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

被引：80

作者：

Elias, Gavin J. B. ^{[1
,2
,3
]}

Boutet, Alexandre ^{[1
,2
,3
,4
]}

Joel, Suresh E. ^{[5
]}

Germann, Jurgen ^{[1
,2
]}

Gwun, Dave ^{[1
,2
]}

Neudorfer, Clemens ^{[1
,2
]}

Gramer, Robert M. ^{[1
,2
]}

Algarni, Musleh ^{[3
,6
,7
]}

Paramanandam, Vijayashankar ^{[3
,6
,7
]}

Prasad, Sreeram ^{[3
,6
,7
]}

Beyn, Michelle E. ^{[1
,2
]}

Horn, Andreas ^{[8
]}

Madhavan, Radhika ^{[5
]}

Ranjan, Manish ^{[1
,2
]}

Lozano, Christopher S. ^{[1
,2
]}

Kuhn, Andrea A. ^{[8
]}

Ashe, Jeff ^{[5
]}

Kucharczyk, Walter ^{[3
,4
]}

Munhoz, Renato P. ^{[3
,6
,7
]}

Giacobbe, Peter ^{[9
]}

Kennedy, Sidney H. ^{[3
,10
]}

Woodside, D. Blake ^{[10
]}

Kalia, Suneil K. ^{[1
,2
,3
]}

Fasano, Alfonso ^{[3
,6
,7
]}

Hodaie, Mojgan ^{[1
,2
,3
]}

Lozano, Andres M. ^{[1
,2
,3
]}

机构：

[1] Univ Hlth Network, Div Neurosurg, Dept Surg, Toronto, ON, Canada

[2] Univ Toronto, Toronto, ON, Canada

[3] Univ Toronto, Krembil Res Inst, Toronto, ON, Canada

[4] Univ Toronto, Joint Dept Med Imaging, Toronto, ON, Canada

[5] GE Global Res, Toronto, ON, Canada

[6] Univ Hlth Network, Edmond J Safra Program Parkinsons Dis, Toronto, ON, Canada

[7] Univ Hlth Network, Morton & Gloria Shulman Movement Disorders Clin, Toronto, ON, Canada

[8] Charite, Dept Neurol, Movement Disorders & Neuromodulat Unit, Berlin, Germany

[9] Univ Toronto, Sunnybrook Res Inst, Dept Psychiat, Sunnybrook Hlth Sci Ctr, Toronto, ON, Canada

[10] Univ Hlth Network, Ctr Mental Hlth, Toronto, ON, Canada

来源：

ANNALS OF NEUROLOGY | 2021年 / 89卷 / 03期

基金：

加拿大健康研究院;

关键词：

REFRACTORY ANOREXIA-NERVOSA; PARKINSONS-DISEASE PATIENTS; GLOBUS-PALLIDUS INTERNUS; HUMAN CEREBRAL-CORTEX; MODEL-BASED ANALYSIS; CAUDAL ZONA INCERTA; SUBCALLOSAL CINGULATE; SUBTHALAMIC NUCLEUS; STRUCTURAL CONNECTIVITY; ELECTRIC-FIELD;

D O I：

10.1002/ana.25975

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

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 2020

引用

页码：426 / 443

页数：18

共 121 条

[1] Refining the Deep Brain Stimulation Target within the Limbic Globus Pallidus Internus for Tourette Syndrome [J].