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Connectome Pathways in Parkinson’s Disease Patients with Deep Brain Stimulators

Authors:
Giorgio Bonmassar
Nikos Makris

Keywords: brain brain stimulation; DBS; Parkinson’s Disease; PD; MRI; DTI; implanted programmable generator; IPG; programming; connectome; STN

Abstract:
The overarching goal of this paper is to optimally control the implanted programmable generator (IPG), a critical device that delivers electrical currents or potentials to treat neurological symptoms in patients with Parkinson’ Disease (PD). Current IPG programming is based on trial and error empirical assessment, which makes the treatment implementation cumbersome, long, frustrating and expensive for the patient. Furthermore, the manifestation of the effects of IPG programming in some patient populations (e.g., dystonia) can be apparent after days, weeks or even months, which makes the trial and error approach unmanageable. Thus, the optimal IPG programming is critical to alleviate the patient’s neurological symptoms. Their programming relies on parameter definition, such as electrode pair, amplitude and frequency. The positioning of the electrodes in a specific anatomical target region of interest (ROI), such as STN is limited by the surgical procedure and presurgical planning. Knowledge of the morphometry of the target ROI and its topographic relationships with surrounding anatomical structures such as whiter matter fibers (such as the internal capsule and the H1 and H2 fields of Forel) and other gray matter structures (such as the zona incerta, the substantia nigra and the red nucleus) allows the precise positioning of the stimulating electrode pair. We show that connectome imaging technology provides the necessary detailed and comprehensive in-vivo imaging of white matter fiber architecture. Based on our previous DBS studies, we present a novel numerical head model to develop a novel IPG programmer to assist neurologist in the patient management.

Pages: 23 to 26

Copyright: Copyright (c) IARIA, 2015

Publication date: March 22, 2015

Published in: conference

ISSN: 2308-4197

ISBN: 978-1-61208-390-2

Location: Nice, France

Dates: from March 22, 2015 to March 27, 2015