Detection of deep brain stimulation lead position and orientation in patients using magnetoencephalography.

OBJECTIVE

Deep brain stimulation (DBS) programming in patients with directional DBS requires precise lead position and orientation knowledge. Current computed tomography (CT)-based methods expose patients to radiation. This study investigates a non-radiation-based magnetic detection approach using magnetoencephalography (MEG) in four Parkinson's disease patients.

METHODS

MEG recordings were performed under omnidirectional and directional electrode configurations. Three patients were measured with individualized head-casts to minimize head movement. Magnetic detection was applied to determine DBS lead's position and orientation, compared with those derived from postoperative CT imaging.

RESULTS

Conventional MEG recordings without head-casts achieved lead position and orientation accuracies of up to 17.3 mm and 24.1°. The use of head-casts improved accuracies to 5.8 ± 1.3 mm and 8.8 ± 2.2° at best. Higher mean errors indicate the presence of systematic biases, primarily caused by the MEG system's limited spatial precision. Reduced error variability demonstrates potential for 1-2 mm localization and 2-4° orientation accuracy.

CONCLUSIONS

While magnetic lead position detection is inferior to established approaches, DBS lead orientation could be determined with sufficient accuracy for potential clinical use. Advances in MEG technology may offer improvements in spatial precision and detection accuracy.

SIGNIFICANCE: This method may serve as a radiation-free alternative to imaging-based approaches.