Real-time refinement of subthalamic nucleus targeting using bayesian decision-making on the root mean square measure
Identifieur interne : 001925 ( PascalFrancis/Checkpoint ); précédent : 001924; suivant : 001926Real-time refinement of subthalamic nucleus targeting using bayesian decision-making on the root mean square measure
Auteurs : Anan Moran [Israël] ; Izhar Bar-Gad [Israël] ; Hagai Bergman [Israël] ; Zvi Israel [Israël]Source :
- Movement disorders [ 0885-3185 ] ; 2006.
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Abstract
The subthalamic nucleus (STN) is a major target for treatment of advanced Parkinson's disease patients undergoing deep brain stimulation surgery. Microelectrode recording (MER) is used in many cases to identify the target nucleus. A real-time procedure for identifying the entry and exit points of the STN would improve the outcome of this targeting procedure. We used the normalized root mean square (NRMS) of a short (5 seconds) MER sampled signal and the estimated anatomical distance to target (EDT) as the basis for this procedure. Electrode tip location was defined intraoperatively by an expert neurophysiologist to be before, within, or after the STN. Data from 46 trajectories of 27 patients were used to calculate the Bayesian posterior probability of being in each of these locations, given RMS-EDT pair values. We tested our predictions on each trajectory using a bootstrapping technique, with the rest of the trajectories serving as a training set and found the error in predicting the STN entry to be (mean ± SD) 0.18 ± 0.84, and 0.50 ± 0.59 mm for STN exit point, which yields a 0.30 ± 0.28 mm deviation from the expert's target center. The simplicity and computational ease of RMS calculation, its spike sorting-independent nature and tolerance to electrode parameters of this Bayesian predictor, can lead directly to the development of a fully automated intraoperative physiological procedure for the refinement of imaging estimates of STN borders.
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aut.</sZ></inist:fA14><country>Israël</country><wicri:noRegion>Ramat Gan</wicri:noRegion></affiliation></author><author><name sortKey="Bergman, Hagai" sort="Bergman, Hagai" uniqKey="Bergman H" first="Hagai" last="Bergman">Hagai Bergman</name><affiliation wicri:level="1"><inist:fA14 i1="02"><s1>Department of Physiology, Hadassah Medical School and Interdisciplinary Center for Neural Computation, Hebrew University</s1><s2>Jerusalem</s2><s3>ISR</s3><sZ>3 aut.</sZ></inist:fA14><country>Israël</country><wicri:noRegion>Jerusalem</wicri:noRegion></affiliation></author><author><name sortKey="Israel, Zvi" sort="Israel, Zvi" uniqKey="Israel Z" first="Zvi" last="Israel">Zvi Israel</name><affiliation wicri:level="1"><inist:fA14 i1="03"><s1>Department of Neurosurgery, Hadassah University Hospital</s1><s2>Jerusalem</s2><s3>ISR</s3><sZ>4 aut.</sZ></inist:fA14><country>Israël</country><wicri:noRegion>Jerusalem</wicri:noRegion></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">INIST</idno><idno type="inist">06-0518097</idno><date when="2006">2006</date><idno type="stanalyst">PASCAL 06-0518097 INIST</idno><idno type="RBID">Pascal:06-0518097</idno><idno type="wicri:Area/PascalFrancis/Corpus">001999</idno><idno type="wicri:Area/PascalFrancis/Curation">001322</idno><idno type="wicri:Area/PascalFrancis/Checkpoint">001925</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a">Real-time refinement of subthalamic nucleus targeting using bayesian decision-making on the root mean square measure</title><author><name sortKey="Moran, Anan" sort="Moran, Anan" uniqKey="Moran A" first="Anan" last="Moran">Anan Moran</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Gonda Multidisciplinary Brain Research Center and Faculty of Life Sciences, Bar Ilan University</s1><s2>Ramat Gan</s2><s3>ISR</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ></inist:fA14><country>Israël</country><wicri:noRegion>Ramat Gan</wicri:noRegion></affiliation></author><author><name sortKey="Bar Gad, Izhar" sort="Bar Gad, Izhar" uniqKey="Bar Gad I" first="Izhar" last="Bar-Gad">Izhar Bar-Gad</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Gonda Multidisciplinary Brain Research Center and Faculty of Life Sciences, Bar Ilan University</s1><s2>Ramat Gan</s2><s3>ISR</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ></inist:fA14><country>Israël</country><wicri:noRegion>Ramat Gan</wicri:noRegion></affiliation></author><author><name sortKey="Bergman, Hagai" sort="Bergman, Hagai" uniqKey="Bergman H" first="Hagai" last="Bergman">Hagai Bergman</name><affiliation wicri:level="1"><inist:fA14 i1="02"><s1>Department of Physiology, Hadassah Medical School and Interdisciplinary Center for Neural Computation, Hebrew University</s1><s2>Jerusalem</s2><s3>ISR</s3><sZ>3 aut.</sZ></inist:fA14><country>Israël</country><wicri:noRegion>Jerusalem</wicri:noRegion></affiliation></author><author><name sortKey="Israel, Zvi" sort="Israel, Zvi" uniqKey="Israel Z" first="Zvi" last="Israel">Zvi Israel</name><affiliation wicri:level="1"><inist:fA14 i1="03"><s1>Department of Neurosurgery, Hadassah University Hospital</s1><s2>Jerusalem</s2><s3>ISR</s3><sZ>4 aut.