Strelow Joshua N, Dembek Till A, Baldermann Juan C, Andrade Pablo, Jergas Hannah, Visser-Vandewalle Veerle, Barbe Michael T
Department of Neurology, Faculty of Medicine and University Hospital Cologne, University of Cologne, 50937 Cologne, Germany.
Department of Stereotactic and Functional Neurosurgery, Faculty of Medicine and University Hospital Cologne, University of Cologne, 50937 Cologne, Germany.
Brain Sci. 2022 Dec 16;12(12):1726. doi: 10.3390/brainsci12121726.
Intra- and perioperatively recorded local field potential (LFP) activity of the nucleus subthalamicus (STN) has been suggested to guide contact selection in patients undergoing deep brain stimulation (DBS) for Parkinson's disease (PD). Despite the invention of sensing capacities in chronically implanted devices, a comprehensible algorithm that enables contact selection using such recordings is still lacking. We evaluated a fully automated algorithm that uses the weighted average of bipolar recordings to determine effective monopolar contacts based on elevated activity in the beta band. LFPs from 14 hemispheres in seven PD patients with newly implanted directional DBS leads of the STN were recorded. First, the algorithm determined the stimulation level with the highest beta activity. Based on the prior determined level, the directional contact with the highest beta activity was chosen in the second step. The mean clinical efficacy of the contacts chosen using the algorithm did not statistically differ from the mean clinical efficacy of standard contact selection as performed in clinical routine. All recording sites were projected into MNI standard space to investigate the feasibility of the algorithm with respect to the anatomical boundaries of the STN. We conclude that the proposed algorithm is a first step towards LFP-based contact selection in STN-DBS for PD using chronically implanted devices.
丘脑底核（STN）的术中及围手术期局部场电位（LFP）活动已被建议用于指导帕金森病（PD）患者接受深部脑刺激（DBS）时的触点选择。尽管长期植入设备具备传感能力，但仍缺乏一种能够利用此类记录进行触点选择的可理解算法。我们评估了一种全自动算法，该算法使用双极记录的加权平均值，根据β波段的活动增强来确定有效的单极触点。记录了7例新植入STN定向DBS电极的PD患者14个半球的LFP。首先，该算法确定具有最高β活动的刺激水平。基于先前确定的水平，在第二步中选择具有最高β活动的定向触点。使用该算法选择的触点的平均临床疗效与临床常规中进行的标准触点选择的平均临床疗效在统计学上无差异。将所有记录部位投影到MNI标准空间，以研究该算法相对于STN解剖边界的可行性。我们得出结论，所提出的算法是使用长期植入设备在STN-DBS治疗PD中基于LFP进行触点选择的第一步。
