Factors Influencing Electrode Position and Bending of the Proximal Lead in Deep Brain Stimulation for Movement Disorders

Jacob Niederer; Rémi Patriat; Oren Rosenberg; Tara Palnitkar; David Darrow; Michael C. Park; Lauren Schrock; Lynn E. Eberly; Noam Harel

doi:10.1159/000507029

Factors Influencing Electrode Position and Bending of the Proximal Lead in Deep Brain Stimulation for Movement Disorders

Jacob Niederer, Rémi Patriat, Oren Rosenberg, Tara Palnitkar, David Darrow, Michael C. Park, Lauren Schrock, Lynn E. Eberly, Noam Harel

Research output: Contribution to journal › Article › peer-review

9 Scopus citations

Abstract

Background: The introduction of intracranial air (ICA) during deep brain stimulation (DBS) surgery is thought to have a negative influence on targeting and clinical outcomes. Objective: To investigate ICA volumes following surgery and other patient-specific factors as potential variables influencing translocation of the DBS electrode and proximal lead bowing. Methods: High-resolution postoperative computed tomography scans (≤1.0 mm resolution in all directions) within 24 h following DBS surgery and 4-6 weeks of follow-up were acquired. A total of 50 DBS leads in 33 patients were available for analysis. DBS leads included Abbott/St. Jude Medical InfinityTM, Boston Scientific VerciseTM, and Medtronic 3389TM. Results: Both ICA volume and anatomical target were significantly associated with measures of DBS electrode translocation. ICA volume and DBS lead model were found to be significant predictors of proximal lead bowing. Measures of proximal lead bowing and translocation along the electrode trajectory for the Medtronic 3389TM DBS lead were significantly larger than measures for the Abbott/St. Jude Medical InfinityTM and Boston Scientific VerciseTM DBS leads. Conclusion: The association between ICA volume and translocation of the DBS electrode is small in magnitude and not clinically relevant for DBS cases within a normal range of postoperative subdural air volumes. Differences in proximal lead bowing observed between DBS leads may reflect hardware engineering subtleties in the construction of DBS lead models.

Original language	English (US)
Pages (from-to)	300-312
Number of pages	13
Journal	Stereotactic and Functional Neurosurgery
Volume	98
Issue number	5
DOIs	https://doi.org/10.1159/000507029
State	Published - Sep 1 2020

Bibliographical note

Funding Information:
The research reported in this paper was supported in part by grants from the National Institutes of Health (R01-NS085188), the National Institute of Biomedical Imaging and Bioengineering (P41 EB015894), NINDS Institutional Center Core Grants to Support Neuroscience Research (P30 NS076408), and the University of Minnesota Udall Center (P50NS098573).

Publisher Copyright:
© 2020 S. Karger AG, Basel. Copyright: All rights reserved.

Keywords

Brain shift
Deep brain stimulation
Electrode translocation
Intracranial air volume
Proximal lead bowing

Center for Magnetic Resonance Research (CMRR) tags

NM
P41

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10.1159/000507029

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title = "Factors Influencing Electrode Position and Bending of the Proximal Lead in Deep Brain Stimulation for Movement Disorders",

abstract = "Background: The introduction of intracranial air (ICA) during deep brain stimulation (DBS) surgery is thought to have a negative influence on targeting and clinical outcomes. Objective: To investigate ICA volumes following surgery and other patient-specific factors as potential variables influencing translocation of the DBS electrode and proximal lead bowing. Methods: High-resolution postoperative computed tomography scans (≤1.0 mm resolution in all directions) within 24 h following DBS surgery and 4-6 weeks of follow-up were acquired. A total of 50 DBS leads in 33 patients were available for analysis. DBS leads included Abbott/St. Jude Medical InfinityTM, Boston Scientific VerciseTM, and Medtronic 3389TM. Results: Both ICA volume and anatomical target were significantly associated with measures of DBS electrode translocation. ICA volume and DBS lead model were found to be significant predictors of proximal lead bowing. Measures of proximal lead bowing and translocation along the electrode trajectory for the Medtronic 3389TM DBS lead were significantly larger than measures for the Abbott/St. Jude Medical InfinityTM and Boston Scientific VerciseTM DBS leads. Conclusion: The association between ICA volume and translocation of the DBS electrode is small in magnitude and not clinically relevant for DBS cases within a normal range of postoperative subdural air volumes. Differences in proximal lead bowing observed between DBS leads may reflect hardware engineering subtleties in the construction of DBS lead models.",

keywords = "Brain shift, Deep brain stimulation, Electrode translocation, Intracranial air volume, Proximal lead bowing",

author = "Jacob Niederer and R{\'e}mi Patriat and Oren Rosenberg and Tara Palnitkar and David Darrow and Park, {Michael C.} and Lauren Schrock and Eberly, {Lynn E.} and Noam Harel",

