ABSTRACT
Deep Brain Stimulation (DBS) of the Subthalamic Nuclei (STN) is the most used surgical treatment to improve motor skills in patients with Parkinson's Disease (PD) who do not adequately respond to pharmacological treatment, or have related side effects. During surgery for the implantation of a DBS system, signals are obtained through microelectrodes recordings (MER) at different depths of the brain. These signals are analyzed by neurophysiologists to detect the entry and exit of the STN region, as well as the optimal depth for electrode implantation. In the present work, a classification model is developed and supervised by the K-nearest neighbour algorithm (KNN), which is automatically trained from the 18 temporal features of MER registers of 14 patients with PD in order to provide a clinical support tool during DBS surgery. We investigate the effect of different standardizations of the generated database, the optimal definition of KNN configuration parameters, and the selection of features that maximize KNN performance. The results indicated that KNN trained with data that was standardized per cerebral hemisphere and per patient presented the best performance, achieving an accuracy of 94.35% (p < 0.001). By using feature selection algorithms, it was possible to achieve 93.5% in accuracy in selecting a subset of six features, improving computation time while processing in real time.
ABSTRACT
Deep Brain Stimulation (DBS) is a surgical procedure for the treatment of motor disorders in patients with Parkinson's Disease (PD). DBS involves the application of controlled electrical stimuli to a given brain structure. The implantation of the electrodes for DBS is performed by a minimally invasive stereotactic surgery where neuroimaging and microelectrode recordings (MER) are used to locate the target brain structure. The Subthalamic Nucleus (STN) is often chosen for the implantation of stimulation electrodes in DBS therapy. During the surgery, an intraoperative validation is performed to locate the dorsolateral region of STN. Patients with PD reveal a high power in the ß band (frequencies between 13 Hz and 35 Hz) in MER signal, mainly in the dorsolateral region of STN. In this work, different power spectrum density methods were analyzed with the aim of selecting one that minimizes the calculation time to be used in real time during DBS surgery. In particular, the results of three nonparametric and one parametric methods were compared, each with different sets of parameters. It was concluded that the optimum method to perform the real-time spectral estimation of beta band from MER signal is Welch with Hamming windows of 1.5 seconds and 50% overlap.