DBS targeting in brain-injured patients

DBS Targeting in Brain Injured Patients with Severe Anatomical Lesions

We have developed an original technique of pure direct anatomical mapping of the deep brain, enabling to determine accurately all common targets in stereotactic neurosurgery, as well as their whole neighborhood, and this in 3D. Brain distortion precludes mixed or indirect targeting when anatomical lesions are severe, e.g. after traumatic head injury or intra cerebral hemorrhage. In such conditions (clinical research protocol) we have used advanced direct targeting for the implantation of electrodes according to anatomical landmarks following our direct method of anatomical mapping, extended with several structural MRI sequences and Pet-Scan metabolic data.

Fig. 1: Post-operative location (pink dot) of the left thalamic (pink contours) electrode (white; CTScan artefact): top left, X-ray like display with 3D objects overlaid; clock-wise from top right, axial, frontal and lateral views.

Fig. 2: Position of the left electrode (pink dot) within the thalamus (pink contours): clock-wise from top left, coronal color-code DTI slice, coronal WAIR slice, sagittal WAIR slice, and sagittal color-code DTI slice.

Fig. 3: Position of the left electrode (pink dot) within the thalamus (pink contours): clock-wise, from top left, coronal, coronal WAIR slice, axial WAIR slice, axial SWI slice, and axial PetScan slice.