Abstract
<h3>Objective:</h3> To evaluate the utility of image guided DBS programming. We aimed to determine the correlation between optimal DBS electrode placement predicted by imaging guided software and clinician-determined monopolar review in PD patients with deep brain stimulation. <h3>Background:</h3> The current paradigm for DBS programming, monopolar review - an empirical technique that is a time-consuming process that can last 60–90 minutes for each lead and is performed in a dopaminergic-off state. Recent developments in imaging software with detailed anatomical atlases allow visualization of each individual electrode in relation to the target structure. Pre-operative MRI and post-operative CT images are fused to determine the precise location of individual contacts and allows an unbiased determination of best contact and is associated with decreased programing time. <h3>Design/Methods:</h3> An automatic software algorithm (Brainlab, Munich) was used to fuse preoperative MRI with postoperative CT and visualize the location of each electrode inside the STN or GPI. Two independent reviewers assessed the fusion images generated for 50 patients who had undergone DBS lead placement for Parkinson’s disease. <h3>Results:</h3> Our analysis included 50 patients, 13 with GPi and 37 with STN implants. The majority of GPi contacts (71%) deemed best during initial monopolar review correlated with those predicted by the software and had full submersion in the target. In the case of STN, a strong correlation with the software was present in 42% of the cases for the left leads. However, the right STN contacts used for monopolar review had the largest percentage (48%) with no submersion in the target per the software. <h3>Conclusions:</h3> Optimal DBS contacts were successfully predicted by fusion images generated by the Brainlab software in the majority of patients with GPi targets and appreciable percentage of STN targets. This may help guide the monopolar review of patients who have undergone placement of deep brain stimulation electrodes. <b>Disclosure:</b> Mr. Moll has nothing to disclose. Ms. Bullock has nothing to disclose. Dr. Marmol has nothing to disclose. Dr. Hislop has nothing to disclose. Jonathan Jagid has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Medtronic Inc. The institution of Jonathan Jagid has received research support from Boston Scientific. The institution of Jonathan Jagid has received research support from Medtronic Inc. The institution of Dr. Haq has received research support from NINDS. The institution of Dr. Haq has received research support from the Parkinson’s Foundation. The institution of Dr. Haq has received research support from NIMH. Dr. Haq has a non-compensated relationship as a consultant with Medtronics that is relevant to AAN interests or activities. Dr. Haq has a non-compensated relationship as a consultant with Boston Scientific that is relevant to AAN interests or activities. Dr. Haq has a non-compensated relationship as a consultant with Abbott that is relevant to AAN interests or activities. Dr. Luca has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Boston Scientific. Dr. Luca has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Signant Health.
Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
