Potentials and Limitations of Directional Deep Brain Stimulation: A Simulation Approach.

Abstract:

BACKGROUND:Directional leads are increasingly used in deep brain stimulation. They allow shaping the electrical field in the axial plane. These new possibilities increase the complexity of programming. Thus, optimized programming approaches are needed to assist clinical testing and to obtain full clinical benefit. OBJECTIVES:This simulation study investigates to what extent the electrical field can be shaped by directional steering to compensate for lead malposition. METHOD:Binary volumes of tissue activated (VTA) were simulated, by using a finite element method approach, for different amplitude distributions on the three directional electrodes. VTAs were shifted from 0 to 2 mm at different shift angles with respect to the lead orientation, to determine the best compensation of a target volume. RESULTS:Malpositions of 1 mm can be compensated with the highest gain of overlap with directional leads. For larger shifts, an improvement of overlap of 10-30% is possible, depending on the stimulation amplitude and shift angle of the lead. Lead orientation and shift determine the amplitude distribution of the electrodes. CONCLUSION:To get full benefit from directional leads, both the shift angle as well as the shift to target volume are required to choose the correct amplitude distribution on the electrodes. Current directional leads have limitations when compensating malpositions >1 mm; however, they still outperform conventional leads in reducing overstimulation. Further, their main advantage probably lies in the reduction of side effects. Databases like the one from this simulation could serve for optimized lead programming algorithms in the future.

authors

Kramme J,Dembek TA,Treuer H,Dafsari HS,Barbe MT,Wirths J,Visser-Vandewalle V

doi

10.1159/000509781

subject

Has Abstract

pub_date

2020-10-20 00:00:00

pages

1-10

eissn

1011-6125

issn

1423-0372

pii

000509781

pub_type

杂志文章
  • Late local and remote structural changes after capsulotomy for obsessive compulsive disorder.

    abstract::Stereotactic subcaudate capsulotomy (SC) is used to treat medically intractable obsessive compulsive disorders (OCD). Although clinical improvement has been observed, post-SC structural correlates are lacking in this biological disorder. Our study provides imaging evidence for local and distant alterations in structur...

    journal_title:Stereotactic and functional neurosurgery

    pub_type: 杂志文章

    doi:

    authors: Taren JA,Curtis GC,Gebarski SS

    更新日期:1994-01-01 00:00:00

  • Fractionated stereotactic radiotherapy for intracranial neoplasms.

    abstract::Fractionated stereotactic radiotherapy is a method which attempts to combine the radiobiological advantages offered by dose fractionation with a technique for focal delivery of radiation. At McGill University, fractionated stereotactic radiotherapy is given with a linear accelerator-based dynamic stereotactic radiosur...

    journal_title:Stereotactic and functional neurosurgery

    pub_type: 杂志文章

    doi:10.1159/000098941

    authors: Olivier A,Sadikot AF,Villemure JG,Pokrupa R,Souhami L,Podgorsak EB,Hazel J

    更新日期:1992-01-01 00:00:00

  • Effect of chronic deep brain stimulation of the subthalamic nucleus for frontal lobe epilepsy: subtraction SPECT analysis.

    abstract:OBJECTIVES:Experimental data and case reports of patients with intractable epilepsy treated with deep brain stimulation (DBS) of the subthalamic nucleus (STN) suggest a considerable anticonvulsant effect. However, no satisfactory mechanisms of action have yet been elucidated. We investigated the putative therapeutic me...

    journal_title:Stereotactic and functional neurosurgery

    pub_type: 杂志文章

    doi:10.1159/000086867

    authors: Shon YM,Lee KJ,Kim HJ,Chung YA,Ahn KJ,Kim YI,Yang DW,Kim BS

    更新日期:2005-01-01 00:00:00

  • Quantitative on-line analysis of physiological data for lesion placement in pallidotomy.

    abstract::A computerized method of determining the focal point of electrical activity in the pallidum of parkinsonian patients was developed using on-line quantitative physiological data analysis. Thirty patients in a series of 70 were studied in depth. Neuronal activity was recorded from the pallidum using a semi-microelectrod...

