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Wu Y, Hu K, Liu S. Computational models advance deep brain stimulation for Parkinson's disease. NETWORK (BRISTOL, ENGLAND) 2024:1-32. [PMID: 38923890 DOI: 10.1080/0954898x.2024.2361799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 05/25/2024] [Indexed: 06/28/2024]
Abstract
Deep brain stimulation(DBS) has become an effective intervention for advanced Parkinson's disease(PD), but the exact mechanism of DBS is still unclear. In this review, we discuss the history of DBS, the anatomy and internal architecture of the basal ganglia (BG), the abnormal pathological changes of the BG in PD, and how computational models can help understand and advance DBS. We also describe two types of models: mathematical theoretical models and clinical predictive models. Mathematical theoretical models simulate neurons or neural networks of BG to shed light on the mechanistic principle underlying DBS, while clinical predictive models focus more on patients' outcomes, helping to adapt treatment plans for each patient and advance novel electrode designs. Finally, we provide insights and an outlook on future technologies.
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Affiliation(s)
- Yongtong Wu
- School of Mathematics, South China University of Technology, Guangzhou, Guangdong, China
| | - Kejia Hu
- Department of Neurosurgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Center for Functional Neurosurgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Shenquan Liu
- School of Mathematics, South China University of Technology, Guangzhou, Guangdong, China
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Bower KL, Noecker AM, Frankemolle-Gilbert AM, McIntyre CC. Model-Based Analysis of Pathway Recruitment During Subthalamic Deep Brain Stimulation. Neuromodulation 2024; 27:455-463. [PMID: 37097269 PMCID: PMC10598236 DOI: 10.1016/j.neurom.2023.02.084] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 02/06/2023] [Accepted: 02/27/2023] [Indexed: 04/26/2023]
Abstract
BACKGROUND Subthalamic deep brain stimulation (DBS) is an established clinical therapy, but an anatomically clear definition of the underlying neural target(s) of the stimulation remains elusive. Patient-specific models of DBS are commonly used tools in the search for stimulation targets, and recent iterations of those models are focused on characterizing the brain connections that are activated by DBS. OBJECTIVE The goal of this study was to quantify axonal pathway activation in the subthalamic region from DBS at different electrode locations and stimulation settings. MATERIALS AND METHODS We used an anatomically and electrically detailed computational model of subthalamic DBS to generate recruitment curves for eight different axonal pathways of interest, at three generalized DBS electrode locations in the subthalamic nucleus (STN) (ie, central STN, dorsal STN, posterior STN). These simulations were performed with three levels of DBS electrode localization uncertainty (ie, 0.5 mm, 1.0 mm, 1.5 mm). RESULTS The recruitment curves highlight the diversity of pathways that are theoretically activated with subthalamic DBS, in addition to the dependence of the stimulation location and parameter settings on the pathway activation estimates. The three generalized DBS locations exhibited distinct pathway recruitment curve profiles, suggesting that each stimulation location would have a different effect on network activity patterns. We also found that the use of anodic stimuli could help limit activation of the internal capsule relative to other pathways. However, incorporating realistic levels of DBS electrode localization uncertainty in the models substantially limits their predictive capabilities. CONCLUSIONS Subtle differences in stimulation location and/or parameter settings can impact the collection of pathways that are activated during subthalamic DBS.
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Affiliation(s)
- Kelsey L Bower
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH, USA
| | - Angela M Noecker
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH, USA; Department of Biomedical Engineering, Duke University, Durham, NC, USA
| | | | - Cameron C McIntyre
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH, USA; Department of Biomedical Engineering, Duke University, Durham, NC, USA; Department of Neurosurgery, Duke University, Durham, NC, USA.
