A Study on the Feasibility of the Deep Brain Stimulation (DBS) Electrode Localization Based on Scalp Electric Potential Recordings

Abstract

Deep Brain Stimulation (DBS) is an effective therapy for patients disabling motor symptoms from Parkinson’s disease, essential tremor, and other motor disorders. Precise, individualized placement of DBS electrodes is a key contributor to clinical outcomes following surgery. Electroencephalography (EEG) is widely used to identify the sources of intracerebral signals from the potential on the scalp. EEG is portable, non-invasive, low-cost, and it could be easily integrated into the intraoperative or ambulatory environment for localization of either the DBS electrode or evoked potentials triggered by stimulation itself. In this work, we studied with numerical simulations the principle of extracting the DBS electrical pulse from the patient’s EEG – which normally constitutes an artifact – and localizing the source of the artifact (i.e., the DBS electrodes) using EEG localization methods. A high-resolution electromagnetic head model was used to simulate the EEG potential at the scalp generated by the DBS pulse artifact. The potential distribution on the scalp was then sampled at the 256 electrode locations of a high-density EEG Net. The electric potential was modeled by a dipole source created by a given pair of active DBS electrodes. The dynamic Statistical Parametric Maps (dSPM) algorithm was used to solve the EEG inverse problem, and it allowed localization of the position of the stimulus dipole in three DBS electrode bipolar configurations with a maximum error of 1.5 cm. To assess the accuracy of the computational model, the results of the simulation were compared with the electric artifact amplitudes over 16 EEG electrodes measured in five patients. EEG artifacts measured in patients confirmed that simulated data are commensurate to patients’ data (0 ± 6.6 μV). While we acknowledge that further work is necessary to achieve a higher accuracy needed for surgical navigation, the results presented in this study are proposed as the first step toward a validated computational framework that could be used for non-invasive localization not only of the DBS system but also brain rhythms triggered by stimulation at both proximal and distal sites in the human central nervous system.

MaDoPO: Magnetic Detection of Positions and Orientations of Segmented Deep Brain Stimulation Electrodes: A Radiation-Free Method Based on Magnetoencephalography

“…Therefore, possible imaging modalities such as EEG and MEG offer alternatives that eliminate these drawbacks, which are completely harmless and safe for the patient and do not involve an ambiguity problem. EEG has already been investigated for the feasibility of electrode localization, but insufficient accuracy for such problems has been reported [ 17 ].…”

“…Alternative imaging techniques, such as electroencephalography (EEG) and magnetoencephalography (MEG), provide alternative imaging modalities for determining electrode positions and orientations by measuring stimulation-induced DBS magnetic fields, which overcome the fundamental drawbacks of current postoperative imaging techniques without exposing patients to radiation at all. The feasibility of DBS electrode localization based on scalp EEG has already been demonstrated, but localization errors of more than 10 mm have been reported [ 17 ]. The potential of MEG recordings to detect electrode position and orientation has been demonstrated in our previous research [ 18 , 19 , 20 , 21 , 22 ].…”

Deep Brain Stimulation Can Differentiate Subregions of the Human Subthalamic Nucleus Area by EEG Biomarkers

“…The majority of rodent and human DBS cortical evoked response studies have performed bipolar stimulation configurations (Ashby et al, 2001 ; Baker et al, 2002 ; Mackinnon et al, 2005 ; Walker et al, 2012 ; Kelley et al, 2018 ; Kibleur and David, 2018 ; Kumaravelu et al, 2018 ; Miocinovic et al, 2018 ; Iacono et al, 2019 ; Romeo et al, 2019 ). Bipolar stimulation can potentially differentiate between the stimulus artifact and cortical activity (Baker et al, 2002 ; Walker et al, 2012 ).…”

Physiologically informed neuromodulation

“…ERPs complement other forms of connectivity estimation such as tractographic imaging [65], and because they can be quickly measured in clinic, can easily form the basis of a real-time stimulator programming algorithm. In DBS for Parkinson's disease, EEG-based ERP mapping can demonstrate cortical engagement that correlates with both response [66] and side effects [67]. Similar techniques are being explored in DBS for depression [68], with evidence of test-retest reliability.…”