    journal_title:Stereotactic and functional neurosurgery

    pub_type: 杂志文章

    doi:10.1159/000048378

    authors: Lehman RM,Micheli-Tzanakou E,Medl A,Hamilton JL

    更新日期:2000-01-01 00:00:00

  • Epilepsy: principles of surgical management.

    abstract::In his keynote address, the author reviews early work in the surgical management of the epilepsies and presents a state-of-the-art review of current basic science and clinical indications for and results from corpus callosotomy for the treatment of seizure disorders. ...

    journal_title:Stereotactic and functional neurosurgery

    pub_type: 杂志文章,评审

    doi:10.1159/000098621

    authors: Marino R

    更新日期:1994-01-01 00:00:00

  • Electrical stimulation for epilepsy: stimulation of hippocampal foci.

    abstract::Subacute and chronic continuous electrical stimulation at the epileptic focus in the hippocampus or parahippocampal cortex at 130 Hz, 0.21-1.0 ms, 2.5-3.5 V (about 200-300 microA) induces a decrease in focal EEG epileptic interictal activity and also in the occurrence of clinical seizures. This may represent an altern...

    journal_title:Stereotactic and functional neurosurgery

    pub_type: 杂志文章

    doi:10.1159/000064610

    authors: Velasco F,Velasco M,Velasco AL,Menez D,Rocha L

    更新日期:2001-01-01 00:00:00

  • CT analysis of postoperative changes after thalamotomy for Parkinson's disease.

    abstract::Stereotactic operations have long been used to relieve agitation and muscle rigidity in Parkinson disease. Because of its high-density resolution, CT is quite effective to portray the location, size, shape and density of the thermocoagulative focus. The foci were classified into different types according to their chan...

    journal_title:Stereotactic and functional neurosurgery

    pub_type: 杂志文章

    doi:10.1159/000098740

    authors: Zhang G,Guo Q,Wu S

    更新日期:1995-01-01 00:00:00

  • Surgical treatment of patients with Rasmussen encephalitis.

    abstract:BACKGROUND:Rasmussen encephalitis (RE) is a rare progressive encephalitis that results in intractable seizures, cognitive decline and hemiparesis. Surgery seems to be the only effective way to control seizures in RE patients. OBJECTIVE:To describe the clinical, electrophysiological, neuroradiological and histological ...

    journal_title:Stereotactic and functional neurosurgery

    pub_type: 杂志文章

    doi:10.1159/000355901

    authors: Guan Y,Zhou J,Luan G,Liu X

    更新日期:2014-01-01 00:00:00

  • Deep brain stimulation significantly decreases disability from low back pain in patients with advanced Parkinson's disease.

    abstract:BACKGROUND:Up to 60% of Parkinson's disease (PD) patients suffer from low back pain (LBP) during the course of their disease. How LBP affects daily functional status and how to manage this aspect of PD has not been adequately explored. METHODS:We examined 16 patients undergoing bilateral subthalamic nucleus deep brain...

    journal_title:Stereotactic and functional neurosurgery

    pub_type: 杂志文章

    doi:10.1159/000380827

    authors: Smith H,Gee L,Kumar V,Ramirez-Zamora A,Durphy J,Hanspal E,Barba A,Molho E,Shin D,Pilitsis JG

    更新日期:2015-01-01 00:00:00

  • Persistence of the typical spike-wave EEG pattern after surgical excision of a temporal lobe astrocytoma and apical lobectomy.

    abstract::This is a report on a patient with intractable 'primary' generalized seizures and typical spike-wave EEG patterns, in whom an unexpected temporal lobe astrocytoma was detected by MRI studies. Clinical and electrophysiological studies were performed before and after surgical excision of the tumor and apical temporal lo...

    journal_title:Stereotactic and functional neurosurgery

    pub_type: 杂志文章

    doi:10.1159/000098729

    authors: Velasco M,Velasco F,Boleaga B,Ondarza R,Velasco AL

    更新日期:1995-01-01 00:00:00

  • Surgical therapy of temporal lobe seizures.

