Deep Brain Stimulation lead reconstruction and computer simulation based on neuroimaging for patients with Parkinson’s disease
Parkinson’s disease (PD) is a neurodegenerative disease, the second most common age-related illness after Alzheimer’s disease. According to the Spanish Parkinson’s Federation, Parkinson’s affects 160.000 people in Spain and more than seven million people worldwide. Different types of treatment for t...
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| Tipo de recurso: | tesis de maestría |
| Fecha de publicación: | 2022 |
| País: | España |
| Institución: | Universitat Politècnica de Catalunya (UPC) |
| Repositorio: | UPCommons. Portal del coneixement obert de la UPC |
| Idioma: | inglés |
| OAI Identifier: | oai:upcommons.upc.edu:2117/367175 |
| Acceso en línea: | https://hdl.handle.net/2117/367175 |
| Access Level: | acceso abierto |
| Palabra clave: | Parkinson's disease Brain stimulation Parkinson, Malaltia de Cervell--Estimulació Àrees temàtiques de la UPC::Ciències de la salut::Medicina |
| Sumario: | Parkinson’s disease (PD) is a neurodegenerative disease, the second most common age-related illness after Alzheimer’s disease. According to the Spanish Parkinson’s Federation, Parkinson’s affects 160.000 people in Spain and more than seven million people worldwide. Different types of treatment for this disease exist, all of them resulting in a reduction of Parkinson’s symptoms, but none of them are a cure. Deep brain stimulation (DBS) is one of them; it is a functional surgical technique used since the end of the 20th century that considerably improves the quality of life of patients, especially motor and non-motor fluctuations. PD is one of the main diseases to which the Movement Disorders Unit of the Neurology Service, belonging to the Hospital de la Santa Creu i Sant Pau, is specialized. The aim of this Unit is to improve the quality of life of these patients and, -in collaboration with the Neurology Service- perform DBS surgeries. For the success of this type of surgery, an adequate and precise placement of the leads in the target structures is essential, something demonstrated in different studies. Therefore, this project aimed to analyse in a cohort of 55 patients with DBS the relation between the location of the DBS leads and clinical improvements, using the Matlab toolboxes: Lead DBS and Lead Group. To demonstrate that, it was necessary to review the existing literature from PD and DBS. This was followed by a thorough analysis of Lead DBS software to understand all the options available in the toolbox. With Lead DBS, the leads of all the patients were reconstructed and compared with the gold-standard reconstructions (obtained with the program Brainlab Elements). The toolbox Lead Group was also studied in depth in order to obtain the anatomical regions, networks and white matter tracts that were related to symptoms improvements (sweetspot, network mapping and discriminative fiber analysis, respectively). Finally, the results obtained were compared with the literature, concluding that although the subthalamic nucleus (STN) -and more precisely, the dorsolateral area-, is the main target of the surgery, the patients who had the leads away from the STN but close to the white matter tracts emerging from the STN (the so-called hyperdirect pathway) also showed valuable clinical benefits. |
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