Toward Connectomic Deep Brain Stimulation – DBS electrode localization and what we can infer from them in terms of connectivity & causality

Orateur : Andreas HORN (Harvard Medical School)

In deep brain stimulation (DBS), electrode placement within the target structure is crucial for an efficacious outcome. Moreover, the relationship between spatial location of the electrode and resulting clinical effects constitutes an interesting field of research, since it may add substantial knowledge about the mechanism of action in the therapy. As such, probabilistic atlases of clinical outcome may be estimated and give information about a “sweet spot“, i.e. the optimal target location of the therapy. In addition to this, electrophysiological markers can be mapped to the subcortical volume of the brain. Recently, we could show that in Parkinson‘s Disease, the spatial location of the most beneficiary effect in DBS corresponds to the spatial location of maximum beta power based on local field potential recordings. Interestingly, enhanced beta power is considered a biomarker for disease progression in Parkinson‘s Disease. By extending the concept to connectivity, remote effects of DBS therapy that extend to distributed brain networks can be studied in a similar fashion. In this novel field of Connectomic Deep Brain Stimulation, the connectivity profiles from stimulation fields to the rest of the brain are analyzed and weighted with clinical results. In this way, cortical areas associated to beneficiary, neutral and adverse effects are identified and can be used for surgical planning in novel patients. This concept may push the field of DBS to allow for individualized therapeutic procedures that will be able to predict clinical outcomes based on electrode location before surgery, in the future.

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