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1. Use of quantitative tremor evaluation to enhance target selection during deep brain stimulation surgery for essential tremor

Author

Simone Hemm-Ode, Jean-Jacques Lemaire, Erik Schkommodau, Ashesh Shah, Jerome Coste, Institute for Medical and Analytical Technologies, School of Life Sciences (IMA), University of Applied Sciences and Arts Northwestern Switzerland (HES-SO), Service de Neurochirurgie [Clermont-Ferrand], CHU Clermont-Ferrand-CHU Gabriel Montpied [Clermont-Ferrand], CHU Clermont-Ferrand, Institut Pascal (IP), SIGMA Clermont (SIGMA Clermont)-Centre National de la Recherche Scientifique (CNRS)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020]), University of Applied Sciences and Arts Northwestern Switzerland (FHNW), German Society for Biomedical Engineering, Apport de l'accélérométrie à la stimulation cérébrale - 2011-A00774-37 - CHU de Clermont-Ferrand, Service de Neurochirurgie [CHU Clermont-Ferrand], CHU Gabriel Montpied [Clermont-Ferrand], CHU Clermont-Ferrand-CHU Clermont-Ferrand, and SIGMA Clermont (SIGMA Clermont)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020])-Centre National de la Recherche Scientifique (CNRS)

Subjects
medicine.medical_specialty, Deep brain stimulation, Essential tremor, business.industry, [SDV.NEU.NB]Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC]/Neurobiology, medicine.medical_treatment, Thalamus, Biomedical Engineering, Stimulation, medicine.disease, nervous system diseases, deep brain stimulation, Physical medicine and rehabilitation, thalamus, Evaluation methods, medicine, accelerometry, Medicine, [INFO.INFO-BI]Computer Science [cs]/Bioinformatics [q-bio.QM], business, Surgical treatment, essential tremor, Deep brain stimulation surgery
Abstract

Deep brain stimulation (DBS), an effective surgical treatment for Essential Tremor (ET), requires test stimulations in the thalamus to find the optimum site for permanent electrode implantation. During these test stimulations, the changes in tremor are only visually evaluated. This, along with other parameters, increases the subjectivity when comparing the efficacy of different thalamic nuclei. We developed a method to quantitatively evaluate tremor during the test stimulations of DBS surgery and applied to 6 ET patients undergoing this treatment. From the quantitative data collected, we identified effective stimulation amplitudes for every test stimulation position and compared it with the ones identified visually during the surgery. We also classified the data based on the thalamic nuclei in which the center of the stimulating contact was present during test stimulations. Results indicate that, to achieve the same reduction in tremor, on average, the stimulation amplitude identified by our method was 0.6 mA lower than those identified by visual evaluation. The comparison of the different thalamic nuclei showed that stimulations in the Ventro-oral and the Intermediolateral nuclei of the thalamus result in higher reduction in tremor for similar stimulation amplitudes as the frequently targeted Ventrointermediate nucleus. We conclude that our quantitative tremor evaluation method is more sensitive than the widely used visual evaluation. Using such quantitative methods will aid in identifying the optimum target structure for patients undergoing DBS.

Published
2015
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2. Intraoperative acceleration measurements to quantify improvement in tremor during deep brain stimulation surgery

Author

Jean-Jacques Lemaire, W. M. Michael Schüpbach, Claudio Pollo, Ethan Taub, Simone Hemm-Ode, Jerome Coste, Erik Schkommodau, Raphael Guzman, Ashesh Shah, Institute for Medical and Analytical Technologies, School of Life Sciences (IMA), University of Applied Sciences and Arts Northwestern Switzerland (FHNW), Thérapie guidée par l'image (TGI), Institut Pascal (IP), SIGMA Clermont (SIGMA Clermont)-Centre National de la Recherche Scientifique (CNRS)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020])-SIGMA Clermont (SIGMA Clermont)-Centre National de la Recherche Scientifique (CNRS)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020]), Service de Neurochirurgie [Clermont-Ferrand], CHU Clermont-Ferrand-CHU Gabriel Montpied [Clermont-Ferrand], CHU Clermont-Ferrand, SIGMA Clermont (SIGMA Clermont)-Centre National de la Recherche Scientifique (CNRS)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020]), Departments of Neurosurgery and Biomedicine, University Hospital Basel [Basel], Institut du Cerveau et de la Moëlle Epinière = Brain and Spine Institute (ICM), Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Department of Neurology, University Hospital, Bern-University of Bern, Department of Neurosurgery, University Hospital, Bern, This research was funded by the Swiss National Science Foundation and partly by the Germainede Staël program of the Swiss Academy of Engineering Sciences. The experimental procedures were approved by the respective Institutional Ethics Committee (Center1: 2011-A00774-37/AU905, Center 2: 2365—multicenter study together with the UniversityHospital in Basel), Apport de l'accélérométrie à la stimulation cérébrale - 2011-A00774-37 - CHU de Clermont-Ferrand, SIGMA Clermont (SIGMA Clermont)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020])-Centre National de la Recherche Scientifique (CNRS)-SIGMA Clermont (SIGMA Clermont)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020])-Centre National de la Recherche Scientifique (CNRS), Service de Neurochirurgie [CHU Clermont-Ferrand], CHU Gabriel Montpied [Clermont-Ferrand], CHU Clermont-Ferrand-CHU Clermont-Ferrand, SIGMA Clermont (SIGMA Clermont)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020])-Centre National de la Recherche Scientifique (CNRS), Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Centre National de la Recherche Scientifique (CNRS), and Coste, Jérôme

