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  • 1.
    Blystad, Ida
    et al.
    Linköping University, Center for Medical Image Science and Visualization (CMIV). Östergötlands Läns Landsting, Center for Diagnostics, Department of Radiology in Linköping. Linköping University, Department of Medical and Health Sciences, Radiology.
    Warntjes, Marcel
    Linköping University, Center for Medical Image Science and Visualization (CMIV). Linköping University, Department of Medical and Health Sciences, Clinical Physiology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Center, Department of Clinical Physiology in Linköping.
    Helmersson, Teresa
    Linköping University, Department of Medical and Health Sciences. Linköping University, Faculty of Health Sciences.
    Lundberg, Peter
    Linköping University, Center for Medical Image Science and Visualization (CMIV). Linköping University, Department of Medical and Health Sciences, Radiation Physics. Linköping University, Department of Medical and Health Sciences, Radiology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Center for Surgery, Orthopaedics and Cancer Treatment, Department of Radiation Physics. Östergötlands Läns Landsting, Center for Diagnostics, Department of Radiology in Linköping.
    Contrast assessment of Synthetic Magnetic Resonance Imaging in clinical practice2011Conference paper (Refereed)
  • 2.
    Nordin, Teresa
    et al.
    Linköping University, Department of Biomedical Engineering, Division of Biomedical Engineering. Linköping University, Faculty of Science & Engineering.
    Stenmark Persson, Rasmus
    Department of Pharmacology and Clinical Neuroscience, Umeå University, Umeå.
    Blomstedt, Patric
    Department of Pharmacology and Clinical Neuroscience, Umeå University, Umeå.
    Wårdell, Karin
    Linköping University, Department of Biomedical Engineering, Division of Biomedical Engineering. Linköping University, Faculty of Science & Engineering.
    Improvement Maps for Deep Brain Stimulation in Parkinson’s Disease2019Conference paper (Other academic)
  • 3.
    Nordin, Teresa
    et al.
    Linköping University, Department of Biomedical Engineering, Division of Biomedical Engineering. Linköping University, Faculty of Science & Engineering.
    Zsigmond, Peter
    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.
    Pujol, Sonia
    Laboratory of Mathematics in Imaging, Brigham and Women's Hospital, Harvard Medical School, USA / Surgical Planning Laboratory, Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, USA.
    Westin, Carl-Fredrik
    Laboratory of Mathematics in Imaging, Brigham and Women's Hospital, Harvard Medical School, USA.
    Wårdell, Karin
    Linköping University, Department of Biomedical Engineering, Division of Biomedical Engineering. Linköping University, Faculty of Science & Engineering.
    White matter tracing combined with electric field simulation –€“ A patient-specific approach for deep brain stimulation2019In: NeuroImage: Clinical, ISSN 0353-8842, E-ISSN 2213-1582, Vol. 24, p. 1-11, article id 102026Article in journal (Refereed)
    Abstract [en]

    Objective

    Deep brain stimulation (DBS) in zona incerta (Zi) is used for symptom alleviation in essential tremor (ET). Zi is positioned along the dentato-rubro-thalamic tract (DRT). Electric field simulations with the finite element method (FEM) can be used for estimation of a volume where the stimulation affects the tissue by applying a fixed isolevel (VDBS). This work aims to develop a workflow for combined patient-specific electric field simulation and white matter tracing of the DRT, and to investigate the influence on the VDBS from different brain tissue models, lead design and stimulation modes. The novelty of this work lies in the combination of all these components.

    Method

    Patients with ET were implanted in Zi (lead 3389, n = 3, voltage mode; directional lead 6172, n = 1, current mode). Probabilistic reconstruction from diffusion MRI (dMRI) of the DRT (n = 8) was computed with FSL Toolbox. Brain tissue models were created for each patient (two homogenous, one heterogenous isotropic, one heterogenous anisotropic) and the respective VDBS (n = 48) calculated from the Comsol Multiphysics FEM simulations. The DRT and VDBS were visualized with 3DSlicer and superimposed on the preoperative T2 MRI, and the common volumes calculated. Dice Coefficient (DC) and level of anisotropy were used to evaluate and compare the brain models.