    abstract::Resection of epileptogenic lesions and pathological studies were performed in all 35 patients with temporal lobe epilepsy, 20 male and 15 female. Their ages ranged from 6 to 48 years with an average of 22 years. Various examinations including CT scan were carried out without any positive finding. EEG showed spike form...

    journal_title:Stereotactic and functional neurosurgery

    pub_type: 杂志文章

    doi:

    authors: Liu Z,Tian Z,Kang G,Cheng L,Li S,Chen X,Fin H,Zui S

    更新日期:1992-01-01 00:00:00

  • Bilateral subthalamic deep brain stimulation for camptocormia associated with Parkinson's disease.

    abstract:BACKGROUND:Few multiple case studies of the effects of deep brain stimulation for camptocormia associated with Parkinson's disease have been reported. Although deep brain stimulation was in some cases not effective against camptocormia, it is unclear in which types of patients it was effective in treating camptocormia....

    journal_title:Stereotactic and functional neurosurgery

    pub_type: 杂志文章

    doi:10.1159/000324907

    authors: Asahi T,Taguchi Y,Hayashi N,Hamada H,Dougu N,Takashima S,Tanaka K,Endo S

    更新日期:2011-01-01 00:00:00

  • Citation measures in stereotactic radiosurgery: publication across a discipline.

    abstract:OBJECTIVE:It is possible to judge the impact of scientific research by the number of citations a publication has received. We identified the most cited works in the field of stereotactic radiosurgery to study the evolution of this field from the perspective of publication. METHODS:A Web of Science search was performed...

    journal_title:Stereotactic and functional neurosurgery

    pub_type: 杂志文章,评审

    doi:10.1159/000322277

    authors: Kondziolka D

    更新日期:2011-01-01 00:00:00

  • Tremor and skeletal muscle tone.

    abstract::Stereotactic interventions at thalamic/subthalamic levels for parkinsonian tremor give the chance to investigate the influence of the supraspinal proprioceptive loops on the tonic component of motor tasks. Studies demonstrate not only a normalization of the late stretch reflex component and a decrease of the pre-refle...

    journal_title:Stereotactic and functional neurosurgery

    pub_type: 杂志文章

    doi:10.1159/000100603

    authors: Struppler A

    更新日期:1993-01-01 00:00:00

  • Selectivity of retrogasserian glycerol rhizotomy in the treatment of trigeminal neuralgia.

    abstract::The possibility of obtaining a selective effect on different trigeminal branches by glycerol rhizotomy was studied in the treatment of trigeminal neuralgia. Transcutaneous electrical stimulation was used to quantify sensory impairment. An attempt was made to direct the neurotoxic effect by maintaining the patient's he...

    journal_title:Stereotactic and functional neurosurgery

    pub_type: 杂志文章

    doi:10.1159/000099402

    authors: Bergenheim AT,Hariz MI,Laitinen LV

    更新日期:1991-01-01 00:00:00

  • A tremulous twiddler.

    abstract::Twiddler's syndrome describes the intentional external manipulation or spontaneous rotation of implanted devices such as cardiac pacemakers. Here we report the same phenomenon occurring in a patient with an implanted deep brain stimulator generator. The clinical syndrome is described and potential technical nuances to...

    journal_title:Stereotactic and functional neurosurgery

    pub_type: 杂志文章

    doi:10.1159/000155231

    authors: Israel Z,Spivak A

    更新日期:2008-01-01 00:00:00

  • Radiosurgical treatment of meningiomas.

    abstract::From January 1992 to November 1996, 17 patients with the diagnosis of intracranial meningioma underwent radiosurgical treatment. Of these, 7 patients were treated using a Linac-based system (group 1), and 10 using the Leksell Gamma Knife unit (group 2). The follow-up ranged between 12 and 48 (median 33) months for gro...

    journal_title:Stereotactic and functional neurosurgery

    pub_type: 杂志文章

    doi:10.1159/000099869

    authors: Zamorano L,Saenz A,Matter A,Buciuc R,Gaspar L,Fontanesi J,Garzon A,Diaz F

    更新日期:1997-01-01 00:00:00

  • Acoustic neurinomas with macrocysts treated with Gamma Knife radiosurgery.

