Radiology Evaluation Of Bilateral Electrode Locations After Deep Brain Stimulation For Parkinson’s Disease

OBJECTIVE: As is a neurodegenerative disease,advanced Parkinson’s disease(PD)is difficult to maintain a stable condition with optimal drug treatment.Deep brain stimulation(DBS)can treat refractory movement disorders by stimulating specific nucleus with many advantages that drug treatments cannot achieve,including PD with well-known efficacy and safety.In clinical practice,both magnetic resonance imaging(MRI)and computed tomography(CT)have been performed for DBS surgery to target deep brain nucleus and evaluate electrode positions.Different imaging methods have distinct characteristics of presenting the brain.Therefore,optimizing imaging methods has gradually become more popular than ever in the field of neuroimage,which is also a demand for improving the clinical practice.CONTENT: This study retrospectively compared between the short-term CT images fused with preoperative MRI images and long-term MRI images on the last contact of the DBS electrode,evaluating on the clinical value of the two methods,and demonstrating the potential law of imaging differences between the two methods above with analysis of causes to provide a reference for optimizing clinical decision-making.METHODS: CT images were acquired 3-5 days after surgery and MRI images were acquired during 3-6 months on the follow-up of regular programming.The Leksell SurgiPlan(Elekta,Stockholm,Sweden)was used to fuse the images mentioned above with the preoperative images to evaluate the position difference between the two methods.RESULTS: Postoperative CT and MRI images were obtained from 50 groups of the same cases.The bilateral electrodes were respectively compared in three dimensions and spatial distance,from which statistically significant differences were obtained with a distance range of 0.0-4.7 mm.The bilateral electrodes had a tendency to move a little to the medial,posterior and lower site of the brain in the long-term compared to the short-term after surgery.CONCLUSIONS: CT and MRI imaging have shown their own characteristics of presenting DBS electrode contacts.The evaluation of short-term electrode position could be affected by various complex factors,which is still necessary to prospectively evaluate the imaging difference between the two imaging methods in the same period.The potential tendency in shifts of DBS electrodes not only contributes to the modeling of brain shift,but the optimization of implanting the electrodes.