Stereotactic implantation of deep brain stimulation electrodes: a review of technical systems, methods and emerging tools.
Deep brain stimulation (DBS) has become increasingly important for the treatment and relief of neurological disorders such as Parkinson's disease, tremor, dystonia and psychiatric illness. As DBS implantations and any other stereotactic and functional surgical procedure require accurate, precise and safe targeting of the brain structure, the technical aids for preoperative planning, intervention and postoperative follow-up have become increasingly important. The aim of this paper was to give an overview, from a biomedical engineering perspective, of a typical implantation procedure and current supporting techniques. Furthermore, emerging technical aids not yet clinically established are presented. This includes the state-of-the-art of neuroimaging and navigation, patient-specific simulation of DBS electric field, optical methods for intracerebral guidance, movement pattern analysis, intraoperative data visualisation and trends related to new stimulation devices. As DBS surgery already today is an information technology intensive domain, an "intuitive visualisation" interface for improving management of these data in relation to surgery is suggested.
University of Applied Sciences Northwestern Switzerland, Institute for Medical and Analytical Technologies, Muttenz, Switzerland.
Simone
S
Hemm
Karin
K
Wårdell
D046690:Deep Brain Stimulation / Q000295:instrumentation* / Q000379:methods / Q000639:trends; D004567:Electrodes, Implanted; D006801:Humans; D008279:Magnetic Resonance Imaging; D008954:Models, Biological; D019990:Perioperative Care / Q000379:methods; D013238:Stereotaxic Techniques; D014057:Tomography, X-Ray Computed