Document Detail

Relation Between Laser Doppler Signals and Anatomy During Deep Brain Stimulation Electrode Implantation Towards Vim and STN.
MedLine Citation:
PMID:  23190636     Owner:  NLM     Status:  Publisher    
BACKGROUND:: Deep brain stimulation (DBS) requires precise and safe navigation to the chosen target. Optical measurements allow for monitoring of gray-white tissue boundaries (total light intensity, TLI) and microvascular blood flow during stereotactic procedures. OBJECTIVE:: To establish the link between TLI/blood flow and anatomy along trajectories towards the ventral intermediate nucleus (Vim) and subthalamic nucleus (STN). METHODS:: Stereotactic laser Doppler measurements were done with mm-precision from cortex towards Vim (n=13) and STN (n=9). Optical trajectories of TLI and blood flow were created and compared with anatomy by superimposing the Schaltenbrandt-Wahren atlas on the patients' pre-and postoperative images. Measurements were divided into anatomical subgroups and compared statistically. RESULTS:: Typical TLI-trajectories with well-defined anatomical regions could be identified for Vim and STN. TLI was significantly lower (P < .001) and microvascular blood flow significantly higher (P = .01) in the Vim targets. Of 1285 sites, 38 showed blood flow peaks, 27 of them along Vim trajectories. High blood flow was more common close to sulci and in the vicinity to Cd/Put. Along one Vim trajectory a small bleeding was suspected during insertion of the probe and confirmed with post-operative CT. CONCLUSION:: Laser Doppler is useful for intra-operative guidance during DBS implantation, as simultaneous measurement of tissue grayness and microvascular blood flow can be done along the trajectory with mm-precision. Typical but different TLI-trajectories were found for Vim and STN.
Karin Wårdell; Peter Zsigmond; Johan Richter; Simone Hemm
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-11-27
Journal Detail:
Title:  Neurosurgery     Volume:  -     ISSN:  1524-4040     ISO Abbreviation:  Neurosurgery     Publication Date:  2012 Nov 
Date Detail:
Created Date:  2012-11-29     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7802914     Medline TA:  Neurosurgery     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
1Department of Biomedical Engineering, Linköping University, Linköping, Sweden 2Department of Neurosurgery, Linköping University Hospital, Linköping, Sweden 3Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden 4University of Applied Sciences Northwestern Switzerland, Institute for Medical and Analytical Technologies, Muttenz, Switzerland.
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