1. Intraoperative acceleration measurements to quantify improvement in tremor during deep brain stimulation surgery
- Author
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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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