Lead-OR: a multimodal platform for deep brain stimulation surgery
- Charité - Universitätsmedizin Berlin, Germany
- University Health Network, Canada
Abstract
Background: Deep Brain Stimulation (DBS) electrode implant trajectories are stereotactically defined using preoperative neuroimaging. To validate the correct trajectory, microelectrode recordings (MER) or local field potential recordings (LFP) can be used to extend neuroanatomical information (defined by magnetic resonance imaging) with neurophysiological activity patterns recorded from micro- and macroelectrodes probing the surgical target site. Currently, these two sources of information (imaging vs. electrophysiology) are analyzed separately, while means to fuse both data streams have not been introduced.
Methods: Here we present a tool that integrates resources from stereotactic planning, neuroimaging, MER and high-resolution atlas data to create a real-time visualization of the implant trajectory. We validate the tool based on a retrospective cohort of DBS patients (𝑁 = 52) offline and present single use cases of the real-time platform. Results: We establish an open-source software tool for multimodal data visualization and analysis during DBS surgery. We show a general correspondence between features derived from neuroimaging and electrophysiological recordings and present examples that demonstrate the functionality of the tool.
Conclusions: This novel software platform for multimodal data visualization and analysis bears translational potential to improve accuracy of DBS surgery. The toolbox is made openly available and is extendable to integrate with additional software packages.
Funding: Deutsche Forschungsgesellschaft (410169619, 424778381), Deutsches Zentrum für Luftund Raumfahrt (DynaSti), National Institutes of Health (2R01 MH113929), Foundation for OCD Research (FFOR).
Data availability
All processed data and code needed to reproducemain findings of the study aremade openly available in de-identified form (see figure legends). This can be found in https://github.com/simonoxen/Lead-OR_Supplementary and, when file size allowed, attached to the publication. Due to data privacy regulations of patient data, raw data cannot be publicly shared. Upon reasonable request to the corresponding author, data can be made available after setting up a data sharing agreement between our host institution (Charité - Universitätsmedizin Berlin) and the inquiring party. All code used to analyze the dataset is available within Lead-DBS /-OR software (https://github.com/netstim/leaddbs; https://github.com/netstim/SlicerNetstim)
Article and author information
Author details
Wolf-Julian Neumann
Funding
Deutsche Forschungsgemeinschaft (Emmy Noether Stipend 410169619)
- Andreas Horn
Deutsche Forschungsgemeinschaft (Project ID 424778371)
- Andreas Horn
Deutsche Forschungsgemeinschaft (Project ID 424778371)
- Wolf-Julian Neumann
Bundesministerium für Bildung und Forschung (Project iDBS FKZ01GQ1802)
- Wolf-Julian Neumann
Deutsches Zentrum für Luft- und Raumfahrt (DynaSti grant within the EU Joint Programme Neurodegenerative Disease Research,JPND)
- Andreas Horn
National Institutes of Health (2R01 MH113929)
- Andreas Horn
The funders had no role in study design, data collection and interpretation, or the decision to submit the work for publication.
Ethics
Human subjects: The collection and analysis of all patient data used for this article was approved by the Local Ethics committee of Charité - Universitätsmedizin Berlin (master vote EA2/145/21). All data were analyzed retrospectively and obtained in deidentified from Medical Records of Charité. Hence, following local guidelines in Berlin/Brandenburg as well as NIH guidelines for human subjects research, no explicit patient consent to analyze and publish was obtained/necessary.
Copyright
© 2022, Oxenford et al.
This article is distributed under the terms of the Creative Commons Attribution License permitting unrestricted use and redistribution provided that the original author and source are credited.
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Lead-OR: a multimodal platform for deep brain stimulation surgery
eLife 11:e72929.
https://doi.org/10.7554/eLife.72929
Further reading
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Background:
Chemotherapy-induced peripheral neuropathy (CIPN) is a serious therapy-limiting side effect of commonly used anticancer drugs. Previous studies suggest that lipids may play a role in CIPN. Therefore, the present study aimed to identify the particular types of lipids that are regulated as a consequence of paclitaxel administration and may be associated with the occurrence of post-therapeutic neuropathy.
Methods:
High-resolution mass spectrometry lipidomics was applied to quantify d=255 different lipid mediators in the blood of n=31 patients drawn before and after paclitaxel therapy for breast cancer treatment. A variety of supervised statistical and machine-learning methods was applied to identify lipids that were regulated during paclitaxel therapy or differed among patients with and without post-therapeutic neuropathy.
Results:
Twenty-seven lipids were identified that carried relevant information to train machine learning algorithms to identify, in new cases, whether a blood sample was drawn before or after paclitaxel therapy with a median balanced accuracy of up to 90%. One of the top hits, sphinganine-1-phosphate (SA1P), was found to induce calcium transients in sensory neurons via the transient receptor potential vanilloid 1 (TRPV1) channel and sphingosine-1-phosphate receptors.SA1P also showed different blood concentrations between patients with and without neuropathy.
Conclusions:
Present findings suggest a role for sphinganine-1-phosphate in paclitaxel-induced biological changes associated with neuropathic side effects. The identified SA1P, through its receptors, may provide a potential drug target for co-therapy with paclitaxel to reduce one of its major and therapy-limiting side effects.
Funding:
This work was supported by the Deutsche Forschungsgemeinschaft (German Research Foundation, DFG, Grants SFB1039 A09 and Z01) and by the Fraunhofer Foundation Project: Neuropathic Pain as well as the Fraunhofer Cluster of Excellence for Immune-Mediated Diseases (CIMD). This work was also supported by the Leistungszentrum Innovative Therapeutics (TheraNova) funded by the Fraunhofer Society and the Hessian Ministry of Science and Arts. Jörn Lötsch was supported by the Deutsche Forschungsgemeinschaft (DFG LO 612/16-1).