note = "Funding Information: The research reported in this paper was supported in part by grants from the National Institutes of Health (R01-NS085188), the National Institute of Biomedical Imaging and Bioengineering (P41 EB015894), NINDS Institutional Center Core Grants to Support Neuroscience Research (P30 NS076408), and the University of Minnesota Udall Center (P50NS098573). Publisher Copyright: {\textcopyright} 2020 S. Karger AG, Basel. Copyright: All rights reserved.",

year = "2020",

month = sep,

day = "1",

doi = "10.1159/000507029",

language = "English (US)",

volume = "98",

pages = "300--312",

journal = "Stereotactic and Functional Neurosurgery",

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T1 - Factors Influencing Electrode Position and Bending of the Proximal Lead in Deep Brain Stimulation for Movement Disorders

AU - Niederer, Jacob

AU - Patriat, Rémi

AU - Rosenberg, Oren

AU - Palnitkar, Tara

AU - Darrow, David

AU - Park, Michael C.

AU - Schrock, Lauren

AU - Eberly, Lynn E.

AU - Harel, Noam

N1 - Funding Information: The research reported in this paper was supported in part by grants from the National Institutes of Health (R01-NS085188), the National Institute of Biomedical Imaging and Bioengineering (P41 EB015894), NINDS Institutional Center Core Grants to Support Neuroscience Research (P30 NS076408), and the University of Minnesota Udall Center (P50NS098573). Publisher Copyright: © 2020 S. Karger AG, Basel. Copyright: All rights reserved.

PY - 2020/9/1

Y1 - 2020/9/1

N2 - Background: The introduction of intracranial air (ICA) during deep brain stimulation (DBS) surgery is thought to have a negative influence on targeting and clinical outcomes. Objective: To investigate ICA volumes following surgery and other patient-specific factors as potential variables influencing translocation of the DBS electrode and proximal lead bowing. Methods: High-resolution postoperative computed tomography scans (≤1.0 mm resolution in all directions) within 24 h following DBS surgery and 4-6 weeks of follow-up were acquired. A total of 50 DBS leads in 33 patients were available for analysis. DBS leads included Abbott/St. Jude Medical InfinityTM, Boston Scientific VerciseTM, and Medtronic 3389TM. Results: Both ICA volume and anatomical target were significantly associated with measures of DBS electrode translocation. ICA volume and DBS lead model were found to be significant predictors of proximal lead bowing. Measures of proximal lead bowing and translocation along the electrode trajectory for the Medtronic 3389TM DBS lead were significantly larger than measures for the Abbott/St. Jude Medical InfinityTM and Boston Scientific VerciseTM DBS leads. Conclusion: The association between ICA volume and translocation of the DBS electrode is small in magnitude and not clinically relevant for DBS cases within a normal range of postoperative subdural air volumes. Differences in proximal lead bowing observed between DBS leads may reflect hardware engineering subtleties in the construction of DBS lead models.

AB - Background: The introduction of intracranial air (ICA) during deep brain stimulation (DBS) surgery is thought to have a negative influence on targeting and clinical outcomes. Objective: To investigate ICA volumes following surgery and other patient-specific factors as potential variables influencing translocation of the DBS electrode and proximal lead bowing. Methods: High-resolution postoperative computed tomography scans (≤1.0 mm resolution in all directions) within 24 h following DBS surgery and 4-6 weeks of follow-up were acquired. A total of 50 DBS leads in 33 patients were available for analysis. DBS leads included Abbott/St. Jude Medical InfinityTM, Boston Scientific VerciseTM, and Medtronic 3389TM. Results: Both ICA volume and anatomical target were significantly associated with measures of DBS electrode translocation. ICA volume and DBS lead model were found to be significant predictors of proximal lead bowing. Measures of proximal lead bowing and translocation along the electrode trajectory for the Medtronic 3389TM DBS lead were significantly larger than measures for the Abbott/St. Jude Medical InfinityTM and Boston Scientific VerciseTM DBS leads. Conclusion: The association between ICA volume and translocation of the DBS electrode is small in magnitude and not clinically relevant for DBS cases within a normal range of postoperative subdural air volumes. Differences in proximal lead bowing observed between DBS leads may reflect hardware engineering subtleties in the construction of DBS lead models.

KW - Brain shift

KW - Deep brain stimulation

KW - Electrode translocation

KW - Intracranial air volume

KW - Proximal lead bowing

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JO - Stereotactic and Functional Neurosurgery

JF - Stereotactic and Functional Neurosurgery

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ER -

Factors Influencing Electrode Position and Bending of the Proximal Lead in Deep Brain Stimulation for Movement Disorders

Abstract

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