Method for deep brain stimulation targeting based on brain connectivity

Abstract

Due to the lack of internal anatomic detail with traditional magnetic resonance imaging, preoperative stereotactic planning for the treatment of tremor usually relies on indirect targeting based on atlas-derived coordinates. To overcome such disadvantages, a method is provided that allows for deep brain stimulation targeting based on brain connectivity. For example, probabilistic tractography-based thalamic segmentation for deep brain stimulator (DBS) targeting is suitable for the treatment of tremor.

Description

CROSS-REFERENCES TO RELATED APPLICATIONS[0001]This application claims priority to U.S. Provisional Patent Application No. 61 / 512,584 filed Jul. 28, 2011, entitled A METHOD FOR DEEP BRAIN STIMULATION TARGETING BASED ON BRAIN CONNECTIVITY, the entire contents of which is incorporated herein for all purposes by this reference.BACKGROUND OF INVENTION[0002]1. Field of Invention[0003]This application relates, in general, deep brain stimulation targeting based on brain connectivity and more particularly to methods of use.[0004]2. Description of Related Art[0005]The efficacy of deep brain stimulation (DBS) critically depends on accurate and precise targeting of subcortical targets. The lack of preoperative methods to either structurally or functionally delineate thalamic nuclear anatomy usually necessitates indirect targeting of the thalamus based on atlas-derived coordinates. Although indirect targeting of the thalamus is generally robust, variability in cortical and subcortical anatomy an...

AI Technical Summary

Benefits of technology

[0011]Based on the notion that deep brain stimulation achieves therapeutic efficacy by modulating brain networks, the present invention provides for a means of targeting deep brain stimulation electrodes based on brain connectivity patterns and measures. Although measures of brain connectivity using diffusion tensor imaging (DTI) and tractography have been previously described, In accordance with the present invention, this is the first description of using this methodology specifically to target brain structures for therapeutic brain stimulation. Likewise, this is the first demonstration that targeting brain structures based on these connectivity measures is actually precise and can account for interindividual variability. The described methodology is superior to prior methodologies because it (1) identifies targets based on individual anatomy and connectivity instead of relying on standard atlases and (2) can target therapeutic brain electrodes in regions of the brain in which there is normally insufficient contrast to identify internal structure.

Problems solved by technology

Preoperative identification of a precise anatomical or physiological target is even more complicated in the thalamus where there are no readily visible nuclear boundaries that provide patient-specific details to guide targeting.

While these techniques are valid, their utility or reliability with respect to DBS targeting has not been evaluated.

Moreover, in some cases, implementation of the described methodologies requires expertise and resources (e.g., 4.7 T MRI) that are not conventionally available to most physicians.

Despite its increased application in the basic sciences, the value of using connectivity-based thalamic segmentation to guide DBS implantation has not been extensively evaluated.

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