Subjects
medicine.medical_specialty, Movement disorders, Deep brain stimulation, Parkinson's disease, medicine.medical_treatment, [SDV.NEU.NB]Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC]/Neurobiology, 0206 medical engineering, Acceleration, Biomedical Engineering, 610 Medicine & health, 02 engineering and technology, Wrist, Neurosurgical Procedures, 03 medical and health sciences, 0302 clinical medicine, Physical medicine and rehabilitation, Tremor, Medicine, Humans, Lead (electronics), Intraoperative monitoring, [SDV.IB] Life Sciences [q-bio]/Bioengineering, [SDV.MHEP] Life Sciences [q-bio]/Human health and pathology, Movement Disorders, Essential tremor, business.industry, [SDV.NEU.NB] Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC]/Neurobiology, Brain, medicine.disease, 020601 biomedical engineering, Computer Science Applications, Electrodes, Implanted, nervous system diseases, medicine.anatomical_structure, Physical therapy, Parkinson’s disease, [SDV.IB]Life Sciences [q-bio]/Bioengineering, Implant, medicine.symptom, business, 030217 neurology & neurosurgery, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract

International audience; Deep brain stimulation (DBS) surgery is extensively used in the treatment of movement disorders. Nevertheless, methods to evaluate the clinical response during intraoperative stimulation tests to identify the optimal position for the implantation of the chronic DBS lead remain subjective. In this paper, we describe a new, versatile method for quantitative intraoperative evaluation of improvement in tremor with an acceleration sensor that is mounted on the patient's wrist during surgery. At each anatomical test position, the improvement in tremor compared to the initial tremor is estimated on the basis of extracted outcome measures. This method was tested on 15 tremor patients undergoing DBS surgery in two centers. Data from 359 stimulation tests were acquired. Our results suggest that accelerometric evaluation detects tremor changes more sensitively than subjective visual ratings. The effective stimulation current amplitudes identified from the quantitative data (1.1 ± 0.8 mA) are lower than those identified by visual evaluation (1.7 ± 0.8 mA) for similar improvement in tremor. Additionally, if these data had been used to choose the chronic implant position of the DBS lead, 15 of the 26 choices would have been different. These results show that our method of accelerometric evaluation can potentially improve DBS targeting.

Published
2017
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3. Using acceleration sensors to identify rigidity release threshold during Deep Brain Stimulation surgery

Author

Shah, Ashesh, Coste, Jerome, Lemaire, Jean-Jacques, Schkommodau, Erik, Guzman, Raphael, Taub, Ethan, Hemm-Ode, Simone, Institute for Medical and Analytical Technologies, School of Life Sciences (IMA), University of Applied Sciences and Arts Northwestern Switzerland (FHNW), Service de Neurochirurgie [Clermont-Ferrand], CHU Clermont-Ferrand-CHU Gabriel Montpied [Clermont-Ferrand], CHU Clermont-Ferrand, Institut Pascal (IP), SIGMA Clermont (SIGMA Clermont)-Centre National de la Recherche Scientifique (CNRS)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020]), Departments of Neurosurgery and Biomedicine, University Hospital Basel [Basel], Department of Biomedical Engineering (IMT), Linköping University (LIU), This research has been supported by the Swiss National Science Foundation (SNSF) and the Germaine de Stael program. Study approuved: CHU de Clermont-Ferrand, France (clinical study 2011-A00774-37 / AU905)., EMBS, Apport de l'accélérométrie à la stimulation cérébrale - 2011-A00774-37 - CHU de Clermont-Ferrand, Service de Neurochirurgie [CHU Clermont-Ferrand], CHU Gabriel Montpied [Clermont-Ferrand], CHU Clermont-Ferrand-CHU Clermont-Ferrand, and SIGMA Clermont (SIGMA Clermont)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020])-Centre National de la Recherche Scientifique (CNRS)

