Deep Learning and fMRI-Based Pipeline for Optimization of Deep Brain Stimulation During Parkinson’s Disease Treatment: Toward Rapid Semi-Automated Stimulation Optimization
{"title":"Deep Learning and fMRI-Based Pipeline for Optimization of Deep Brain Stimulation During Parkinson’s Disease Treatment: Toward Rapid Semi-Automated Stimulation Optimization","authors":"Jianwei Qiu;Afis Ajala;John Karigiannis;Jürgen Germann;Brendan Santyr;Aaron Loh;Luca Marinelli;Thomas Foo;Radhika Madhavan;Desmond Yeo;Alexandre Boutet;Andres Lozano","doi":"10.1109/JTEHM.2024.3448392","DOIUrl":null,"url":null,"abstract":"Objective: Optimized deep brain stimulation (DBS) is fast becoming a therapy of choice for the treatment of Parkinson’s disease (PD). However, the post-operative optimization (aimed at maximizing patient clinical benefits and minimizing adverse effects) of all possible DBS parameter settings using the standard-of-care clinical protocol requires numerous clinical visits, which substantially increases the time to optimization per patient (TPP), patient cost burden and limit the number of patients who can undergo DBS treatment. The TPP is further elongated in electrodes with stimulation directionality or in diseases with latency in clinical feedback. In this work, we proposed a deep learning and fMRI-based pipeline for DBS optimization that can potentially reduce the TPP from ~1 year to a few hours during a single clinical visit.Methods and procedures: We developed an unsupervised autoencoder (AE)-based model to extract meaningful features from 122 previously acquired blood oxygenated level dependent (BOLD) fMRI datasets from 39 a priori clinically optimized PD patients undergoing DBS therapy. The extracted features are then fed into multilayer perceptron (MLP)-based parameter classification and prediction models for rapid DBS parameter optimization.Results: The AE-extracted features of optimal and non-optimal DBS were disentangled. The AE-MLP classification model yielded accuracy, precision, recall, F1 score, and combined AUC of 0.96 ± 0.04, 0.95 ± 0.07, 0.92 ± 0.07, 0.93 ± 0.06, and 0.98 respectively. Accuracies of 0.79 ± 0.04, 0.85 ± 0.04, 0.82 ± 0.05, 0.83 ± 0.05, and 0.70 ± 0.07 were obtained in the prediction of voltage, frequency, and x-y-z contact locations, respectively.Conclusion: The proposed AE-MLP models yielded promising results for fMRI-based DBS parameter classification and prediction, potentially facilitating rapid semi-automated DBS parameter optimization. Clinical and Translational Impact Statement—A deep learning-based pipeline for semi-automated DBS parameter optimization is presented, with the potential to significantly decrease the optimization duration per patient and patients' financial burden while increasing patient throughput.","PeriodicalId":54255,"journal":{"name":"IEEE Journal of Translational Engineering in Health and Medicine-Jtehm","volume":null,"pages":null},"PeriodicalIF":3.7000,"publicationDate":"2024-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ieeexplore.ieee.org/stamp/stamp.jsp?tp=&arnumber=10643605","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"IEEE Journal of Translational Engineering in Health and Medicine-Jtehm","FirstCategoryId":"5","ListUrlMain":"https://ieeexplore.ieee.org/document/10643605/","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"ENGINEERING, BIOMEDICAL","Score":null,"Total":0}
引用次数: 0
Abstract
Objective: Optimized deep brain stimulation (DBS) is fast becoming a therapy of choice for the treatment of Parkinson’s disease (PD). However, the post-operative optimization (aimed at maximizing patient clinical benefits and minimizing adverse effects) of all possible DBS parameter settings using the standard-of-care clinical protocol requires numerous clinical visits, which substantially increases the time to optimization per patient (TPP), patient cost burden and limit the number of patients who can undergo DBS treatment. The TPP is further elongated in electrodes with stimulation directionality or in diseases with latency in clinical feedback. In this work, we proposed a deep learning and fMRI-based pipeline for DBS optimization that can potentially reduce the TPP from ~1 year to a few hours during a single clinical visit.Methods and procedures: We developed an unsupervised autoencoder (AE)-based model to extract meaningful features from 122 previously acquired blood oxygenated level dependent (BOLD) fMRI datasets from 39 a priori clinically optimized PD patients undergoing DBS therapy. The extracted features are then fed into multilayer perceptron (MLP)-based parameter classification and prediction models for rapid DBS parameter optimization.Results: The AE-extracted features of optimal and non-optimal DBS were disentangled. The AE-MLP classification model yielded accuracy, precision, recall, F1 score, and combined AUC of 0.96 ± 0.04, 0.95 ± 0.07, 0.92 ± 0.07, 0.93 ± 0.06, and 0.98 respectively. Accuracies of 0.79 ± 0.04, 0.85 ± 0.04, 0.82 ± 0.05, 0.83 ± 0.05, and 0.70 ± 0.07 were obtained in the prediction of voltage, frequency, and x-y-z contact locations, respectively.Conclusion: The proposed AE-MLP models yielded promising results for fMRI-based DBS parameter classification and prediction, potentially facilitating rapid semi-automated DBS parameter optimization. Clinical and Translational Impact Statement—A deep learning-based pipeline for semi-automated DBS parameter optimization is presented, with the potential to significantly decrease the optimization duration per patient and patients' financial burden while increasing patient throughput.
期刊介绍:
The IEEE Journal of Translational Engineering in Health and Medicine is an open access product that bridges the engineering and clinical worlds, focusing on detailed descriptions of advanced technical solutions to a clinical need along with clinical results and healthcare relevance. The journal provides a platform for state-of-the-art technology directions in the interdisciplinary field of biomedical engineering, embracing engineering, life sciences and medicine. A unique aspect of the journal is its ability to foster a collaboration between physicians and engineers for presenting broad and compelling real world technological and engineering solutions that can be implemented in the interest of improving quality of patient care and treatment outcomes, thereby reducing costs and improving efficiency. The journal provides an active forum for clinical research and relevant state-of the-art technology for members of all the IEEE societies that have an interest in biomedical engineering as well as reaching out directly to physicians and the medical community through the American Medical Association (AMA) and other clinical societies. The scope of the journal includes, but is not limited, to topics on: Medical devices, healthcare delivery systems, global healthcare initiatives, and ICT based services; Technological relevance to healthcare cost reduction; Technology affecting healthcare management, decision-making, and policy; Advanced technical work that is applied to solving specific clinical needs.