Automatic computation of electrode trajectories for Deep Brain Stimulation: a hybrid symbolic and numerical approach

The optimal electrode trajectory is needed to assist surgeons in planning Deep Brain Stimulation (DBS). A method for image-based trajectory planning was developed and tested. Rules governing the DBS surgical procedure were defined with geometric constraints. A formal geometric solver using multimodal brain images and a template built from 15 brain MRI scans were used to identify a space of possible solutions and select the optimal one. For validation, a retrospective study of 30 DBS electrode implantations from 18 patients was performed. A trajectory was computed in each case and compared with the trajectories of the electrodes that were actually implanted. Computed trajectories had an average difference of 6.45A degrees compared with reference trajectories and achieved a better overall score based on satisfaction of geometric constraints. Trajectories were computed in 2 min for each case. A rule-based solver using pre-operative MR brain images can automatically compute relevant and accurate patient-specific DBS electrode trajectories.