Subjects
ACTI, [SDV.NEU.NB]Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC]/Neurobiology, [INFO.INFO-IM]Computer Science [cs]/Medical Imaging, [SDV.MHEP.CHI]Life Sciences [q-bio]/Human health and pathology/Surgery, ComputingMilieux_MISCELLANEOUS
Abstract

International audience

Published
2015

4. Correlation analysis between quantitatively analyzed stimulation effects and anatomical position during deep brain stimulation surgery

Author

Shah, Ashesh, Coste, Jerome, Lemaire, Jean-Jacques, Schkommodau, Erik, Hemm-Ode, Simone, Institute for Medical and Analytical Technologies, School of Life Sciences (IMA), University of Applied Sciences and Arts Northwestern Switzerland (FHNW), Service de Neurochirurgie [Clermont-Ferrand], CHU Clermont-Ferrand-CHU Gabriel Montpied [Clermont-Ferrand], CHU Clermont-Ferrand, Institut Pascal (IP), SIGMA Clermont (SIGMA Clermont)-Centre National de la Recherche Scientifique (CNRS)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020]), University of Applied Sciences and Arts Northwestern Switzerland (HES-SO), Department of Science and Technology [Linköping], Linköping University (LIU), European Society for Stereotactic and Functional Neurosurgery (ESSFN), Apport de l'accélérométrie à la stimulation cérébrale - 2011-A00774-37 - CHU de Clermont-Ferrand, Service de Neurochirurgie [CHU Clermont-Ferrand], CHU Gabriel Montpied [Clermont-Ferrand], CHU Clermont-Ferrand-CHU Clermont-Ferrand, and SIGMA Clermont (SIGMA Clermont)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020])-Centre National de la Recherche Scientifique (CNRS)

Subjects
[SPI]Engineering Sciences [physics], [SDV.NEU.NB]Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC]/Neurobiology, [INFO.INFO-MO]Computer Science [cs]/Modeling and Simulation
Abstract

International audience; Introduction:DBS is a routinely performed surgical procedure for treatment of movement disorders like Essential Tremor (ET). However, the target selection in DBS is not fully optimized. Incomplete knowledge of the mechanisms of action being one of the reasons, we believe, suboptimal usage of information during surgery is another. We have previously demonstrated the use acceleration sensors to quantify changes in patient tremor during deep brain stimulation surgery. In this paper, we would like to analyze the correlation of the acceleration data results with the different deep brain structures. We present in this paper the result from 5 ET patients implanted in the VIM. Methods: A 3 axis acceleration sensor was used to record and quantify changes in the patient's tremor while test stimulations were performed during DBS surgery using the method described previously. During surgery, for every test stimulation position, the maximum change in patient's tremor and the stimulation amplitude at which it was observed subjectively were noted. As the acceleration data was continuously recorded, it was possible, from offline analysis, to find stimulation amplitudes for changes in statistical features equal to those found subjectively. Additionally, the stimulation amplitudes at which acceleration data suggested maximum change in tremor were also identified for every test stimulation position. For the anatomical analysis, the surgical team carefully identified the anatomical location of the electrode and attributed one thalamic sub-structure to it. Based on this information, the change in tremor and its corresponding stimulation amplitude were grouped into respective sub-structures. For the identification of most effective anatomical sub-structures, we checked for higher reduction in tremor at lower amplitude, both for subjective evaluations and acceleration data analysis. This method was applied to acceleration data collected from 5 Essential tremor patients under a clinical study in University Hospital in Clermont-Ferrand France. A total of 107 test stimulations were analyzed. The different sub-structures of the thalamus have been named according to the previously published nomenclature. Results: The 107 different test stimulation positions were found to be distributed in different parts of the thalamus: Intermedio-Lateral (InL, n=20), Ventro-Oral (VO, n=16), VIM (n=37), Ventro-Caudal-Lateral (VCL, n=2), Central-Medial (CM, n=3), Ventro-Caudal-Medial (VCM, n=23) and the PreLemniscal Radiations (PLR n=6). As the number of test stimulations in the VCL, CM and PLR is low, the significance of the results is very low.For the other structures, the effective stimulation amplitudes for the same clinical effect were lower for acceleration data than the subjective ones (p75%) was on average lower in the VO (1.8 mA) and in VCM (1.9 mA) as compared to the VIM (2.5 mA) and in InL (2.5 mA). Conclusion:The use of sensitive acceleration measurements during the surgery introduces a new approach to analyze the effectiveness of stimulation in different target structures. Our results suggest that the VCM is a better target than the VIM. This information should be considered during the planning of the exploration paths to have more contacts in the effective thalamic area. However, the current analysis does not take into considerations stimulation induced side effects. Those influence the final implant position significantly and can alter our conclusion. Also, attributing one stimulation position to just one structure considering it as a point is suboptimal. A better approach would be to simulate the stimulated volume by using electric field simulations. Along with additional analysis of the results with reference to the known mechanisms of actions of DBS they may result in increasing our understanding of DBS efficiency.

