Electrode Placement Accuracy in Robot-Assisted Asleep Deep Brain Stimulation

David VanSickle, Victoria Volk, Patricia Freeman, Jamie Henry, Meghan Baldwin, Clare K. Fitzpatrick

Research output: Contribution to journalArticlepeer-review

35 Scopus citations

Abstract

Deep brain stimulation (DBS) involves the implantation of electrodes into specific central brain structures for the treatment of Parkinson’s disease. Image guidance and robot-assisted techniques have been developed to assist in the accuracy of electrode placement. Traditional DBS is performed with the patient awake and utilizes microelectrode recording for feedback, which yields lengthy operating room times. Asleep DBS procedures use imaging techniques to verify electrode placement. The objective of this study is to demonstrate the validity of an asleep robot-assisted DBS procedure that utilizes intraoperative imaging techniques for precise electrode placement in a large, inclusive cohort. Preoperative magnetic resonance imaging (MRI) was used to plan the surgical procedure for the 128 patients that underwent asleep DBS. During the surgery, robot assistance was used during the implantation of the electrodes. To verify electrode placement, intraoperative CT scans were fused with the preoperative MRIs. The mean radial error of all final electrode placements is 0.85 ± 0.38 mm. MRI-CT fusion error is 0.64 ± 0.40 mm. The average operating room time for bilateral and unilateral implantations are 139.3 ± 34.7 and 115.4 ± 42.1 min, respectively. This study shows the validity of the presented asleep DBS procedure using robot assistance and intraoperative CT verification for accurate electrode placement with shorter operating room times.

Original languageAmerican English
Pages (from-to)1212-1222
Number of pages11
JournalAnnals of Biomedical Engineering
Volume47
Issue number5
DOIs
StatePublished - May 2019

Keywords

  • Deep brain stimulation
  • Electrode placement
  • Parkinson’s disease
  • Placement accuracy
  • Robot-assisted

EGS Disciplines

  • Biomedical Engineering and Bioengineering
  • Mechanical Engineering

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