CC BY
22B-I-8
Guidance for deep brain surgery with optical fibres
D. DePaoli1, C. Leo2, P. Martin3, D. Côté1 1CERVO Brain Research Center, Physics, Quebec City, Canada 2Hospital Enfant Jesus, Neurochirurgie, Quebec City, Canada 3CERVO Brain Research Center, Neuroscience, Quebec City, Canada
The clinical outcome of deep brain stimulation (DBS) surgery relies heavily on the implantation accuracy of a chronic stimulating electrode in a small target brain region. Most techniques that have been proposed to precisely target these deep brain regions were designed to map intracerebral electrode trajectory, prior to the chronic electrode placement, sometimes leading to positioning error of the final electrode. Taking advantage of diffuse reflectance spectroscopy and coherent Raman spectroscopy, we developed a new surgical tool that senses proximal brain tissue, through the tip of the chronic electrode, by means of a novel stylet which provides rigidity to DBS leads and houses fiber optics. As a proof of concept, we demonstrate the ability of our non-invasive optical guidance technique to precisely locate the border of the subthalamic nucleus during the implantation of commercially available DBS electrodes in anesthetized parkinsonian monkey. Innovative optical recordings combined to standard microelectrode mapping and detailed post-mortem brain examination allowed us to confirm the precision of optical target detection. We also show the optical technique's ability to detect, in real time, upcoming blood vessels, reducing the risk of hemorrhage during the chronic lead implantation.
References
[1] D. T. DePaoli et al., J. Neurosurgery, 2019.
[2] D. T. DePaoli, N. Lapointe, Y. Messaddeq, M. Parent, and D. Côté, "Intact primate brain tissue identification using a completely fibered coherent Raman spectroscopy system.," Neurophotonics, vol. 5, no. 3, p. 035005, Jul. 2018.