Published
2014
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5. Acceleration measurements to quantify changes in rigidity during deep brain stimulation surgery

Author

Shah, A. A., Jérôme Coste, Lemaire, J. J., Ulla, M., Schkommodau, E., Hemm-Ode, S., Institute for Medical and Analytical Technologies, School of Life Sciences (IMA), University of Applied Sciences and Arts Northwestern Switzerland (FHNW), Service de Neurochirurgie [Clermont-Ferrand], CHU Clermont-Ferrand-CHU Gabriel Montpied [Clermont-Ferrand], CHU Clermont-Ferrand, Institut Pascal (IP), SIGMA Clermont (SIGMA Clermont)-Centre National de la Recherche Scientifique (CNRS)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020]), Image Guided Clinical Neurosciences and Connectomics (IGCNC), Université d'Auvergne - Clermont-Ferrand I (UdA), Service de Neurologie [CHU Clermont-Ferrand], CHU Estaing [Clermont-Ferrand], CHU Clermont-Ferrand-CHU Clermont-Ferrand-CHU Gabriel Montpied [Clermont-Ferrand], Neuro-Psycho Pharmacologie des Systèmes Dopimanégiques sous-corticaux (NPsy-Sydo), CHU Clermont-Ferrand-Université Clermont Auvergne [2017-2020] (UCA [2017-2020]), International Parkinson and Movement Disorder Society, Apport de l'accélérométrie à la stimulation cérébrale - 2011-A00774-37 - CHU de Clermont-Ferrand, Service de Neurochirurgie [CHU Clermont-Ferrand], CHU Gabriel Montpied [Clermont-Ferrand], CHU Clermont-Ferrand-CHU Clermont-Ferrand, SIGMA Clermont (SIGMA Clermont)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020])-Centre National de la Recherche Scientifique (CNRS), and CHU Clermont-Ferrand-CHU Clermont-Ferrand-CHU Estaing [Clermont-Ferrand]

Subjects
[SPI]Engineering Sciences [physics], [SDV.NEU.NB]Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC]/Neurobiology
Abstract

Objective The aim of the present study was to evaluate the feasibility to objectively assess clinical effects on rigidity obtained during intraoperative test stimulation based on acceleration measurements. Background Deep brain stimulation (DBS) has few uncertainties associated with suboptimal target selection. The feasibility of using acceleration measurements to evaluate tremor quantitatively during DBS surgery has been shown earlier (1). However to be able to quantitatively evalute the clinical effects of intraoperative stimulation on Parkinson's disease patients it is important to take rigidity as a symptom into consideration. Methods 3 patients referred for bilateral sub thalamic nucleus DBS implantation were included in the study. To quantitatively evaluate rigidity a 3 axis acceleration sensor was fixed to the neurologist's wrist during the evaluation of the patient. Accelerometer data was post operatively analyzed statistical features were extracted similar to those in (1) with the same method but with different cut off frequencies for the filters. The effective stimulation amplitudes (thresholds) were identified. Wilcoxon two sided rank test was used to identify the significance of changes in the statistical features 1) before and at thresholds identified by medical experts and 2) those before and at thresholds found using acceleration data alone. Results Out of the calculated statistical features standard deviation signal energy and peak frequency amplitude were the most sensitive to changes in patient rigidity. The changes in the features when compared to baseline were in the range of 0 40. The thresholds identified based on acceleration data were lower in 40 of the cases compared to the one chosen by the neurologist. The results of the statistical test showed higher significance for the changes at the acceleration thresholds than the ones identified subjectively. Conclusion The results of this study suggest that acceleration measurements of the neurologist's wrist can be used to quantitatively evaluate the changes in patient's rigidity. This simple method may provide additional support to the neurosurgeon in selecting the optimal target even if identified changes (0 40) are less significant than for tremor (0 99).

