Department of Neurology, University Hospital of Cologne, Germany.
Department of Stereotactic and Functional Neurosurgery, University Hospital of Cologne, Germany.
Parkinsonism Relat Disord. 2019 Oct;67:117-121. doi: 10.1016/j.parkreldis.2019.08.017. Epub 2019 Aug 27.
Lead orientation is a new degree of freedom with directional deep brain stimulation (DBS) leads. We investigated how prevalent deviations from the intended implantation direction are in a large patient cohort.
The Directional Orientation Detection (DiODe) algorithm to determine lead orientation from postoperative CT scans was implemented into the open-source Lead-DBS toolbox. Lead orientation was analyzed in 100 consecutive patients (198 leads). Different anatomical targets and intraoperative setups were compared.
Deviations of up to 90° from the intended implantation direction were observed. Deviations of more than 30° were seen in 42% of the leads and deviations of more than 60° in about 11% of the leads. Deviations were independent from the neuroanatomical target and the stereotactic frame but increased depending on which microdrive was used.
Our results indicate that large deviations from the intended implantation direction are a common phenomenon in directional leads. Postoperative determination of lead orientation is thus mandatory for investigating directional DBS.
导丝定向是一种新的有向深部脑刺激（DBS）导丝自由度。我们研究了在大型患者队列中，偏离预期植入方向的情况有多普遍。
用于从术后 CT 扫描确定导丝方向的定向定向检测（DiODe）算法被纳入开源 Lead-DBS 工具箱。对 100 名连续患者（198 个导丝）进行了导丝定向分析。比较了不同的解剖靶点和术中设置。
观察到与预期植入方向的偏差高达 90°。42%的导丝出现了超过 30°的偏差，约 11%的导丝出现了超过 60°的偏差。偏差与神经解剖靶点和立体定向框架无关，但随着微驱动器的使用而增加。
我们的结果表明，与预期植入方向的大偏差是有向导丝的常见现象。因此，在研究有向 DBS 时，术后确定导丝方向是强制性的。
