Deep brain stimulation electrodes used for staged lesion within the basal ganglia: experimental studies for parameter validation : Laboratory investigation
Identifieur interne : 000240 ( France/Analysis ); précédent : 000239; suivant : 000241Deep brain stimulation electrodes used for staged lesion within the basal ganglia: experimental studies for parameter validation : Laboratory investigation
Auteurs : Sylvie Raoul [France] ; Dominique Leduc [France] ; Thomas Vegas [France] ; Paul Sauleau [France] ; Andres M. Lozano [Canada] ; Marc Verin [France] ; Philippe Damier [France] ; Youenn Lajat [France]Source :
- Journal of neurosurgery [ 0022-3085 ] ; 2007.
Descripteurs français
- Pascal (Inist)
English descriptors
- KwdEn :
Abstract
Object. Deep brain stimulation (DBS) has been shown to be an effective treatment for various types of movement disorders. High-frequency stimulation is applied to specific brain targets through an implanted quadripolar lead connected to a pulse generator. These leads can be used for creating lesions in the brain. The experimental study reported here was designed to examine the electrical parameters that could be used to create reproducible therapeutic lesions in the brain. Methods. Egg whites were used to measure the relationship between the electrical parameters (current and voltage) applied through the DBS electrode and the size of coagulum. The authors measured current spread from the electrode contact used for lesioning to the adjacent contact. Similar studies were performed in the pallidum or the thalamus of human cadavers. Modeling of the lesion size was performed with simulation of current density and temperature. The ultrastructure of the electrodes after lesioning was verified by electron microscopy. Results. Coagulation size increased with time but reached a plateau after 30 seconds. For a given set of electrical parameters, reproducibility of the size of lesions was high. Using constant voltage, lesions were larger in egg whites than in cadaveric brains with a mean length of 5 ± 0.6 mm in egg whites at 40 V, 125 mA, impedance 233 Ω; and 4.0 ± 0.8 mm in cadavers at 40 V, 38 mA, impedance 1333 fl. Computer modeling indicated negligible current flow to the adjacent, unused electrodes. The electrodes showed no structural alterations on scanning electron microscopy after more than 200 lesions. Conclusions. Results of this study demonstrate that DBS electrodes can be used to generate lesions reproducibly in the brain. The choice of lesioning parameters must take into account differences in impedance between the test medium (egg whites) and the human brain parenchyma.
Affiliations:
- Canada, France
- Ontario, Pays de la Loire
- Nantes, Toronto
- Université de Nantes, Université de Toronto
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Nantes Atlantique Universités, Institut de Recherche en Electrotechnique et Electronique de Nantes Atlantique</s1><s3>FRA</s3><sZ>2 aut.</sZ><sZ>3 aut.</sZ></inist:fA14><country>France</country><wicri:noRegion>Institut de Recherche en Electrotechnique et Electronique de Nantes Atlantique</wicri:noRegion><wicri:noRegion>Faculté des Sciences, Université de Nantes, Nantes Atlantique Universités, Institut de Recherche en Electrotechnique et Electronique de Nantes Atlantique</wicri:noRegion><orgName type="university">Université de Nantes</orgName><placeName><settlement type="city">Nantes</settlement><region type="region" nuts="2">Pays de la Loire</region></placeName></affiliation></author><author><name sortKey="Sauleau, Paul" sort="Sauleau, Paul" uniqKey="Sauleau P" first="Paul" last="Sauleau">Paul Sauleau</name><affiliation wicri:level="1"><inist:fA14 i1="03"><s1>Department of Neurology, Centre Hospitalier Universitaire de Rennes</s1><s3>FRA</s3><sZ>4 aut.</sZ><sZ>6 aut.</sZ></inist:fA14><country>France</country><wicri:noRegion>Centre Hospitalier Universitaire de Rennes</wicri:noRegion><wicri:noRegion>Department of Neurology, Centre Hospitalier Universitaire de Rennes</wicri:noRegion></affiliation></author><author><name sortKey="Lozano, Andres M" sort="Lozano, Andres M" uniqKey="Lozano A" first="Andres M." last="Lozano">Andres M. Lozano</name><affiliation wicri:level="4"><inist:fA14 i1="04"><s1>Department of Neuroscience, Division of Neurosurgery, Toronto Western Hospital, University of Toronto</s1><s3>CAN</s3><sZ>5 aut.</sZ></inist:fA14><country>Canada</country><placeName><settlement type="city">Toronto</settlement><region type="state">Ontario</region></placeName><orgName type="university">Université de Toronto</orgName></affiliation></author><author><name sortKey="Verin, Marc" sort="Verin, Marc" uniqKey="Verin M" first="Marc" last="Verin">Marc Verin</name><affiliation wicri:level="1"><inist:fA14 i1="03"><s1>Department of Neurology, Centre Hospitalier Universitaire de Rennes</s1><s3>FRA</s3><sZ>4 aut.</sZ><sZ>6 aut.</sZ></inist:fA14><country>France</country><wicri:noRegion>Centre Hospitalier Universitaire de Rennes</wicri:noRegion><wicri:noRegion>Department of Neurology, Centre Hospitalier Universitaire de Rennes</wicri:noRegion></affiliation></author><author><name sortKey="Damier, Philippe" sort="Damier, Philippe" uniqKey="Damier P" first="Philippe" last="Damier">Philippe Damier</name><affiliation wicri:level="1"><inist:fA14 i1="05"><s1>Department of Neurology, Clinical Investigation Center, Institut National de la Santé et de la Recherche Médicale UMR 643, Centre Hospitalier Universitaire de Nantes</s1><s3>FRA</s3><sZ>7 aut.