Published
2014
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6. Quantifying changes in patient tremor using accelerometer during deep brain stimulation surgery

Author

Ashesh Shah, Jérôme Coste, Jean-Jacques Lemaire, Erik Schkommodau, Simone Hemm-Ode, Institute for Medical and Analytical Technologies, School of Life Sciences (IMA), University of Applied Sciences and Arts Northwestern Switzerland (FHNW), Service de Neurochirurgie [CHU Clermont-Ferrand], CHU Gabriel Montpied [Clermont-Ferrand], CHU Clermont-Ferrand-CHU Clermont-Ferrand, Image Guided Clinical Neurosciences and Connectomics (IGCNC), Université d'Auvergne - Clermont-Ferrand I (UdA), Apport de l'accélérométrie à la stimulation cérébrale - 2011-A00774-37 - CHU de Clermont-Ferrand, Service de Neurochirurgie [Clermont-Ferrand], CHU Clermont-Ferrand-CHU Gabriel Montpied [Clermont-Ferrand], and CHU Clermont-Ferrand

Subjects
[SPI]Engineering Sciences [physics], [SDV.NEU]Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC]
Abstract

International audience; Objective Deep brain stimulation (DBS), a routine neurosurgical treatment for movement related disorders, has few uncertainties associated with suboptimal target selection. Our aim is to evaluate the feasibility to objectively assess clinical effects on tremor obtained during intraoperative test stimulation based on acceleration measurements. Methods Five patients (1 Parkinson's disease and 4 Essential Tremor) referred for bilateral DBS-implantation were included in the study. Tremor was evaluated by fixing a 3-axis accelerometer on the patient's wrist during intraoperative test stimulation. The accelerometer data was post-operatively analyzed, statistical features were extracted and effective stimulation amplitudes (thresholds) identified (Fig 1). Wilcoxon two sided rank test was used to identify significance of changes in the statistical values before and at thresholds identified by medical experts and those before and at thresholds found using acceleration data alone. Results Out of the statistical features identified, the standard deviation, signal energy and peak frequency amplitude were the most sensitive to changes in patient tremor. The thresholds identified based on acceleration data were lower in 65% of the cases compared to the one chosen by the neurologist. The results of the statistical test showed higher significance for the changes at the acceleration thresholds than the ones identified subjectively.

Published
2013

7. A method to quantitatively evaluate changes in tremor during deep brain stimulation surgery

Author

Jerome Coste, Simone Hemm-Ode, Jean-Jacques Lemaire, Erik Schkommodau, Ashesh Shah, Institute for Medical and Analytical Technologies, School of Life Sciences (IMA), University of Applied Sciences and Arts Northwestern Switzerland (FHNW), Service de Neurochirurgie [CHU Clermont-Ferrand], CHU Gabriel Montpied [Clermont-Ferrand], CHU Clermont-Ferrand-CHU Clermont-Ferrand, Image Guided Clinical Neurosciences and Connectomics (IGCNC), Université d'Auvergne - Clermont-Ferrand I (UdA), Apport de l'accélérométrie à la stimulation cérébrale - 2011-A00774-37 - CHU de Clermont-Ferrand, Service de Neurochirurgie [Clermont-Ferrand], CHU Clermont-Ferrand-CHU Gabriel Montpied [Clermont-Ferrand], and CHU Clermont-Ferrand

Subjects
medicine.medical_specialty, Deep brain stimulation, medicine.medical_treatment, [SDV.NEU.NB]Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC]/Neurobiology, 0206 medical engineering, Symptomatic treatment, Acceleration, Trajectory, Stimulation, 02 engineering and technology, Electromyography, Wrist, 03 medical and health sciences, 0302 clinical medicine, Physical medicine and rehabilitation, Satellite broadcasting, Medicine, medicine.diagnostic_test, business.industry, Neurophysiology, 020601 biomedical engineering, medicine.anatomical_structure, Brain stimulation, Feature extraction, Surgery, [SDV.IB]Life Sciences [q-bio]/Bioengineering, Accelerometers, business, 030217 neurology & neurosurgery, Deep brain stimulation surgery
Abstract

International audience; Deep Brain Stimulation (DBS) surgery is used increasingly as a symptomatic treatment for patients with movement related neuro-degenerative disorders. However, the method of intraoperative symptom evaluation is subjective. This paper proposes a method to quantitatively evaluate tremor by measuring the acceleration of the patient's wrist during the surgery. The results of applying the method to 2 patients suggest that the acceleration measurements are very sensitive to the change in the tremor and that they can be used to identify clinically effective stimulation amplitudes. By collecting acceleration data from DBS surgeries for many patients, we hope to add more knowledge to the mechanisms of deep brain stimulation.

