Divide and Conquer: Automatic Detection of the Thalamus to Empower DBS Physiological Navigation to the Subthalamic Region

Our aim was to identify thalamic electrophysiological activity along the trajectory to the subthalamic region using micro-electrode recordings in deep brain stimulation (DBS) surgery by integrating site- and sequence-based approaches, without compromising subthalamic nucleus (STN) detection accuracy...

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Main Authors: Stefanie Glowinsky, Zvi Israel, Sami Heymann, Hagai Bergman
Format: Article
Language:English
Published: IEEE 2025-01-01
Series:IEEE Transactions on Neural Systems and Rehabilitation Engineering
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Online Access:https://ieeexplore.ieee.org/document/11048996/
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author Stefanie Glowinsky
Zvi Israel
Sami Heymann
Hagai Bergman
author_facet Stefanie Glowinsky
Zvi Israel
Sami Heymann
Hagai Bergman
author_sort Stefanie Glowinsky
collection DOAJ
description Our aim was to identify thalamic electrophysiological activity along the trajectory to the subthalamic region using micro-electrode recordings in deep brain stimulation (DBS) surgery by integrating site- and sequence-based approaches, without compromising subthalamic nucleus (STN) detection accuracy. We used electrophysiological data from 29,735 recording sites across 112 patients to develop algorithms for automatic detection of the thalamus, STN, and non-cellular brain areas. We combined site-specific features with sequence-based information using two approaches: classical machine learning using a support vector machine and a Gaussian-HMM (SVM-GHMM), and a recurrent neural network (LSTM). The performance of both algorithms was compared to the commercially available HaGuide STN-detection algorithm. We assessed algorithm performance on thalamus and STN detection in pseudo-real-time using clinically relevant metrics. Our algorithms achieved 73%-77% sensitivity and 97%-98% specificity for thalamus detection, and 94%-96% sensitivity and 98%-99% specificity for STN detection. The thalamus, with its electrophysiological heterogeneity, is particularly well-suited for sequence-based classification. The SVM-GHMM performed slightly better than the LSTM in clinical metrics for STN detection, though both were significantly better than HaGuide. Both models were also effective in identifying the thalamus and STN in the closely related case of trajectories targeting the nearby posterior subthalamic area. We demonstrated the ability to automatically identify thalamic activity along the trajectory to subthalamic region by leveraging site- and sequence-based algorithms, without compromising on STN detection accuracy. This study highlights the feasibility of real-time, automated thalamus and STN detection, offering valuable context to neurosurgeons during DBS surgery.
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spelling doaj-art-0e3d74eec8bf45eaa280a8437edd0fcd2025-08-20T03:12:09ZengIEEEIEEE Transactions on Neural Systems and Rehabilitation Engineering1534-43201558-02102025-01-01332672268310.1109/TNSRE.2025.358277711048996Divide and Conquer: Automatic Detection of the Thalamus to Empower DBS Physiological Navigation to the Subthalamic RegionStefanie Glowinsky0https://orcid.org/0000-0003-3928-3637Zvi Israel1Sami Heymann2https://orcid.org/0009-0001-2657-3259Hagai Bergman3https://orcid.org/0000-0002-2402-6673Edmond and Lily Safra Center for Brain Sciences, Jerusalem, IsraelDepartment of Neurosurgery, Hadassah Medical Center, Jerusalem, IsraelDepartment of Neurosurgery, Hadassah Medical Center, Jerusalem, IsraelEdmond and Lily Safra Center for Brain Sciences, Jerusalem, IsraelOur aim was to identify thalamic electrophysiological activity along the trajectory to the subthalamic region using micro-electrode recordings in deep brain stimulation (DBS) surgery by integrating site- and sequence-based approaches, without compromising subthalamic nucleus (STN) detection accuracy. We used electrophysiological data from 29,735 recording sites across 112 patients to develop algorithms for automatic detection of the thalamus, STN, and non-cellular brain areas. We combined site-specific features with sequence-based information using two approaches: classical machine learning using a support vector machine and a Gaussian-HMM (SVM-GHMM), and a recurrent neural network (LSTM). The performance of both algorithms was compared to the commercially available HaGuide STN-detection algorithm. We assessed algorithm performance on thalamus and STN detection in pseudo-real-time using clinically relevant metrics. Our algorithms achieved 73%-77% sensitivity and 97%-98% specificity for thalamus detection, and 94%-96% sensitivity and 98%-99% specificity for STN detection. The thalamus, with its electrophysiological heterogeneity, is particularly well-suited for sequence-based classification. The SVM-GHMM performed slightly better than the LSTM in clinical metrics for STN detection, though both were significantly better than HaGuide. Both models were also effective in identifying the thalamus and STN in the closely related case of trajectories targeting the nearby posterior subthalamic area. We demonstrated the ability to automatically identify thalamic activity along the trajectory to subthalamic region by leveraging site- and sequence-based algorithms, without compromising on STN detection accuracy. This study highlights the feasibility of real-time, automated thalamus and STN detection, offering valuable context to neurosurgeons during DBS surgery.https://ieeexplore.ieee.org/document/11048996/Deep brain stimulationessential tremorParkinson’s diseasethalamussubthalamic nucleusposterior subthalamic area
spellingShingle Stefanie Glowinsky
Zvi Israel
Sami Heymann
Hagai Bergman
Divide and Conquer: Automatic Detection of the Thalamus to Empower DBS Physiological Navigation to the Subthalamic Region
IEEE Transactions on Neural Systems and Rehabilitation Engineering
Deep brain stimulation
essential tremor
Parkinson’s disease
thalamus
subthalamic nucleus
posterior subthalamic area
title Divide and Conquer: Automatic Detection of the Thalamus to Empower DBS Physiological Navigation to the Subthalamic Region
title_full Divide and Conquer: Automatic Detection of the Thalamus to Empower DBS Physiological Navigation to the Subthalamic Region
title_fullStr Divide and Conquer: Automatic Detection of the Thalamus to Empower DBS Physiological Navigation to the Subthalamic Region
title_full_unstemmed Divide and Conquer: Automatic Detection of the Thalamus to Empower DBS Physiological Navigation to the Subthalamic Region
title_short Divide and Conquer: Automatic Detection of the Thalamus to Empower DBS Physiological Navigation to the Subthalamic Region
title_sort divide and conquer automatic detection of the thalamus to empower dbs physiological navigation to the subthalamic region
topic Deep brain stimulation
essential tremor
Parkinson’s disease
thalamus
subthalamic nucleus
posterior subthalamic area
url https://ieeexplore.ieee.org/document/11048996/
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AT samiheymann divideandconquerautomaticdetectionofthethalamustoempowerdbsphysiologicalnavigationtothesubthalamicregion
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