    abstract::Six cases of acoustic neurinomas with macrocystic components are presented. In three cases the cystic portion was within the tumor, while in the other three, the cyst was peritumoral, in the form of a cul-de-sac within the arachnoid, in other words it was not a true tumor cyst. The six tumors are from a series of 74 a...

    journal_title:Stereotactic and functional neurosurgery

    pub_type: 杂志文章

    doi:10.1159/000099775

    authors: Pendl G,Ganz JC,Kitz K,Eustacchio S

    更新日期:1996-01-01 00:00:00

  • Stereotactic radiosurgery: current status and future trends.

    abstract::The first Gamma Knife was installed in Stockholm in 1968 after nearly two decades of development. Following the opening of the Gamma Knife facility in Pittsburgh in 1987, radiosurgery has seen an explosive expansion. Along with this expansion there has been a development of alternative technologies, of which the most ...

    journal_title:Stereotactic and functional neurosurgery

    pub_type: 杂志文章

    doi:

    authors: Leksell DG

    更新日期:1993-01-01 00:00:00

  • Outcome of Internal Neurolysis for Trigeminal Neuralgia without Neurovascular Compression and Its Relationship with Intraoperative Trigeminocardiac Reflex.

    abstract:BACKGROUND:Internal neurolysis (IN) is an effective surgical treatment for trigeminal neuralgia (TN) without neurovascular compression (NVC) or postoperative recurrence. However, the trigeminal nerve is directly manipulated during the procedure, and there is a high incidence of trigeminocardiac reflex (TCR). The aim of...

    journal_title:Stereotactic and functional neurosurgery

    pub_type: 杂志文章

    doi:10.1159/000493547

    authors: Wu M,Jiang X,Niu C,Fu X

    更新日期:2018-01-01 00:00:00

  • Comparison of MRI and ventriculographic target acquisition for posteroventral pallidotomy.

    abstract::The true accuracy of MRI scanners utilized for target acquisition in functional stereotaxis remains undefined. We have performed pallidotomies at the Loma Linda University Medical Center using both MRI and MRI concomitant with positive contrast ventriculography. A retrospective study of 33 cases revealed significant d...

    journal_title:Stereotactic and functional neurosurgery

    pub_type: 杂志文章

    doi:10.1159/000098897

    authors: Mandybur G,Morenski J,Kuniyoshi S,Iacono RP

    更新日期:1995-01-01 00:00:00

  • Deep brain stimulation parameters associated with neuropsychological changes in subthalamic nucleus stimulation for refractory Parkinson's disease.

    abstract:BACKGROUND/AIMS:Parkinson's disease (PD) is an idiopathic progressive neurological disorder. Improvement in motor function of PD patients has been established with subthalamic nucleus (STN) deep brain stimulation (DBS). While variations in DBS settings (i.e. amplitude, frequency and pulse width) on motor function have ...

    journal_title:Stereotactic and functional neurosurgery

    pub_type: 临床试验,杂志文章

    doi:10.1159/000163554

    authors: Schoenberg MR,Mash KM,Bharucha KJ,Francel PC,Scott JG

    更新日期:2008-01-01 00:00:00

  • Propofol Anesthesia Precludes LFP-Based Functional Mapping of Pallidum during DBS Implantation.

    abstract:BACKGROUND/AIMS:There are reports that microelectrode recording (MER) can be performed under certain anesthetized conditions for functional confirmation of the optimal deep brain stimulation (DBS) target. However, it is generally accepted that anesthesia affects MER. Due to a potential role of local field potentials (L...

    journal_title:Stereotactic and functional neurosurgery

    pub_type: 杂志文章

    doi:10.1159/000492231

    authors: Malekmohammadi M,Sparks H,AuYong N,Hudson A,Pouratian N

    更新日期:2018-01-01 00:00:00

  • Intraparenchymal cyst development after deep brain stimulator placement.

    abstract::Following deep brain stimulation (DBS) surgery, a variety of potential mechanical or functional complications ranging from perioperative events to hardware malfunction may occur. We present 2 patients who developed a unique complication of cyst formation at the tip of the DBS electrode in the absence of infection. One...