Published
2013
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8. Using acceleration to quantify symptoms during deep brain stimulation surgery

Author

Jerome Coste, Erik Schkommodau, Jean-Jacques Lemaire, Simone Hemm-Ode, Ashesh Shah, Institute for Medical and Analytical Technologies, School of Life Sciences (IMA), University of Applied Sciences and Arts Northwestern Switzerland (FHNW), Service de Neurochirurgie [Clermont-Ferrand], CHU Clermont-Ferrand-CHU Gabriel Montpied [Clermont-Ferrand], CHU Clermont-Ferrand, Image Guided Clinical Neurosciences and Connectomics (IGCNC), Université d'Auvergne - Clermont-Ferrand I (UdA), This research has been supported by the Swiss National Science Foundation (SNSF), Clermont-Ferrand University Hospital and the School of Life Sciences., German Society for Biomedical Engineering, Apport de l'accélérométrie à la stimulation cérébrale - 2011-A00774-37 - CHU de Clermont-Ferrand, Service de Neurochirurgie [CHU Clermont-Ferrand], CHU Gabriel Montpied [Clermont-Ferrand], and CHU Clermont-Ferrand-CHU Clermont-Ferrand

Subjects
medicine.medical_specialty, Deep brain stimulation, General interest, medicine.medical_treatment, [SDV.NEU.NB]Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC]/Neurobiology, 0206 medical engineering, Biomedical Engineering, Stimulation, acceleration measurements, 02 engineering and technology, 03 medical and health sciences, [SPI]Engineering Sciences [physics], 0302 clinical medicine, Physical medicine and rehabilitation, Medicine, business.industry, movement related disorders, 020601 biomedical engineering, deep brain stimulation, Physical therapy, tremor quantification, [SDV.IB]Life Sciences [q-bio]/Bioengineering, Neurosurgery, business, 030217 neurology & neurosurgery, Deep brain stimulation surgery
Abstract

The use of Deep Brain Stimulation (DBS) surgery is increasing as a treatment for movement related disorders. One of the important areas of improvement is the target selection procedure. To do so we measured the acceleration of tremor by sensors in 6 patients during their DBS surgeries to evaluate the changes quantitatively. The post operative data analysis revealed that acceleration measurements are very sensitive to the changes in tremor and that they can be used to identify clinically effective stimulation amplitudes. With the aim to increase objectivity in symptom evaluation we intend to introduce real time analysis so as to provide more information to the neurosurgeon to aid him in his target selection during the surgery. © 2013 by Walter de Gruyter.

Published
2013
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9. A method to quantitatively evaluate tremor during deep brain stimulation surgery

Author

Ashesh Shah, Jérôme Coste, Jean-Jacques Lemaire, Erik Schkommodau, Simone Hemm-Ode, Institute for Medical and Analytical Technologies, School of Life Sciences (IMA), University of Applied Sciences and Arts Northwestern Switzerland (FHNW), Service de Neurochirurgie [CHU Clermont-Ferrand], CHU Gabriel Montpied [Clermont-Ferrand], CHU Clermont-Ferrand-CHU Clermont-Ferrand, Image Guided Clinical Neurosciences and Connectomics (IGCNC), Université d'Auvergne - Clermont-Ferrand I (UdA), CARS, Apport de l'accélérométrie à la stimulation cérébrale - 2011-A00774-37 - CHU de Clermont-Ferrand, Service de Neurochirurgie [Clermont-Ferrand], CHU Clermont-Ferrand-CHU Gabriel Montpied [Clermont-Ferrand], and CHU Clermont-Ferrand

Subjects
Accelerometer, [SDV.NEU.NB]Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC]/Neurobiology, Tremor quantification, Deep brain stimulation, Parkinson’s disease, Essential tremor, [SDV.NEU]Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC], [SDV.IB]Life Sciences [q-bio]/Bioengineering, [SDV.MHEP.CHI]Life Sciences [q-bio]/Human health and pathology/Surgery, nervous system diseases
Abstract

