Evidence map›Paper›PMID 37717576›Full record

ArticleStereotactic and functional neurosurgery2023

Variations in Determining Actual Orientations of Segmented Deep Brain Stimulation Leads Using the DiODe Algorithm: A Retrospective Study Across Different Lead Designs and Medical Institutions.

Kaylee R Henry, Milina Michelle Miulli, Noa B Nuzov, Mark J Nolt, Joshua M Rosenow, Behzad Elahi, Julie Pilitsis, Laleh Golestanirad

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In one paragraph

Article in Stereotactic and functional neurosurgery, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

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5 · Who and what money

Authors and funding

8 authors.

Kaylee R HenryDepartment of Biomedical Engineering, Northwestern University, Evanston, Illinois, USA, kaylee.henry@northwestern.edu.
Milina Michelle MiulliDepartment of Neuroscience and Department of Global Health Studies, Northwestern University, Evanston, Illinois, USA.
Noa B NuzovDepartment of Biomedical Engineering, Northwestern University, Evanston, Illinois, USA.
Mark J NoltDepartment of Neurosurgery, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA.
Joshua M RosenowDepartment of Neurosurgery, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA.
Behzad ElahiDepartment of Physical Therapy and Human Movement Sciences, Northwestern University, Chicago, Illinois, USA.
Julie PilitsisDepartment of Neurosciences and Experimental Therapeutics, Albany Medical College, Albany, New York, USA.
Laleh GolestaniradDepartment of Biomedical Engineering, Northwestern University, Evanston, Illinois, USA.

Funding

Reconfigurable MRI technology for safe and high-resolution imaging of deep brain stimulation at 3TR01EB030324 · NIBIB · NORTHWESTERN UNIVERSITY AT CHICAGO · PI GOLESTANI RAD, LALEH · 2021 to 2024
$2.1M
NIBIB NIH HHS R01 EB030324
6 · The paper itself

Abstract

introductionDirectional deep brain stimulation (DBS) leads have become widely used in the past decade. Understanding the asymmetric stimulation provided by directional leads requires precise knowledge of the exact orientation of the lead in respect to its anatomical target. Recently, the DiODe algorithm was developed to automatically determine the orientation angle of leads from the artifact on postoperative computed tomography (CT) images. However, manual DiODe results are user-dependent. This study analyzed the extent of lead rotation as well as the user agreement of DiODe calculations across the two most common DBS systems, namely, Boston Scientific's Vercise and Abbott's Infinity, and two independent medical institutions.

methodsData from 104 patients who underwent an anterior-facing unilateral/bilateral directional DBS implantation at either Northwestern Memorial Hospital (NMH) or Albany Medical Center (AMC) were retrospectively analyzed. Actual orientations of the implanted leads were independently calculated by three individual users using the DiODe algorithm in Lead-DBS and patients' postoperative CT images. The deviation from the intended orientation and user agreement were assessed.

resultsAll leads significantly deviated from the intended 0° orientation (p < 0.001), regardless of DBS lead design (p < 0.05) or institution (p < 0.05). However, the Boston Scientific leads showed an implantation bias toward the left at both institutions (p = 0.014 at NMH, p = 0.029 at AMC). A difference of 10° between at least two users occurred in 28% (NMH) and 39% (AMC) of all Boston Scientific and 76% (NMH) and 53% (AMC) of all Abbott leads.

conclusionOur results show that there is a significant lead rotation from the intended surgical orientation across both DBS systems and both medical institutions; however, a bias toward a single direction was only seen in the Boston Scientific leads. Additionally, these results raise questions into the user error that occurs when manually refining the orientation angles calculated with DiODe.

Indexed as

Deep Brain StimulationAlgorithmsElectrodes, ImplantedHumansRetrospective StudiesTomography, X-Ray ComputedDeep brain stimulationDirectional leadsDirectional orientation detectionManual refinementUser agreement

Identifiers

PMID37717576
PMCPMC10866684

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