    Result

    Combined patient-specific tractography and electric field simulation was designed and evaluated, and all patients showed benefit from DBS. All VDBS overlapped the reconstructed DRT. Current stimulation showed prominent difference between the tissue models, where the homogenous grey matter deviated most (67 < DC < 69). Result from heterogenous isotropic and anisotropic models were similar (DC > 0.95), however the anisotropic model consistently generated larger volumes related to a greater extension of the electric field along the DBS lead. Independent of tissue model, the steering effect of the directional lead was evident and consistent.

    Conclusion

    A workflow for patient-specific electric field simulations in combination with reconstruction of DRT was successfully implemented. Accurate tissue classification is essential for electric field simulations, especially when using the current control stimulation. With an accurate targeting and tractography reconstruction, directional leads have the potential to tailor the electric field into the desired region.

    Download full text (pdf)
    White matter tracing combined with electric field simulation –€“ A patient-specific approach for deep brain stimulation
  • 4.
    Nordin, Teresa
    et al.
    Linköping University, Department of Biomedical Engineering, Division of Biomedical Engineering. Linköping University, Faculty of Science & Engineering.
    Zsigmond, Peter
    Department of Neurosurgery and Department of Clinical and Experimental Medicine, Linköping University Hospital.
    Pujol, Sonja
    Laboratory of Mathematics in Imaging, Brigham and Women’s Hospital, Harvard Medical School, USA, Surgical Planning Laboratory, Department of Radiology, Brigham and Women’s Hospital, Harvard Medical School, USA.
    Westin, Carl-Fredrik
    Linköping University, Department of Biomedical Engineering, Division of Biomedical Engineering. Linköping University, Faculty of Science & Engineering. Laboratory of Mathematics in Imaging, Brigham and Women’s Hospital, Harvard Medical School, USA.
    Wårdell, Karin
    Linköping University, Department of Biomedical Engineering, Division of Biomedical Engineering. Linköping University, Faculty of Science & Engineering.
    Computer models in deep brain stimulation based on diffusion MRI2018Conference paper (Refereed)
  • 5.
    Nordin, Teresa
    et al.
    Linköping University, Department of Biomedical Engineering, Division of Biomedical Engineering. Linköping University, Faculty of Science & Engineering.
    Zsigmond, Peter
    Department of Neurosurgery and Department of Clinical and Experimental Medicine, Linköping University Hospital, SE.
    Pujol, Sonja
    Laboratory of Mathematics in Imaging, Brigham and Women’s Hospital, Harvard Medical School, USA, Surgical Planning Laboratory, Department of Radiology, Brigham and Women’s Hospital, Harvard Medical School, USA.
    Westin, Carl-Fredrik
    Linköping University, Department of Biomedical Engineering, Division of Biomedical Engineering. Linköping University, Faculty of Science & Engineering. Laboratory of Mathematics in Imaging, Brigham and Women’s Hospital, Harvard Medical School, USA.
    Wårdell, Karin
    Linköping University, Department of Biomedical Engineering, Division of Biomedical Engineering. Linköping University, Faculty of Science & Engineering.
    Deep brain stimulation: Patient-specific electrical field simulation2018Conference paper (Refereed)
  • 6.
    Stenmark Persson, Rasmus
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för farmakologi och klinisk neurovetenskap.
    Nordin, Teresa
    Linköping University, Department of Biomedical Engineering, Division of Biomedical Engineering. Linköping University, Faculty of Science & Engineering.
    Hariz, Gun-Marie
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Arbetsterapi. Umeå universitet, Medicinska fakulteten, Institutionen för farmakologi och klinisk neurovetenskap, Klinisk neurovetenskap..
    Hariz, Marwan
    Umeå universitet, Medicinska fakulteten, Institutionen för farmakologi och klinisk neurovetenskap..
    Blomstedt, Patric
    Umeå universitet, Medicinska fakulteten, Institutionen för farmakologi och klinisk neurovetenskap.
    Bilateral deep brain stimulation in the caudal zona incerta for Parkinson’s disease – 1-year follow-up2018Conference paper (Refereed)
1 - 6 of 6
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