摘要
目的基于临床常用的手术计划系统进行脑深部刺激电极三维重建,评估该项技术临床应用的可行性。方法回顾性纳入2017-01-12接受双侧丘脑底核(STN)DBS治疗的帕金森病患者21例,基于脑深部电极三维重建技术,根据植入电极与STN的位置关系,将病例分为2组(组1:双侧电极位于STN内;组2:一侧或双侧电极均不位于STN内)。分析基于电极重建技术与标准开机程控两种方式筛选的最佳刺激触点二者的吻合度,比较两种不同电极植入精确度对该吻合度的影响,并进一步分析两种筛选方式的最佳触点几何中心的空间坐标的差异。结果基于重建电极与标准开机流程两种方式筛选的最佳触点的吻合度达83.33%(35/42),左右两侧的吻合度差异无统计学意义,组1的最佳触点吻合度高于组2(88.24%vs 62.50%),但差异无统计学意义,两种方式筛选的最佳触点的空间坐标值差异也无统计学意义。结论脑深部电极重建技术能够立体直观呈现颅内电极与DBS目标核团的空间位置关系,基于该方式筛选的最佳刺激触点与传统开机程控方式存在较高的吻合度,该项技术可能有助于提高术后程控最佳DBS触点筛选的准确性与效率。
Objective To evaluate feasibility of intracranial electrode stereo reconstruction in deep brain stimulation for optimal stimulating contact selection with clinical commonly used surgical planning system.Methods Twenty-one patients with Parkinson’s disease treated with bilateral subthalamic nucleus(STN) DBS from 2017-01 to 2017-12 were retrospectively included.Based on the 3 d reconstruction technology of deep brain stimulation electrode,according to the position relationship between implanted electrode and STN,the patients were divided into two groups(group 1:bilateral electrodes were located in STN;Group 2:one or both electrodes were out of bilateral STN boundary).Statistical analysis was made on the coincidence between the optimal stimulation contacts selected by the electrode reconstruction technology and the standard boot programming method,and the influence of implantation electrode with different accuracy on the degree of coincidence was compared as well.Moreover,the spatial coordinate difference of the optimal contact geometric center selected by the two screening methods was further analyzed.Results The degree of coincidence by the two screening methods for the optimal contact selection was 83.33% in the total leads(35/42),there was no significant statistical difference between the lead between the left and right side.The alignment of the two optimal contact selection methods is higher in group one comparing to group 2(88.24% vs 62.50%),but no significant statistical difference was observed,this was also found in the differences of the space coordinate of the optimal contacts selected by the two screening methods.Conclusion The deep brain electrode reconstruction technology can display the spatial position relationship between intracranial electrode and DBS target nucleus in a stereoscopic and intuitive manner.The optimal stimulation contact selected based on this method has a high degree of coincidence with the traditional boot programming method.This technology may be helpful to improve the accuracy and efficiency of the selection of optimal stimulating contacts after DBS surgery.
作者
郑小斌
余良宏
万欣龙
王惠清
俞挺
何秋
林章雅
康德智
ZHENG Xiaobin;YU Lianghong;WAN Xinlong;WANG Huiqing;YU Ting;HE Qiu;LIN Zhangya;KANG Dezhi(Department of Neurosurgery,Neuromedicine Center of Fujian Province,First Affiliated Hospital of Fujian Medical University,Fuzhou 350000,China;Department of Neuro spinal Surgery,People’s Hospital of Yuanzhou District,Guyuan 756000,China)
出处
《中国实用神经疾病杂志》
2019年第19期2089-2096,共8页
Chinese Journal of Practical Nervous Diseases
基金
福建省科技厅青年创新基金(编号:2015J05064)
国家自然科学青年基金(编号:81701363)
关键词
帕金森病
脑深部刺激术
电极重建
最佳DBS触点
程控效率
Parkinson’s disease
Deep brain stimulation
Lead reconstruction
Optimal DBS contact
Programming efficacy
