Microelectrode Neuronal Activity of the Internal Globus Pallidus in Dystonia Correlates with Postoperative Neuromodulation Effects and Placement of the Stimulation Electrode |
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| Institution: | 1. Department of Biomedical Informatics, Faculty of Biomedical Engineering, Czech Technical University in Prague, Kladno, Czech Republic;2. Department of Neurology, 1st Faculty of Medicine, Charles University, Prague, Czech Republic;1. School of Mechanical Engineering, Iran University of Science and Technology, Tehran, 16846 13114, Iran;2. Shezan Research and Innovation Centre, No. 25, Innovation 2 St., Pardis TechPark, Tehran, Iran;3. Department of Mechanical Engineering, Ferdowsi University of Mashhad, Mashhad, Iran;1. CHU Nantes, Nantes, France;2. CHUV Lausanne, Suisse;3. Hôpitaux universitaires Henri-Mondor (HUHM), AP–HP, 94010 Créteil, France;4. CH Avignon, Avignon, France;5. GCS UniHA, France;6. ICR Toulouse, Toulouse, France;7. CHU de Liège, Liège, Belgique;8. Clinique Saint-Martin, Caen, France;9. HU de Genève, Genève, Suisse;10. CH de Verdun, France;11. CH Montauban, Montauban, France;12. CHU Amiens, Amiens, France;13. CH Métropole, Savoie, France;1. Chemical Ind. Res. Div., National Research Centre, 33 Bohouth Str., Dokki, Giza, Egypt;2. Chem. of Natural & Microbial Products Dept., National Research Centre, 33 Bohouth Str., Dokki, Giza, Egypt;3. Pharmaceutical Technology Dept., National Research Centre, 33 Bohouth Str., Dokki, Giza, Egypt;1. Functional MR Unit, Policlinico S. Orsola – Malpighi, Bologna (IT), Via Massarenti 9, 40138 Bologna, Italy;2. Department of Biomedical and NeuroMotor Sciences, University of Bologna, Bologna (IT), Via U. Foscolo 7, 40123 Bologna, Italy;3. IRCCS Istituto Delle Scienze Neurologiche di Bologna, Bologna (IT), Via Altura 3, 40139 Bologna, Italy;4. Neurology Unit, Policlinico S. Orsola – Malpighi, Bologna (IT), Via Massarenti 9, 40138 Bologna, Italy;5. Neurology Unit, Ospedale Maggiore, Bologna (IT), Via B. Nigrisoli 2, 40133 Bologna, Italy |
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| Abstract: | BackgroundDeep brain stimulation (DBS) is emerging as a viable treatment option for selected patients with dystonia. Intraoperative extracellular microelectrode recordings (MER) are considered as the standard electrophysiological method for the precise positioning of the DBS electrode into the target brain structure. Accurate targeting of the permanent stimulation electrode into the Globus Pallidus internus (GPi) is key to positive long-term effects. The suitability of the location is peroperatively assessed by microelectrodes that register single-unit neuronal activity. The aim of this article is to analyse electrophysiological recordings of patient's neuronal activity with a focus on the identification of markers relevant to the patient's clinical state.MethodsIn this study, 13 patients chronically treated with double-sided DBS GPi were examined with a microrecording. The signal (24 kHz) processing, included bandpass filtering (0.5–5 kHz), automated detection of artefacts and feature extraction. Pre-processed signals were analysed by means of statistical learning.ResultsThe results show that the GPi was distinguished from its vicinity with p < 0.001 and 3 machine learning models AUCs had an accuracy of higher than 0.87. The observed biomarker, Hjort mobility, additionally correlated with the long-term neuromodulation effect (rho = ?0.4; p < 0.05). Furthermore, we revealed a change of neural activity associated with the active distal DBS contact localization along the medio-lateral direction.ConclusionThis paper demonstrates the quantitative relationship between electrophysiological findings and the clinical effects of pallidal stimulation in dystonia and suggested objectification predictors of the effectiveness of this therapy. |
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| Keywords: | Dystonia Deep brain stimulation Microrecording Globus pallidus interna Neuromodulation |
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