Effect of Biophysical Model Complexity on Predictions of Volume of Tissue Activated (VTA) during Deep Brain Stimulation

Jiang, Fuchang; Nguyen, Bach T.; Elahi, Behzad; Pilitsis, Julie G.; Golestanirad, Laleh

doi:10.1109/embc44109.2020.9175300

Cited by 4 publications

(3 citation statements)

References 16 publications

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“…To facilitate this process, it is crucial to accurately understand the location and orientation of the directional DBS leads in regard to the surrounding anatomy when clinically interpreting DBS response [22]. This is particularly important for the reliable application of recent image-guided programming approaches that are based on computational models of current diffusion within patient-specific anatomy [23][24][25][26][27].…”

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

View full text Add to dashboard Cite

show abstract

“…It is crucial to accurately understand the location and orientation of the directional DBS leads in regard to surrounding anatomy when clinically interpreting DBS response and avoiding stimulation of specific brain regions that can cause severe psychiatric and motor side effects (20). This is particularly important for the reliable application of recent image-guided programming approaches that are based on computational models of current diffusion within patient-specific anatomy (21)(22)(23).…”

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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“…One commonly accepted explanation for the variability in patient outcomes is the differences in stimulation that each patient receives. In this regard, computational models have been proposed to estimate the effect of stimulation on an individual basis [6][7][8][9][10][11][12][13]. In this study, we investigated if the volume of tissue activated (VTA) around the DBS electrode is associated with the patient's clinical response to stimulation.…”

Section: Introductionmentioning

confidence: 99%

Patient-specific modeling of the volume of tissue activated (VTA) is associated with clinical outcome of DBS in patients with an obsessive-compulsive disorder

Jiang

Elahi

Saxena

et al. 2021

2021 43rd Annual International Conference of the IEEE Engineering in Medicine &Amp; Biology Society (EMBC)

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Deep brain stimulation (DBS) promises to treat an increasing number of neurological and psychiatric disorders. DBS outcome is directly a factor of optimal targeting of the relevant brain structures. Computational models can help to interpret a patient’s outcome by predicting the volume of tissue activated (VTA) around DBS electrode contacts. Here we report results of a preliminary study of DBS in two patients with obsessive-compulsive disorder and show that VTA predictions, which are based on patient-specific volume conductor models, correlate with clinical outcome. Our results suggest that patient specific VTA calculation can help inform device programing to maximize therapeutic effects and minimize side effects.

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Effect of Biophysical Model Complexity on Predictions of Volume of Tissue Activated (VTA) during Deep Brain Stimulation

Cited by 4 publications

References 16 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

Patient-specific modeling of the volume of tissue activated (VTA) is associated with clinical outcome of DBS in patients with an obsessive-compulsive disorder

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