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Sánchez-Gómez A, Camargo P, Cámara A, Roldán P, Rumià J, Compta Y, Carbayo Á, Martí MJ, Muñoz E, Valldeoriola F. Utility of Postoperative Imaging Software for Deep Brain Stimulation Targeting in Patients with Movement Disorders. World Neurosurg 2022; 166:e163-e176. [PMID: 35787960 DOI: 10.1016/j.wneu.2022.06.132] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Revised: 06/24/2022] [Accepted: 06/25/2022] [Indexed: 12/15/2022]
Abstract
OBJECTIVE The objective of this study was to evaluate the accuracy of the SureTune3 postoperative imaging software in determining the location of a deep brain stimulation (DBS) electrode based on clinical outcomes and the adverse effects (AEs) observed. METHODS Twenty-six consecutive patients with Parkinson disease (n = 17), essential tremor (n = 8), and dystonia (n = 1) who underwent bilateral DBS surgery (52 electrodes) were included in this study. Presurgical assessments were performed in all patients prior to surgery and at 3 and 6 months after surgery, using quality-of-life and clinical scales in each case. The SureTune3 software was used to evaluate the anatomical positioning of the DBS electrodes. RESULTS Following DBS surgery, motor and quality-of-life improvement was observed in all patients. Different AEs were detected in 12 patients, in 10 of whom (83.3%) SureTune3 related the symptoms to the positioning of an electrode. A clinical association was observed with SureTune3 for 48 of 52 (92.3%) electrodes, whereas no association was found between the AEs or clinical outcomes and the SureTune3 reconstructions for 4 of 52 electrodes (7.7%) from 4 different patients. In 2 patients, the contact chosen was modified based on the SureTune3 data, and in 2 cases, the software helped determine that second electrode replacement surgery was necessary. CONCLUSIONS The anatomical position of electrodes analyzed with SureTune3 software was strongly correlated with both the AEs and clinical outcomes. Thus, SureTune3 may be useful in clinical practice, and it could help improve stimulation parameters and influence decisions to undertake electrode replacement surgery.
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Affiliation(s)
- Almudena Sánchez-Gómez
- Institut de Neurociències, Service of Neurology, Parkinson's Disease and Movement Disorders Unit., Hospital Clinic de Barcelona, Barcelona, Catalonia, Spain; Institut de Neurociències, Maeztu Center, Universitat de Barcelona, Barcelona, Catalonia, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Catalonia, Spain
| | - Paola Camargo
- Institut de Neurociències, Service of Neurology, Parkinson's Disease and Movement Disorders Unit., Hospital Clinic de Barcelona, Barcelona, Catalonia, Spain; Institut de Neurociències, Maeztu Center, Universitat de Barcelona, Barcelona, Catalonia, Spain
| | - Ana Cámara
- Institut de Neurociències, Service of Neurology, Parkinson's Disease and Movement Disorders Unit., Hospital Clinic de Barcelona, Barcelona, Catalonia, Spain; Institut de Neurociències, Maeztu Center, Universitat de Barcelona, Barcelona, Catalonia, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Catalonia, Spain
| | - Pedro Roldán
- Institut de Neurociències, Maeztu Center, Universitat de Barcelona, Barcelona, Catalonia, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Catalonia, Spain; Institut de Neurociències, Service of Neurosurgery, Hospital Clínic de Barcelona, Barcelona, Catalonia, Spain
| | - Jordi Rumià
- Institut de Neurociències, Maeztu Center, Universitat de Barcelona, Barcelona, Catalonia, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Catalonia, Spain; Institut de Neurociències, Service of Neurosurgery, Hospital Clínic de Barcelona, Barcelona, Catalonia, Spain
| | - Yaroslau Compta
- Institut de Neurociències, Service of Neurology, Parkinson's Disease and Movement Disorders Unit., Hospital Clinic de Barcelona, Barcelona, Catalonia, Spain; Institut de Neurociències, Maeztu Center, Universitat de Barcelona, Barcelona, Catalonia, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Catalonia, Spain
| | - Álvaro Carbayo
- Institut de Neurociències, Service of Neurology, Parkinson's Disease and Movement Disorders Unit., Hospital Clinic de Barcelona, Barcelona, Catalonia, Spain; Institut de Neurociències, Maeztu Center, Universitat de Barcelona, Barcelona, Catalonia, Spain
| | - Maria José Martí
- Institut de Neurociències, Service of Neurology, Parkinson's Disease and Movement Disorders Unit., Hospital Clinic de Barcelona, Barcelona, Catalonia, Spain; Institut de Neurociències, Maeztu Center, Universitat de Barcelona, Barcelona, Catalonia, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Catalonia, Spain
| | - Esteban Muñoz
- Institut de Neurociències, Service of Neurology, Parkinson's Disease and Movement Disorders Unit., Hospital Clinic de Barcelona, Barcelona, Catalonia, Spain; Institut de Neurociències, Maeztu Center, Universitat de Barcelona, Barcelona, Catalonia, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Catalonia, Spain
| | - Francesc Valldeoriola
- Institut de Neurociències, Service of Neurology, Parkinson's Disease and Movement Disorders Unit., Hospital Clinic de Barcelona, Barcelona, Catalonia, Spain; Institut de Neurociències, Maeztu Center, Universitat de Barcelona, Barcelona, Catalonia, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Catalonia, Spain.
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