Probabilistic Mapping of Deep Brain Stimulation: Insights from 15 Years of Therapy.

Autor: Elias GJB; Division of Neurosurgery, Department of Surgery, University Health Network and University of Toronto, Toronto, Ontario, Canada.; Krembil Research Institute, University of Toronto, Toronto, Ontario, Canada., Boutet A; Division of Neurosurgery, Department of Surgery, University Health Network and University of Toronto, Toronto, Ontario, Canada.; Krembil Research Institute, University of Toronto, Toronto, Ontario, Canada.; Joint Department of Medical Imaging, University of Toronto, Toronto, Ontario, Canada., Joel SE; GE Global Research, Toronto, Ontario, Canada., Germann J; Division of Neurosurgery, Department of Surgery, University Health Network and University of Toronto, Toronto, Ontario, Canada., Gwun D; Division of Neurosurgery, Department of Surgery, University Health Network and University of Toronto, Toronto, Ontario, Canada., Neudorfer C; Division of Neurosurgery, Department of Surgery, University Health Network and University of Toronto, Toronto, Ontario, Canada., Gramer RM; Division of Neurosurgery, Department of Surgery, University Health Network and University of Toronto, Toronto, Ontario, Canada., Algarni M; Krembil Research Institute, University of Toronto, Toronto, Ontario, Canada.; Edmond J. Safra Program in Parkinson's Disease and Morton and Gloria Shulman Movement Disorders Clinic, University Health Network, Toronto, Ontario, Canada., Paramanandam V; Krembil Research Institute, University of Toronto, Toronto, Ontario, Canada.; Edmond J. Safra Program in Parkinson's Disease and Morton and Gloria Shulman Movement Disorders Clinic, University Health Network, Toronto, Ontario, Canada., Prasad S; Krembil Research Institute, University of Toronto, Toronto, Ontario, Canada.; Edmond J. Safra Program in Parkinson's Disease and Morton and Gloria Shulman Movement Disorders Clinic, University Health Network, Toronto, Ontario, Canada., Beyn ME; Division of Neurosurgery, Department of Surgery, University Health Network and University of Toronto, Toronto, Ontario, Canada., Horn A; Movement Disorders and Neuromodulation Unit, Department for Neurology, Charité-Universitätsmedizin, Berlin, Germany., Madhavan R; GE Global Research, Toronto, Ontario, Canada., Ranjan M; Division of Neurosurgery, Department of Surgery, University Health Network and University of Toronto, Toronto, Ontario, Canada., Lozano CS; Division of Neurosurgery, Department of Surgery, University Health Network and University of Toronto, Toronto, Ontario, Canada., Kühn AA; Movement Disorders and Neuromodulation Unit, Department for Neurology, Charité-Universitätsmedizin, Berlin, Germany., Ashe J; GE Global Research, Toronto, Ontario, Canada., Kucharczyk W; Krembil Research Institute, University of Toronto, Toronto, Ontario, Canada.; Joint Department of Medical Imaging, University of Toronto, Toronto, Ontario, Canada., Munhoz RP; Krembil Research Institute, University of Toronto, Toronto, Ontario, Canada.; Edmond J. Safra Program in Parkinson's Disease and Morton and Gloria Shulman Movement Disorders Clinic, University Health Network, Toronto, Ontario, Canada., Giacobbe P; Department of Psychiatry, Sunnybrook Health Sciences Centre, Sunnybrook Research Institute, University of Toronto, Toronto, Ontario, Canada., Kennedy SH; Krembil Research Institute, University of Toronto, Toronto, Ontario, Canada.; Centre for Mental Health, University Health Network, Toronto, Ontario, Canada., Woodside DB; Centre for Mental Health, University Health Network, Toronto, Ontario, Canada., Kalia SK; Division of Neurosurgery, Department of Surgery, University Health Network and University of Toronto, Toronto, Ontario, Canada.; Krembil Research Institute, University of Toronto, Toronto, Ontario, Canada., Fasano A; Krembil Research Institute, University of Toronto, Toronto, Ontario, Canada.; Edmond J. Safra Program in Parkinson's Disease and Morton and Gloria Shulman Movement Disorders Clinic, University Health Network, Toronto, Ontario, Canada., Hodaie M; Division of Neurosurgery, Department of Surgery, University Health Network and University of Toronto, Toronto, Ontario, Canada.; Krembil Research Institute, University of Toronto, Toronto, Ontario, Canada., Lozano AM; Division of Neurosurgery, Department of Surgery, University Health Network and University of Toronto, Toronto, Ontario, Canada.; Krembil Research Institute, University of Toronto, Toronto, Ontario, Canada.
Jazyk: angličtina
Zdroj: Annals of neurology [Ann Neurol] 2021 Mar; Vol. 89 (3), pp. 426-443. Date of Electronic Publication: 2020 Dec 21.
DOI: 10.1002/ana.25975
Abstrakt: Deep brain stimulation (DBS) depends on precise delivery of electrical current to target tissues. However, the specific brain structures responsible for best outcome are still debated. We applied probabilistic stimulation mapping to a retrospective, multidisorder DBS dataset assembled over 15 years at our institution (n total = 482 patients; n Parkinson disease = 303; n dystonia = 64; n tremor = 39; n treatment-resistant depression/anorexia nervosa = 76) to identify the neuroanatomical substrates of optimal clinical response. Using high-resolution structural magnetic resonance imaging and activation volume modeling, probabilistic stimulation maps (PSMs) that delineated areas of above-mean and below-mean response for each patient cohort were generated and defined in terms of their relationships with surrounding anatomical structures. Our results show that overlap between PSMs and individual patients' activation volumes can serve as a guide to predict clinical outcomes, but that this is not the sole determinant of response. In the future, individualized models that incorporate advancements in mapping techniques with patient-specific clinical variables will likely contribute to the optimization of DBS target selection and improved outcomes for patients. ANN NEUROL 2021;89:426-443.
(© 2020 American Neurological Association.)
Databáze: MEDLINE
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