</sZ></inist:fA14><country>Israël</country><wicri:noRegion>Jerusalem</wicri:noRegion></affiliation></author></analytic><series><title level="j" type="main">Movement disorders</title><title level="j" type="abbreviated">Mov. disord.</title><idno type="ISSN">0885-3185</idno><imprint><date when="2006">2006</date></imprint></series></biblStruct></sourceDesc><seriesStmt><title level="j" type="main">Movement disorders</title><title level="j" type="abbreviated">Mov. disord.</title><idno type="ISSN">0885-3185</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Decision making</term><term>Deep brain stimulation</term><term>Inference</term><term>Localization</term><term>Microelectrode</term><term>Nervous system diseases</term><term>Parkinson disease</term><term>Refinement</term><term>Square root</term><term>Subthalamic nucleus</term><term>Targeting</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Système nerveux pathologie</term><term>Parkinson maladie</term><term>Affinement</term><term>Noyau sousthalamique</term><term>Ciblage</term><term>Prise décision</term><term>Racine carrée</term><term>Inférence</term><term>Microélectrode</term><term>Localisation</term><term>Stimulation cérébrale profonde</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">The subthalamic nucleus (STN) is a major target for treatment of advanced Parkinson's disease patients undergoing deep brain stimulation surgery. Microelectrode recording (MER) is used in many cases to identify the target nucleus. A real-time procedure for identifying the entry and exit points of the STN would improve the outcome of this targeting procedure. We used the normalized root mean square (NRMS) of a short (5 seconds) MER sampled signal and the estimated anatomical distance to target (EDT) as the basis for this procedure. Electrode tip location was defined intraoperatively by an expert neurophysiologist to be before, within, or after the STN. Data from 46 trajectories of 27 patients were used to calculate the Bayesian posterior probability of being in each of these locations, given RMS-EDT pair values. We tested our predictions on each trajectory using a bootstrapping technique, with the rest of the trajectories serving as a training set and found the error in predicting the STN entry to be (mean ± SD) 0.18 ± 0.84, and 0.50 ± 0.59 mm for STN exit point, which yields a 0.30 ± 0.28 mm deviation from the expert's target center. The simplicity and computational ease of RMS calculation, its spike sorting-independent nature and tolerance to electrode parameters of this Bayesian predictor, can lead directly to the development of a fully automated intraoperative physiological procedure for the refinement of imaging estimates of STN borders.</div></front></TEI><inist><standard h6="B"><pA><fA01 i1="01" i2="1"><s0>0885-3185</s0></fA01><fA03 i2="1"><s0>Mov. disord.</s0></fA03><fA05><s2>21</s2></fA05><fA06><s2>9</s2></fA06><fA08 i1="01" i2="1" l="ENG"><s1>Real-time refinement of subthalamic nucleus targeting using bayesian decision-making on the root mean square measure</s1></fA08><fA11 i1="01" i2="1"><s1>MORAN (Anan)</s1></fA11><fA11 i1="02" i2="1"><s1>BAR-GAD (Izhar)</s1></fA11><fA11 i1="03" i2="1"><s1>BERGMAN (Hagai)</s1></fA11><fA11 i1="04" i2="1"><s1>ISRAEL (Zvi)</s1></fA11><fA14 i1="01"><s1>Gonda Multidisciplinary Brain Research Center and Faculty of Life Sciences, Bar Ilan University</s1><s2>Ramat Gan</s2><s3>ISR</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ></fA14><fA14 i1="02"><s1>Department of Physiology, Hadassah Medical School and Interdisciplinary Center for Neural Computation, Hebrew University</s1><s2>Jerusalem</s2><s3>ISR</s3><sZ>3 aut.</sZ></fA14><fA14 i1="03"><s1>Department of Neurosurgery, Hadassah University Hospital</s1><s2>Jerusalem</s2><s3>ISR</s3><sZ>4 aut.</sZ></fA14><fA20><s1>1425-1431</s1></fA20><fA21><s1>2006</s1></fA21><fA23 i1="01"><s0>ENG</s0></fA23><fA43 i1="01"><s1>INIST</s1><s2>20953</s2><s5>354000158780860190</s5></fA43><fA44><s0>0000</s0><s1>© 2006 INIST-CNRS. All rights reserved.</s1></fA44><fA45><s0>21 ref.</s0></fA45><fA47 i1="01" i2="1"><s0>06-0518097</s0></fA47><fA60><s1>P</s1></fA60><fA61><s0>A</s0></fA61><fA64 i1="01" i2="1"><s0>Movement disorders</s0></fA64><fA66 i1="01"><s0>USA</s0></fA66><fC01 i1="01" l="ENG"><s0>The subthalamic nucleus (STN) is a major target for treatment of advanced Parkinson's disease patients undergoing deep brain stimulation surgery. Microelectrode recording (MER) is used in many cases to identify the target nucleus. A real-time procedure for identifying the entry and exit points of the STN would improve the outcome of this targeting procedure. We used the normalized root mean square (NRMS) of a short (5 seconds) MER sampled signal and the estimated anatomical distance to target (EDT) as the basis for this procedure. Electrode tip location was defined intraoperatively by an expert neurophysiologist to be before, within, or after the STN. 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