</sZ></inist:fA14><country>France</country><wicri:noRegion>Centre Hospitalier Universitaire de Nantes</wicri:noRegion><wicri:noRegion>Department of Neurology, Clinical Investigation Center, Institut National de la Santé et de la Recherche Médicale UMR 643, Centre Hospitalier Universitaire de Nantes</wicri:noRegion></affiliation></author><author><name sortKey="Lajat, Youenn" sort="Lajat, Youenn" uniqKey="Lajat Y" first="Youenn" last="Lajat">Youenn Lajat</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Department of Neurosurgery, Centre Hospitalier Universitaire de Nantes</s1><s3>FRA</s3><sZ>1 aut.</sZ><sZ>8 aut.</sZ></inist:fA14><country>France</country><wicri:noRegion>Centre Hospitalier Universitaire de Nantes</wicri:noRegion><wicri:noRegion>Department of Neurosurgery, Centre Hospitalier Universitaire de Nantes</wicri:noRegion></affiliation></author></analytic><series><title level="j" type="main">Journal of neurosurgery</title><title level="j" type="abbreviated">J. neurosurg.</title><idno type="ISSN">0022-3085</idno><imprint><date when="2007">2007</date></imprint></series></biblStruct></sourceDesc><seriesStmt><title level="j" type="main">Journal of neurosurgery</title><title level="j" type="abbreviated">J. neurosurg.</title><idno type="ISSN">0022-3085</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Basal ganglion</term><term>Cadaver</term><term>Experimental study</term><term>Laboratory investigations</term><term>Parkinson disease</term><term>Thermocoagulation</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Parkinson maladie</term><term>Noyau gris central</term><term>Etude expérimentale</term><term>Examen laboratoire</term><term>Cadavre</term><term>Thermocoagulation</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Object. Deep brain stimulation (DBS) has been shown to be an effective treatment for various types of movement disorders. High-frequency stimulation is applied to specific brain targets through an implanted quadripolar lead connected to a pulse generator. These leads can be used for creating lesions in the brain. The experimental study reported here was designed to examine the electrical parameters that could be used to create reproducible therapeutic lesions in the brain. Methods. Egg whites were used to measure the relationship between the electrical parameters (current and voltage) applied through the DBS electrode and the size of coagulum. The authors measured current spread from the electrode contact used for lesioning to the adjacent contact. Similar studies were performed in the pallidum or the thalamus of human cadavers. Modeling of the lesion size was performed with simulation of current density and temperature. The ultrastructure of the electrodes after lesioning was verified by electron microscopy. Results. Coagulation size increased with time but reached a plateau after 30 seconds. For a given set of electrical parameters, reproducibility of the size of lesions was high. Using constant voltage, lesions were larger in egg whites than in cadaveric brains with a mean length of 5 ± 0.6 mm in egg whites at 40 V, 125 mA, impedance 233 Ω; and 4.0 ± 0.8 mm in cadavers at 40 V, 38 mA, impedance 1333 fl. Computer modeling indicated negligible current flow to the adjacent, unused electrodes. The electrodes showed no structural alterations on scanning electron microscopy after more than 200 lesions. Conclusions. Results of this study demonstrate that DBS electrodes can be used to generate lesions reproducibly in the brain. The choice of lesioning parameters must take into account differences in impedance between the test medium (egg whites) and the human brain parenchyma.</div></front></TEI><affiliations><list><country><li>Canada</li><li>France</li></country><region><li>Ontario</li><li>Pays de la Loire</li></region><settlement><li>Nantes</li><li>Toronto</li></settlement><orgName><li>Université de Nantes</li><li>Université de Toronto</li></orgName></list><tree><country name="France"><noRegion><name sortKey="Raoul, Sylvie" sort="Raoul, Sylvie" uniqKey="Raoul S" first="Sylvie" last="Raoul">Sylvie Raoul</name></noRegion><name sortKey="Damier, Philippe" sort="Damier, Philippe" uniqKey="Damier P" first="Philippe" last="Damier">Philippe Damier</name><name sortKey="Lajat, Youenn" sort="Lajat, Youenn" uniqKey="Lajat Y" first="Youenn" last="Lajat">Youenn Lajat</name><name sortKey="Leduc, Dominique" sort="Leduc, Dominique" uniqKey="Leduc D" first="Dominique" last="Leduc">Dominique Leduc</name><name sortKey="Sauleau, Paul" sort="Sauleau, Paul" uniqKey="Sauleau P" first="Paul" last="Sauleau">Paul Sauleau</name><name sortKey="Vegas, Thomas" sort="Vegas, Thomas" uniqKey="Vegas T" first="Thomas" last="Vegas">Thomas Vegas</name><name sortKey="Verin, Marc" sort="Verin, Marc" uniqKey="Verin M" first="Marc" last="Verin">Marc Verin</name></country><country name="Canada"><region name="Ontario"><name sortKey="Lozano, Andres M" sort="Lozano, Andres M" uniqKey="Lozano A" first="Andres M." last="Lozano">Andres M. Lozano</name></region></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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