Analysis of the intended and actual orientations of directional deep brain stimulation leads across deep brain stimulation systems

Henry, Kaylee R; Miulli, Milina Michelle; Elahi, Behzad; Rosenow, Joshua M.; Nolt, Mark J.; Golestanirad, Laleh

doi:10.1109/embc48229.2022.9871608

Cited by 3 publications

(2 citation statements)

References 15 publications

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“…Using the first version of the DiODe algorithm implemented in v2.5 of the Lead-DBS software [31], three independent studies reported large deviations of up to 90° between the intended and actual lead orientations in patients [30, 31, 33]. Notably, however, the original DiODe algorithm needed manual interventions by selecting CT slices on which the artifacts were most visible, making its output user-dependent.…”

Section: Introductionmentioning

confidence: 99%

Variations in Determining Actual Orientations of Segmented Deep Brain Stimulation Leads Using the DiODe Algorithm: A Retrospective Study Across Different Lead Designs and Medical Institutions

Henry,

Miulli,

Nuzov

et al. 2023

Stereotact Funct Neurosurg

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Introduction: Directional deep brain stimulation (DBS) leads have become widely used in the past decade. Understanding the asymmetric stimulation provided by directional leads requires precise knowledge of the exact orientation of the lead in respect to its anatomical target. Recently, the DiODe algorithm was developed to automatically determine the orientation angle of leads from the artifact on postoperative computed tomography (CT) images. However, manual DiODe results are user-dependent. This study analyzed the extent of lead rotation as well as the user agreement of DiODe calculations across the two most common DBS systems, namely, Boston Scientific’s Vercise and Abbott’s Infinity, and two independent medical institutions. Methods: Data from 104 patients who underwent an anterior-facing unilateral/bilateral directional DBS implantation at either Northwestern Memorial Hospital (NMH) or Albany Medical Center (AMC) were retrospectively analyzed. Actual orientations of the implanted leads were independently calculated by three individual users using the DiODe algorithm in Lead-DBS and patients’ postoperative CT images. The deviation from the intended orientation and user agreement were assessed. Results: All leads significantly deviated from the intended 0° orientation (p < 0.001), regardless of DBS lead design (p < 0.05) or institution (p < 0.05). However, the Boston Scientific leads showed an implantation bias toward the left at both institutions (p = 0.014 at NMH, p = 0.029 at AMC). A difference of 10° between at least two users occurred in 28% (NMH) and 39% (AMC) of all Boston Scientific and 76% (NMH) and 53% (AMC) of all Abbott leads. Conclusion: Our results show that there is a significant lead rotation from the intended surgical orientation across both DBS systems and both medical institutions; however, a bias toward a single direction was only seen in the Boston Scientific leads. Additionally, these results raise questions into the user error that occurs when manually refining the orientation angles calculated with DiODe.

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Section: Introductionmentioning

confidence: 99%

Variations in Determining Actual Orientations of Segmented Deep Brain Stimulation Leads Using the DiODe Algorithm: A Retrospective Study Across Different Lead Designs and Medical Institutions

Henry,

Miulli,

Nuzov

et al. 2023

Stereotact Funct Neurosurg

Self Cite

View full text Add to dashboard Cite

show abstract

“…Using the first version of the DiODe algorithm implemented in version 2.5 of the Lead-DBS software (29), three independent studies reported large deviations of up to 90° between the intended and actual lead orientations in patients (26,27,30). Notably, however, the original DiODe algorithm needed manual interventions by selecting CT slices on which the artifacts were most visible, making its output user-dependent.…”

Section: Introductionmentioning

confidence: 99%

Variations in determining actual orientations of segmented deep brain stimulation leads using the manually refined DiODe algorithm: a retrospective study across different lead designs and medical institutions

Henry

Miulli

Nuzov

et al. 2022

Preprint

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Purpose: Directional deep brain stimulation (DBS) leads have become widely used in the past decade. Understanding the asymmetric stimulation provided by directional leads requires precise knowledge of the exact orientation of the lead in respect to its anatomical target. Recently, the DiODe algorithm was developed to automatically determine the orientation angle of leads from the artifact on postoperative computed tomography (CT) images. However, DiODe results are user-dependent. This study analyzed the significance of lead rotation as well as the user agreement of DiODe calculations across the two most common DBS systems and two independent medical institutions. Methods: Data from 104 patients who underwent an anterior-facing unilateral/bilateral directional DBS implantation at either Northwestern Memorial Hospital (NMH) or Albany Medical Center (AMC) were retrospectively analyzed. Actual orientations of the implanted leads were independently calculated by three individual users using the DiODe algorithm in Lead-DBS and patients' postoperative CT images. Deviation from the intended orientation and user agreement were assessed. Results: All leads significantly deviated from the intended 0° orientation (p<0.001), regardless of DBS lead design (p<0.05) or institution (p<0.05). However, a bias of the implantation towards a single direction was seen for the Boston Scientific leads (p=0.014 at NMH, p=0.029 at AMC). A difference of 10° between at least two users occurred in 28% (NMH) and 39% (AMC) of all Boston Scientific and 53% (AMC) and 76% (NMH) of all St. Jude leads. Conclusion: Our results show that there is a significant lead rotation from the intended surgical orientation across both DBS systems and both medical institutions, however, a bias towards a single direction was only seen in Boston Scientific leads. Additionally, these results raise questions into the user error that occurs when manually refining the orientation angles calculated with DiODe.

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Neuromorphic computing for modeling neurological and psychiatric disorders: implications for drug development

Raikar,

Andrew,

Dessai

et al. 2024

Artif Intell Rev

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The emergence of neuromorphic computing, inspired by the structure and function of the human brain, presents a transformative framework for modelling neurological disorders in drug development. This article investigates the implications of applying neuromorphic computing to simulate and comprehend complex neural systems affected by conditions like Alzheimer’s, Parkinson’s, and epilepsy, drawing from extensive literature. It explores the intersection of neuromorphic computing with neurology and pharmaceutical development, emphasizing the significance of understanding neural processes and integrating deep learning techniques. Technical considerations, such as integrating neural circuits into CMOS technology and employing memristive devices for synaptic emulation, are discussed. The review evaluates how neuromorphic computing optimizes drug discovery and improves clinical trials by precisely simulating biological systems. It also examines the role of neuromorphic models in comprehending and simulating neurological disorders, facilitating targeted treatment development. Recent progress in neuromorphic drug discovery is highlighted, indicating the potential for transformative therapeutic interventions. As technology advances, the synergy between neuromorphic computing and neuroscience holds promise for revolutionizing the study of the human brain’s complexities and addressing neurological challenges.

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Analysis of the intended and actual orientations of directional deep brain stimulation leads across deep brain stimulation systems

Cited by 3 publications

References 15 publications

Variations in Determining Actual Orientations of Segmented Deep Brain Stimulation Leads Using the DiODe Algorithm: A Retrospective Study Across Different Lead Designs and Medical Institutions

Variations in Determining Actual Orientations of Segmented Deep Brain Stimulation Leads Using the DiODe Algorithm: A Retrospective Study Across Different Lead Designs and Medical Institutions

Variations in determining actual orientations of segmented deep brain stimulation leads using the manually refined DiODe algorithm: a retrospective study across different lead designs and medical institutions

Neuromorphic computing for modeling neurological and psychiatric disorders: implications for drug development

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