Claire Haegelen

• Centre Hospitalier Universitaire de Rennes

The analysis of electrophysiological data is crucial for certain surgical procedures such as deep brain stimulation, which has been adopted for the treatment of a variety of neurological disorders. During the procedure, auditory analysis of these signals helps the clinical team to infer the neuroanatomical location of the stimulation electrode and...

Introduction: Risk factors (e.g., motor symptom asymmetry) for short- and long-term cognitive and neuropsychiatric symptoms following deep brain stimulation (DBS) of the subthalamic nucleus (STN) in patients with Parkinson's disease have yet to be fully identified. The objectives of the present study were to determine whether motor symptom asymmet...

Voxel-based analysis is an invaluable tool for biomarker discovery in population neuroimaging. The traditional approach however is limited to local, linear biomarkers, determining if the linear correlation between the quantitative value of an image is correlated with the disease state at a single voxel. By analysing convolutional neural networks th...

Extracting population‐wise information from medical images, specifically in the neurological domain, is crucial to better understanding disease processes and progression. This is frequently done in a whole‐brain voxel‐wise manner, in which a population of patients and healthy controls are registered to a common co‐ordinate space and a statistical t...

Extracting population-wise information from medical images, specifically in the neurological domain, is crucial to better understanding disease processes and progression. This is frequently done in a whole-brain voxel-wise manner, in which a population of patients and healthy controls are registered to a common co-ordinate space and a statistical t...

Risk factors for long-term non-motor symptoms and quality of life following subthalamic nucleus deep brain stimulation (STN DBS) have not yet been fully identified. In the present study, we investigated the impact of motor symptom asymmetry in Parkinson’s disease. Data were extracted for 52 patients with Parkinson’s disease (half with predominantly...

Risk factors for long-term non-motor disorders and quality of life following subthalamic nucleus deep-brain stimulation (STN DBS) have not yet been fully identified. In the present study, we investigated the impact of motor symptom asymmetry in Parkinson’s disease. Data were extracted for 52 patients with Parkinson’s disease (half with left-sided m...

Objectif Décrire la procédure de l’hystérectomie extrafasciale par laparoscopie pour éviter les lésions de l’uretère. Méthodes Les données ont été obtenues à partir de : – l’étude anatomique de 10 cadavres féminins frais pour mesurer la distance entre le croisement de l’uretère et de l’artère utérine et le niveau de section de la branche ascendant...

PurposeDeep Brain Stimulation (DBS) is a proven therapy for Parkinson’s Disease (PD), frequently resulting in an enhancement of motor function. Nonetheless, several undesirable side effects can occur after DBS, which can worsen the quality of life of the patient. Thus, the clinical team has to carefully select patients on whom to perform DBS. Over...

PurposeDeep brain stimulation (DBS) is a common treatment for a variety of neurological disorders which involves the precise placement of electrodes at particular subcortical locations such as the subthalamic nucleus. This placement is often guided by auditory analysis of micro-electrode recordings (MERs) which informs the clinical team as to the a...

Deep brain stimulation (DBS) is an interventional treatment for Parkinson's disease which involves the precise positioning of stimulated electrodes within deep brain structures, such as the Subthalamic Nucleus (STN). Although originally identified via imaging, additional inter-operative guidance is necessary to localize the target anatomy. Analysis...

Medical questionnaires are a valuable source of information but are often difficult to analyse due to both their size and the high possibility of having missing values. This is a problematic issue in biomedical data science as it may complicate how individual questionnaire data is represented for statistical or machine learning analysis. In this pa...

Introduction: Internal globus pallidus (GPi) deep brain stimulation (DBS) is a safe and effective alternative treatment in Parkinson's disease (PD) for patients with cognitive impairment. However, no study has yet investigated metabolic changes within a large series of patients undergoing GPi stimulation. Objective: We assessed motor, cognitive...

In addition to the subthalamic nucleus’ (STN) role in motor control, STN deep brain stimulation (DBS) for Parkinson’s disease (PD) has also uncovered its involvement in cognitive and limbic processing. STN neural oscillations analyzed through local field potential (LFP) recordings have been shown to contribute to emotional (mostly in the alpha band...