    journal_title:Stereotactic and functional neurosurgery

    pub_type: 杂志文章

    doi:10.1159/000350021

    authors: Ramirez-Zamora A,Levine D,Sommer DB,Dalfino J,Novak P,Pilitsis JG

    更新日期:2013-01-01 00:00:00

  • Recommissioning of the Sheffield Gamma Knife Unit following a source change.

    abstract::Reinstallation of the Sheffield Gamma Knife Unit was completed in early November, 1991, following the replacement of the cobalt sources. Two methods were used to evaluate the isodose configuration within the replenished unit. The first method used a scanning microdensitometer to interrogate films exposed within a sphe...

    journal_title:Stereotactic and functional neurosurgery

    pub_type: 杂志文章

    doi:10.1159/000100672

    authors: Walton L,Griffiths LM,Hampshire A

    更新日期:1993-01-01 00:00:00

  • Complications of deep brain stimulation surgery.

    abstract::Although technological advances have reduced device-related complications, DBS surgery still carries a significant risk of transient and permanent complications. We report our experience in 86 patients and 149 DBS implants. Patients with Parkinson's disease, essential tremor and dystonia were treated. There were 8 per...

    journal_title:Stereotactic and functional neurosurgery

    pub_type: 杂志文章

    doi:10.1159/000064600

    authors: Beric A,Kelly PJ,Rezai A,Sterio D,Mogilner A,Zonenshayn M,Kopell B

    更新日期:2001-01-01 00:00:00

  • Pressure monitoring inside Meckel's cave during percutaneous microcompression of gasserian ganglion.

    abstract::During percutaneous microcompression of the gasserian ganglion for the relief of trigeminal neuralgia, a computerized technique for monitoring the pressure inside Meckel's cave was employed in 22 patients. A dedicated transducer connected to a computer records the balloon inflation pressure. Its variations are discern...

    journal_title:Stereotactic and functional neurosurgery

    pub_type: 杂志文章

    doi:10.1159/000099391

    authors: Zanusso M,Curri D,Landi A,Colombo F,Volpin L,Cervellini P

    更新日期:1991-01-01 00:00:00

  • Efficacy of corticosteroids in hearing preservation after radiosurgery for vestibular schwannoma: a prospective study.

    abstract:OBJECTIVES:We prospectively investigated the efficacy of corticosteroid medication in salvaging acute hearing deterioration after radiosurgery for vestibular schwannoma (VS) and analyzed prognostic factors for hearing preservation. METHODS:Forty-one patients with serviceable hearing treated with gamma knife radiosurge...

    journal_title:Stereotactic and functional neurosurgery

    pub_type: 临床试验,杂志文章

    doi:10.1159/000321913

    authors: Kim JW,Kim DG,Paek SH,Chung HT,Kim YH,Han JH,Park CK,Jung HW

    更新日期:2011-01-01 00:00:00

  • Release of neurotransmitters in the CNS by spinal cord stimulation: survey of present state of knowledge and recent experimental studies.

    abstract::Electric stimulation applied to the posterior surface of the spinal cord (SCS) is an established treatment in certain chronic pain syndromes resistant to conventional therapeutic procedures. Despite the clinical value of SCS, the mechanisms behind the efficacy of the method are largely unknown. Several neurotransmitte...

    journal_title:Stereotactic and functional neurosurgery

    pub_type: 杂志文章

    doi:10.1159/000100634

    authors: Linderoth B,Stiller CO,Gunasekera L,O'Connor WT,Franck J,Gazelius B,Brodin E

    更新日期:1993-01-01 00:00:00

  • Peri- and postoperative magnetic resonance imaging localization of pallidotomy.

    abstract::Postoperative magnetic resonance imaging (MRI) of basal ganglia functional lesions illustrates the accuracy of preoperative target localization. The technique of perioperative MRI and CT localization for pallidotomy will be discussed and correlated with the center of the lesion on postoperative standard MRI as well as...

    journal_title:Stereotactic and functional neurosurgery

    pub_type: 杂志文章

    doi:10.1159/000098598

    authors: Lehman RM,Mezrich R,Sage J,Goldbe L

    更新日期:1994-01-01 00:00:00