International audience; Deep brain stimulation (DBS) of basal ganglia using surgically implanted electrodes is now an effective and widely-used method to treat neurological movement related disorders such as Parkinson's Disease (PD) and Essential Tremor (ET). The mechanism of action of DBS is not fully understood; optimal target definition is difficult and thus most groups use complementary intraoperative methods. Intraoperative stimulation tests are performed along the predetermined trajectories to evaluate the clinical effects on tremor while gradually increasing the stimulation parameters (voltage/current), determining the thresholds for clinical effects (subjective threshold) and side effects at each anatomical measurement position. Currently, these evaluations are performed semi quantitatively by the neurosurgeon or the neurologist. Our method intends to improve the targeting procedure and make it more objective by measuring the acceleration of the patient's wrist.

Published
2013

10. Acceleration measurements during DBS surgery for tremor

Author

Shah, Ashesh, Coste, Jerome, Ulla, Miguel, Lemaire, Jean-Jacques, Schkommodau, Erik, Hemm-Ode, Simone, Institute for Medical and Analytical Technologies, School of Life Sciences (IMA), University of Applied Sciences and Arts Northwestern Switzerland (FHNW), Service de Neurochirurgie [Clermont-Ferrand], CHU Clermont-Ferrand-CHU Gabriel Montpied [Clermont-Ferrand], CHU Clermont-Ferrand, Image Guided Clinical Neurosciences and Connectomics (IGCNC), Université d'Auvergne - Clermont-Ferrand I (UdA), Service de Neurologie [CHU Clermont-Ferrand], CHU Estaing [Clermont-Ferrand], CHU Clermont-Ferrand-CHU Clermont-Ferrand-CHU Gabriel Montpied [Clermont-Ferrand], Neuro-Psycho Pharmacologie des Systèmes Dopimanégiques sous-corticaux (NPsy-Sydo), CHU Clermont-Ferrand-Université Clermont Auvergne [2017-2020] (UCA [2017-2020]), This research has been supported by the Swiss National Science Foundation (SNSF) and the school of life sciences., Jean-Jacques LEMAIRE, IGCNC, Apport de l'accélérométrie à la stimulation cérébrale - 2011-A00774-37 - CHU de Clermont-Ferrand, Service de Neurochirurgie [CHU Clermont-Ferrand], CHU Gabriel Montpied [Clermont-Ferrand], CHU Clermont-Ferrand-CHU Clermont-Ferrand, and CHU Clermont-Ferrand-CHU Clermont-Ferrand-CHU Estaing [Clermont-Ferrand]

Subjects
[SDV.NEU.NB]Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC]/Neurobiology, [SDV.NEU]Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC], [SDV.IB]Life Sciences [q-bio]/Bioengineering, ComputingMilieux_MISCELLANEOUS
Abstract

International audience

Published
2012

11. Quantitative rigidity evaluation during deep brain stimulation surgery - a preliminary study

Author

Jerome Coste, Dagmar Gmünder, Simone Hemm-Ode, Jean-Jacques Lemaire, Ashesh Shah, Ulla Miguel, Institute for Medical and Analytical Technologies, School of Life Sciences (IMA), University of Applied Sciences and Arts Northwestern Switzerland (FHNW), Service de Neurologie [CHU Clermont-Ferrand], CHU Gabriel Montpied [Clermont-Ferrand], CHU Clermont-Ferrand-CHU Clermont-Ferrand-CHU Estaing [Clermont-Ferrand], CHU Clermont-Ferrand, Neuro-Psycho Pharmacologie des Systèmes Dopimanégiques sous-corticaux (NPsy-Sydo), CHU Clermont-Ferrand-Université Clermont Auvergne [2017-2020] (UCA [2017-2020]), Service de Neurochirurgie [CHU Clermont-Ferrand], CHU Clermont-Ferrand-CHU Clermont-Ferrand, Image Guided Clinical Neurosciences and Connectomics (IGCNC), Université d'Auvergne - Clermont-Ferrand I (UdA), Fond National Suisse de la recherche scientifique, programme franco-suisse «Germaine de Staël», University of Applied Sciences and Arts Northwestern Switzerland, CHU de Clermont-Ferrand., German Society for Biomedical Engineering, Apport de l'accélérométrie à la stimulation cérébrale - 2011-A00774-37 - CHU de Clermont-Ferrand, CHU Estaing [Clermont-Ferrand], CHU Clermont-Ferrand-CHU Clermont-Ferrand-CHU Gabriel Montpied [Clermont-Ferrand], Service de Neurochirurgie [Clermont-Ferrand], and CHU Clermont-Ferrand-CHU Gabriel Montpied [Clermont-Ferrand]

