title: Intraoperative acceleration measurements to quantify improvement in tremor during deep brain stimulation surgery.
abstract: 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.
authors.affiliation: Institute for Medical and Analytical Technologies, University of Applied Sciences and Arts Northwestern Switzerland, Gruendenstrasse 40, 4132, Muttenz, Switzerland.
authors.forename: Ashesh
authors.initials: A
authors.lastname: Shah
authors.affiliation: Image-Guided Clinical Neuroscience and Connectomics (EA 7282), Université Clermont Auvergne, Clermont-Ferrand, France.|Service de Neurochirurgie, CHU Clermont-Ferrand, Clermont-Ferrand, France.
authors.forename: Jérôme
authors.initials: J
authors.lastname: Coste
authors.affiliation: Image-Guided Clinical Neuroscience and Connectomics (EA 7282), Université Clermont Auvergne, Clermont-Ferrand, France.|Service de Neurochirurgie, CHU Clermont-Ferrand, Clermont-Ferrand, France.
authors.forename: Jean-Jacques
authors.initials: JJ
authors.lastname: Lemaire
authors.affiliation: Departments of Neurosurgery and Biomedicine, University of Basel, Basel, Switzerland.
authors.forename: Ethan
authors.initials: E
authors.lastname: Taub
authors.affiliation: Department of Neurology, University Hospital Bern and University of Bern, Bern, Switzerland.|Assistance Publique Hôpitaux de Paris, Institut National de Santé et en Recherche Médicale, Institut du Cerveau et de la Moelle Epinière, Centre d'Investigation Clinique 1422, Département de Neurologie, Hôpital Pitié-Salpêtrière, 75013, Paris, France.
authors.forename: W M Michael
authors.initials: WMM
authors.lastname: Schüpbach
authors.affiliation: Department of Neurosurgery, University Hospital Bern, Bern, Switzerland.
authors.forename: Claudio
authors.initials: C
authors.lastname: Pollo
authors.affiliation: Institute for Medical and Analytical Technologies, University of Applied Sciences and Arts Northwestern Switzerland, Gruendenstrasse 40, 4132, Muttenz, Switzerland.
authors.forename: Erik
authors.initials: E
authors.lastname: Schkommodau
authors.affiliation: Departments of Neurosurgery and Biomedicine, University of Basel, Basel, Switzerland.
authors.forename: Raphael
authors.initials: R
authors.lastname: Guzman
authors.affiliation: Institute for Medical and Analytical Technologies, University of Applied Sciences and Arts Northwestern Switzerland, Gruendenstrasse 40, 4132, Muttenz, Switzerland. simone.hemm@fhnw.ch.
authors.forename: Simone
authors.initials: S
authors.lastname: Hemm-Ode
mesh_terms: D000054:Acceleration; D001921:Brain / Q000601:surgery*; D046690:Deep Brain Stimulation / Q000379:methods; D004567:Electrodes, Implanted; D006801:Humans; D009069:Movement Disorders / Q000601:surgery; D019635:Neurosurgical Procedures / Q000379:methods*; D014202:Tremor / Q000601:surgery*
keywords: Acceleration; Deep brain stimulation; Essential tremor; Intraoperative monitoring; Parkinson’s disease; Tremor