两种脑深部刺激导联重建方法的比较及其预测能力。

IF 3.5 3区 医学 Q2 CLINICAL NEUROLOGY
Renata Montes Garcia Barbosa, Joyce Yuri Silvestre Yamamoto, Miriam Carvalho Soares, Isabela Bruzzi Bezerra Paraguay, Sara Carvalho Barbosa Casagrande, Jorge Dornellys da Silva Lapa, Marcos Eugênio Ramalho Bezerra, Guilherme Sperling Torezani, Vanessa Milanese Holanda, Gabriel de Castro Micheli, Egberto Reis Barbosa, Rubens Gisbert Cury
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引用次数: 0

摘要

目的:脑深部刺激(DBS)技术越来越先进,需要能够优化编程的工具。三维(3D)电极成像重建有可能帮助临床医生选择最有效的DBS接触。在本研究中,与临床检查(护理标准)相比,我们评估了两种不同方法(Matlab软件[Mathworks, Inc., Natick, MA]和Brainlab软件[Brainlab, Munich, Germany])识别有效脑起搏器接触者的预测能力。研究还分析了一种方法是否更优。材料和方法:共纳入29例患者:27例帕金森病(PD)和2例肌张力障碍(DT)。因此,获得了58个大脑半球的图像。其中56个有定向引线,2个有8环触点的引线。采用Matlab软件和Brainlab软件进行电极重构。分析了电极与靶核(丘脑下核或内苍白球)的解剖关系。通过三维重建可视化,选择目标最佳点内的接触点。此外,如果最佳接触电平是定向的,则选择最佳位置的定向接触(这可能在40个引线中)。最佳接触者定义为基于临床检查(护理标准)的运动症状改善率最高的接触者。结果:患者平均年龄56岁;24例患者术后≤1年内接受手术,术后最长时间为3年。接触水平建议的差异只有一个半球,Matlab软件正确建议最佳临床接触的比例为83% (48/58),Brainlab软件正确建议最佳临床接触的比例为84%(49/58)。两种方法的定向接触提示量均为80%。两种方法在图像重建的基础上选择最佳接触点的一致性为94.8%(55/58)。结论:Matlab软件和Brainlab软件是在临床检查的基础上准确提示最佳接触点的有效图像重建方法。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Comparison of Two Methods of Deep Brain Stimulation Lead Reconstruction and Their Prediction Capacities.

Objectives: Deep brain stimulation (DBS) technology has become increasingly advanced, and tools capable of optimizing programming are necessary. Three-dimensional (3D) electrode imaging reconstruction has the potential to assist clinicians in selecting the most effective DBS contacts. In this study, we evaluated the predictive capacity of two different methods (Matlab software [Mathworks, Inc., Natick, MA] and Brainlab software [Brainlab, Munich, Germany]) in identifying effective DBS contacts, compared with clinical examination (the standard of care). The study also analyzes whether one method is superior.

Materials and methods: Overall, 29 patients were included: 27 with Parkinson's disease (PD) and two with dystonia (DT). Therefore, images of the 58 brain hemispheres were obtained. Of these, 56 had directional leads, and two had leads with eight-ring contacts. Electrode reconstruction was performed using Matlab software and Brainlab software. The anatomic relationship between the electrodes and the targets (subthalamic nucleus or globus pallidus internus) was analyzed. Contacts within the sweet spot of the target were chosen through 3D reconstruction visualization. In addition, if the best contact levels were directional, the best located directional contacts were chosen (this was possible in 40 leads). The best contact was defined as that with the highest motor symptoms improvement rate based on clinical examination (standard of care).

Results: The mean age of the patients was 56 years; 24 patients underwent surgery within ≤one year from the surgery, and the maximum time from surgery was three years. The difference in contact-level suggestion was only one hemisphere, with Matlab software correctly suggesting the best clinical contact in 83% (48/58) and Brainlab software in 84% (49/58). The suggestion capacity of the directional contacts was 80% for both methods. Furthermore, there was a 94.8% concordance rate between the two methods (55/58) on choosing the best contacts on the basis of image reconstruction.

Conclusion: Matlab software and Brainlab software are effective image reconstruction methods for accurately suggesting the best contact on the basis of clinical examination.

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来源期刊
Neuromodulation
Neuromodulation 医学-临床神经学
CiteScore
6.40
自引率
3.60%
发文量
978
审稿时长
54 days
期刊介绍: Neuromodulation: Technology at the Neural Interface is the preeminent journal in the area of neuromodulation, providing our readership with the state of the art clinical, translational, and basic science research in the field. For clinicians, engineers, scientists and members of the biotechnology industry alike, Neuromodulation provides timely and rigorously peer-reviewed articles on the technology, science, and clinical application of devices that interface with the nervous system to treat disease and improve function.
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