The subthalamic nucleus (STN) is involved in different aspects of emotional processes and more specifically in emotional prosody recognition. Recent studies on the behavioral effects of deep brain stimulation (DBS) in patients with Parkinson's disease (PD) have uncovered an asymmetry in vocal emotion decoding in PD, with left-onset PD patients show...

Micro-electrode recording (MER) is a powerful way of localizing target structures during neurosurgical procedures such as the implantation of deep brain stimulation electrodes, which is a common treatment for Parkinson's disease and other neurological disorders. While Micro-electrode Recording (MER) provides adjunctive information to guidance assis...

The objective of this study was to explore the brain modifications associated with vocal emotion (i.e., emotional prosody) processing deficits in patients with Parkinson’s disease after deep brain stimulation of the subthalamic nucleus, and the impact of motor asymmetry on these deficits. We therefore conducted 18-fluorodeoxyglucose positron emissi...

Parkinson’s Disease provokes alterations of subcortical deep gray matter, leading to subtle changes in the shape of several subcortical structures even before the manifestation of motor and non-motor clinical symptoms. We used an automated registration and segmentation pipeline to measure this structural alteration in one early and one advanced Par...

Introduction Patients with Parkinson’s disease sometimes report postural instability and gait disorders (PIGD) after subthalamic nucleus deep brain stimulation (STN-DBS). Whether this is the direct consequence of DBS or the result of natural disease progression is still subject to debate. Objective To compare changes in brain metabolism during STN...

Résumé Introduction La spasticité des muscles ischio-jambiers peut entraîner une déformation en flexion du genou, susceptible de causer une invalidité. Le traitement chirurgical par neurotomie sélective des branches du nerf sciatique pour les muscles ischio-jambiers peut alors être indiqué. Peu d’études ont démontré l’origine précise de ces branch...

Background: Hamstring spasticity can bring about a flexion deformity of the knee, liable to cause disability. Surgical treatment by selective neurotomies of the sciatic nerve branches leading to the hamstring muscles may then be indicated. Few studies have investigated the precise origin of these branches on the sciatic nerve, describing the inner...

Cognitive action control depends on cortical-subcortical circuits, involving notably the subthalamic nucleus (STN), as evidenced by local field potentials recordings (LFPs) studies. The STN consistently shows an increase in theta oscillations power during conflict resolution. Some studies have shown that cognitive action control in Parkinson's dise...

Cognitive action control depends on cortical-subcortical circuits, involving notably the subthalamic nucleus (STN), as evidenced by local field potentials recordings (LFPs) studies. The STN consistently shows an increase in theta oscillations power during conflict resolution. Some studies have shown that cognitive action control in Parkinson's dise...

Anatomical atlases have been developed to improve the targeting of basal ganglia in deep brain stimulation. However, the sole anatomy cannot predict the functional outcome of this surgery. Deep brain stimulation is often a compromise between several functional outcomes: motor, fluency and neuropsychological outcomes in particular. In this study, we...

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Background: Moving from awake surgery under local anesthesia to asleep surgery under general anesthesia will require to precisely predict the outcome of deep brain stimulation. Objective: To propose a data-driven prediction of both the therapeutic effect and side effects of the surgery. Methods: The retrospective intraoperative data from 30 pati...

Deep brain stimulation effectively relieves most motor symptoms of Parkinson's disease • Effects on freezing of gait remain controversial with reports of improvement, worsening, and even induction post-surgery. Our objective was to evaluate the effects of bilateral subthalamic nucleus deep brain stimulation on subjective and objective freezing of g...

Subthalamic deep brain stimulation (STN DBS) is an effective treatment for reducing the motor symptoms of patients with Parkinson's disease (PD), but several side effects have been reported, concerning the processing of emotions. Music has been shown to evoke powerful emotional experiences - not only basic emotions, but also complex, so-called aest...

Objective: Deep brain stimulation (DBS) is an increasingly common treatment for neurodegenerative diseases. Neurosurgeons must have thorough procedural, anatomical, and functional knowledge to plan electrode trajectories and thus ensure treatment efficacy and patient safety. Developing this knowledge requires extensive training. We propose a train...

Purpose: Deep brain stimulation (DBS) is a procedure requiring accurate targeting and electrode placement. The two key elements for successful planning are preserving patient safety by ensuring a safe trajectory and creating treatment efficacy through optimal selection of the stimulation point. In this work, we present the first approach of comput...