Subjects
medicine.medical_specialty, Deep brain stimulation, medicine.medical_treatment, [SDV.NEU.NB]Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC]/Neurobiology, 0206 medical engineering, Biomedical Engineering, Clinical state, Stimulation, 02 engineering and technology, [SDV.MHEP.CHI]Life Sciences [q-bio]/Human health and pathology/Surgery, Wrist, Accelerometer, Clinical study, 03 medical and health sciences, 0302 clinical medicine, Physical medicine and rehabilitation, Medicine, business.industry, 020601 biomedical engineering, Surgery, nervous system diseases, medicine.anatomical_structure, [SDV.IB]Life Sciences [q-bio]/Bioengineering, business, 030217 neurology & neurosurgery, Deep brain stimulation surgery
Abstract

Introduction Deep brain stimulation (DBS) is a common neurosurgical procedure for relieving movement related disorders such as Parkinson’s disease. DBS extends uncertainties associated with suboptimal target selection. Our aim was to evaluate the feasibility to objectively assess clinical effects obtained during intraoperative test stimulation based on acceleration measurements of the neurologist’s wrist. Methods One patient referred for bilateral DBS-implantation for the treatment of Parkinson’s disease was included in the study. A 3-axis accelerometer was fixed on the neurologist's wrist during intraoperative test stimulation. While the intensity of electric current used for stimulation was increased , the neurologist continuously moved the patient's wrist to determine the moment of and the amplitude at rigidity release ("stimulation threshold"). For each test stimulation position, differrent mathematical features were determined and statistically compared a) for the time period before re aching the stimulation threshold that had been identified by the neurologist and b) after reaching the threshold. We then visually identified the stimulation thresholds that would have been chosen based on the acceleration signal alone and compared them to the ones subjectively identified by the neurologist. Results A statistical significant change in rigidity (p

Published
2012
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12. Quantitative rigidity evaluation during deep brain stimulation surgery-a preliminary study

Author

Hemm-Ode, Simone, Gmünder, Dagmar, Ulla, Miguel, Lemaire, Jean-Jacques, Coste, Jerome, Institute for Medical and Analytical Technologies, School of Life Sciences (IMA), University of Applied Sciences and Arts Northwestern Switzerland (FHNW), Service de Neurologie [CHU Clermont-Ferrand], CHU Gabriel Montpied [Clermont-Ferrand], CHU Clermont-Ferrand-CHU Clermont-Ferrand-CHU Estaing [Clermont-Ferrand], CHU Clermont-Ferrand, Neuro-Psycho Pharmacologie des Systèmes Dopimanégiques sous-corticaux (NPsy-Sydo), CHU Clermont-Ferrand-Université Clermont Auvergne [2017-2020] (UCA [2017-2020]), Service de Neurochirurgie [CHU Clermont-Ferrand], CHU Clermont-Ferrand-CHU Clermont-Ferrand, Image Guided Clinical Neurosciences and Connectomics (IGCNC), Université d'Auvergne - Clermont-Ferrand I (UdA), This recearch has been supported by the Swiss National Science Foundation (SNF) and the Germaine de Stael program.PHRC local ACCELEROMETRIE 2011 - CHU de Clermont-Ferrand, Swiss Society for Biomedical Engineering, Apport de l'accélérométrie à la stimulation cérébrale - 2011-A00774-37 - CHU de Clermont-Ferrand, CHU Estaing [Clermont-Ferrand], CHU Clermont-Ferrand-CHU Clermont-Ferrand-CHU Gabriel Montpied [Clermont-Ferrand], Service de Neurochirurgie [Clermont-Ferrand], and CHU Clermont-Ferrand-CHU Gabriel Montpied [Clermont-Ferrand]

Subjects
[SDV.NEU.NB]Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC]/Neurobiology, [SDV.IB]Life Sciences [q-bio]/Bioengineering, [SDV.NEU]Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC], [SDV.MHEP.CHI]Life Sciences [q-bio]/Human health and pathology/Surgery, ComputingMilieux_MISCELLANEOUS
Abstract

National audience

Published
2011

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