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Stereotactic implantation of deep brain stimulation electrodes: a review of technical systems, methods and emerging tools

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Abstract

Deep brain stimulation (DBS) has become increasingly important for the treatment and relief of neurological disorders such as Parkinson’s disease, tremor, dystonia and psychiatric illness. As DBS implantations and any other stereotactic and functional surgical procedure require accurate, precise and safe targeting of the brain structure, the technical aids for preoperative planning, intervention and postoperative follow-up have become increasingly important. The aim of this paper was to give an overview, from a biomedical engineering perspective, of a typical implantation procedure and current supporting techniques. Furthermore, emerging technical aids not yet clinically established are presented. This includes the state-of-the-art of neuroimaging and navigation, patient-specific simulation of DBS electric field, optical methods for intracerebral guidance, movement pattern analysis, intraoperative data visualisation and trends related to new stimulation devices. As DBS surgery already today is an information technology intensive domain, an “intuitive visualisation” interface for improving management of these data in relation to surgery is suggested.

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Abbreviations

AC PC:

Anterior and the posterior commissure

DBS:

Deep brain stimulation

DTI:

Diffusion tensor imaging

FEM:

Finite element method

GPi:

Globus pallidus internus

LDPM:

Laser Doppler perfusion monitoring

MER:

Microelectrode recording

PPN:

Pedunculopontine nucleus

RF:

Radiofrequency

SAR:

Specific absorption rate

STN:

Subthalamic nucleus

UPDRS:

Unified Parkinson’s disease rating scale

Vim:

Nucleus ventrointermedius of the thalamus

Zi:

Zona incerta

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Acknowledgments

This work was supported by the Swedish Foundation for Strategic Research (SSF), Swedish Research Council (VR) and Swedish Governmental Agency for Innovation Systems (VINNOVA) (group grant 311-2006-7661). Financial support has been obtained as well from the Förderverein Solothurn of the University of Applied Sciences Northwestern Switzerland.

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  1. University of Applied Sciences Northwestern Switzerland, Institute for Medical and Analytical Technologies, Muttenz, Switzerland

    Simone Hemm

  2. Department of Biomedical Engineering, Linköping University, 581 85, Linköping, Sweden

    Karin Wårdell

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Correspondence to Karin Wårdell.

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Hemm, S., Wårdell, K. Stereotactic implantation of deep brain stimulation electrodes: a review of technical systems, methods and emerging tools. Med Biol Eng Comput 48, 611–624 (2010). https://doi.org/10.1007/s11517-010-0633-y

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