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70. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
Joint Meeting mit der Skandinavischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

12.05. - 15.05.2019, Würzburg

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Visualisation of the volume of tissue activated in a clinical planning system for deep brain stimulation

Visualisierung des aktivierten Gewebevolumens in einem klinischen Planungssystem für Tiefe Hirnstimulation

Meeting Abstract

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  • presenting/speaker Barbara Carl - Universitätsklinikum Marburg, Klinik für Neurochirurgie, Marburg, Deutschland
  • Miriam Bopp - Universitätsklinikum Marburg, Klinik für Neurochirurgie, Marburg, Deutschland
  • Benjamin Saß - Universitätsklinikum Marburg, Klinik für Neurochirurgie, Marburg, Deutschland
  • Josefine Waldthaler - Universitätsklinikum Marburg, Klinik für Neurologie, Marburg, Deutschland
  • Lars Timmermann - Universitätsklinikum Marburg, Klinik für Neurologie, Marburg, Deutschland
  • Christopher Nimsky - Universitätsklinikum Marburg, Klinik für Neurochirurgie, Marburg, Deutschland

Deutsche Gesellschaft für Neurochirurgie. 70. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Skandinavischen Gesellschaft für Neurochirurgie. Würzburg, 12.-15.05.2019. Düsseldorf: German Medical Science GMS Publishing House; 2019. DocV238

doi: 10.3205/19dgnc257, urn:nbn:de:0183-19dgnc2574

Published: May 8, 2019

© 2019 Carl et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

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Objective: Pathway activating models try to describe stimulation spread in deep brain stimulation (DBS). Volume of tissue activated (VTA) models are simplified model variants allowing faster and easier computation. Our study aimed to investigate, how VTA visualization can be integrated into a clinical workflow using a standard DBS planning system.

Methods: Twelve patients underwent DBS, using directional electrodes for bilateral subthalamic nucleus (STN) stimulation in Parkinson’s disease. In all of them the VTA was visualized in relation to the electrode, the STN target, and surrounding structures e.g. major fiber tracts.

Results: The percentage of VTA covering the STN volume ranged from 25% to 100% (mean ± standard deviation: 60±25%) on the left side and from 0 to 98% (mean ± standard deviation: 51±30%) on the right side. The mean coordinate of all VTA centers was: 12.6±1.2mm lateral, 2.1±1.2mm posterior, and 2.3±1.4mm inferior in relation to the midcommissural point. Stimulation effects could be compared to the VTA visualization in relation to surrounding structures, facilitating programming. In case of suboptimal lead placement, VTA visualization supported programming resulting in good clinical outcome.

Conclusion: VTA visualization in a clinical planning system allows an intuitive adjustment of the stimulation parameters, facilitates programming, and enhances understanding of effects and side effects of DBS.