-10-10 Created: 2009-10-10 Last updated: 2017-12-13Bibliographically approved
In thesis
1. Modelling, Simulaltion, and Visualization of Deep Brain Stimulation
Open this publication in new window or tab >>Modelling, Simulaltion, and Visualization of Deep Brain Stimulation
2011 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Deep brain stimulation (DBS) is an effective surgical treatment for neurological diseases such as essential tremor, Parkinsonʹs disease (PD) and dystonia. DBS has so far been used in more than 70 000 patients with movement disorders, and is currently in trial for intractable Gilles de la Tourette’s syndrome, obsessive compulsive disorders, depression, and epilepsy. DBS electrodes are implanted with stereotactic neurosurgical techniques in the deep regions of the brain. Chronic electrical stimulation is delivered to the electrodes from battery-operated pulse generators that are implanted below the clavicle.

The clinical benefit of DBS is largely dependent on the spatial distribution of the electric field in relation to brain anatomy. To maximize therapeutic benefits while avoiding unwanted side-effects, knowledge of the distribution of the electric field in relation anatomy is essential. Due to difficulties in measuring electric fields in vivo, computerized analysis with finite element models have emerged as an alternative.

The aim of the thesis was to investigate technical and clinical aspects of DBS by means of finite element models, simulations, and visualizations of the electric field and tissue anatomy. More specifically the effects of dilated perivascular spaces filled with cerebrospinal fluid on the electrical field generated by DBS was evaluated. A method for patient-specific finite element modelling and simulation of DBS was developed and used to investigate the anatomical distribution of the electric field in relation to clinical effects and side effects. Patient-specific models were later used to investigate the electric field in relation to effects on speech and movement during DBS in patients with PD (n=10). Patient-specific models and simulations were also used to evaluate the influence of heterogeneous isotropic and heterogeneous anisotropic tissue on the electric field during DBS. In addition, methods were developed for visualization of atlas-based and patient-specific anatomy in 3D for interpretation of anatomy, visualization of neural activation with the activating function, and visualization of tissue micro structure. 3D visualization of anatomy was used to assess electrode contact locations in relation to stimulation-induced side-effects (n=331) during DBS for patients with essential tremor (n=28). The modelling, simulation, and visualization of DBS provided detailed information about the distribution of the electric field and its connection to clinical effects and side-effects of stimulation. In conclusion, the results of this thesis provided insights that may help to improve DBS as a treatment for movement disorders as well as for other neurological diseases in the future.

Place, publisher, year, edition, pages
Linköping: Linköping University Electronic Press, 2011. 84 p.
Series
Linköping Studies in Science and Technology. Dissertations, ISSN 0345-7524 ; 1384
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-70090 (URN)978-91-7393-114-4 (ISBN)
Public defence
2011-09-09, Eken, Campus US, Linköpings universitet, Linköping, 09:00 (English)
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Supervisors
Available from: 2011-08-18 Created: 2011-08-18 Last updated: 2017-02-09Bibliographically approved

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Åström, MattiasJohansson, JohannesEriksson, OlaWårdell, Karin

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