Using intracranial local field potential (LFP) recordings in patients with Parkinson's disease (PD) undergoing deep brain stimulation (DBS), we explored the electrophysiological activity of the subthalamic nucleus (STN) in response to emotional stimuli in the auditory modality. Previous studies focused on the influence of visual stimuli. To this en...

Objective: subthalamic nucleus deep brain stimulation (STN DBS) is limited by the occurrence of a pyramidal tract side effect (PTSE) induced by electrical activation of the pyramidal tract. Predictive models are needed to assist the surgeon during the electrode trajectory preplanning. The objective of the study was to compare two methods of PTSE p...

In a controlled before-and-after study in a single-center, we assessed whether identification of Staphylococcus aureus (SA) nasal carriers followed by nasal mupirocin ointment and chlorhexidine soap reduced surgical site infections (SSI) among 182 patients undergoing deep brain stimulation. 119 patients were included in the control group and 63 in...

Preoperative path planning for Deep Brain Stimulation (DBS) is a multi-objective optimization problem consisting in searching the best compromise between multiple placement constraints. Its automation is usually addressed by turning the problem into mono-objective thanks to an aggregative approach. However, despite its intuitiveness, this approach...

Abstract Subthalamic nucleus deep-brain stimulation (STN-DBS) is an effective treatment in Parkinson's disease (PD), but can have cognitive side effects, such as increasing the difficulty of producing appropriate responses when a habitual but inappropriate responses represent strong alternatives. STN-DBS also appears to modulate representations of...

Background Deep Brain Stimulation (DBS) is effective for Parkinson’s disease (PD) symptom relief; however, improvement of freezing of gait (FOG) remains under debate. Some studies indicate STN-DBS alleviates FOG, while others suggest an association of STN-DBS with worsening of gait and balance or even induction of FOG. The VANTAGE study assesses mo...

Purpose: The dorsolateral prefrontal cortex (DLPFC) is a cortical area involved in higher cognitive functions, and at the center of the pathophysiology of mental disorders such as depression and schizophrenia. Considering these major roles and the development of deep brain stimulation, the object of this study was to assess the patterns of connect...

Introduction: Deep brain stimulation (DBS) of the subthalamic nucleus (STN) for the management of motor symptoms of Parkinson disease (PD) is typically performed under conscious sedation with awake evaluation during intraoperative physiologic testing. However, developments in surgical techniques now allow for subjects to be asleep during the proce...

Introduction: Deep brain stimulation (DBS) has been demonstrated to be effective for Parkinson disease (PD) symptom relief. We sought to characterize the benefit of subthalamic nucleus (STN) DBS for PD patients using a recently CE-marked multiple-source, constant-current system that permits a well-defined distribution of applied current. We report...

Deep brain stimulation of the medial globus pallidus (GPm) is a surgical procedure for treating patients suffering from Parkinson's disease. Its therapeutic effect may be limited by the presence of pyramidal tract side effect (PTSE). PTSE is a contraction time-locked to the stimulation when the current spreading reaches the motor fibers of the pyra...

Deep brain stimulation of the medial globus pallidus (GPm) is a surgical procedure for treating patients suffering from Parkinson’s disease. Its therapeutic effect may be limited by the presence of pyramidal tract side effect (PTSE). PTSE is a contraction time-locked to the stimulation when the current spreading reaches the motor fibers of the pyra...

The mechanisms behind weight gain following deep brain stimulation (DBS) surgery seem to be multifactorial and suspected depending on the target, either the subthalamic nucleus (STN) or the globus pallidus internus (GPi). Decreased energy expenditure following motor improvement and behavioral and/or metabolic changes are possible explanations. Focu...

Individual clinical and demographic characteristics of the patients before and after GPi surgery. (XLSX)

Objective: We hypothesized that high frequency oscillations (HFOs) with irregular amplitude and frequency more specifically reflect epileptogenicity than HFOs with stable amplitude and frequency. Methods: We developed a fully automatic algorithm to detect HFOs and classify them based on their morphology, with types defined according to regularit...

Subthalamic nucleus (STN) deep brain stimulation (DBS) has recently advanced our understanding of the major role played by this basal ganglion in human emotion. Research indicates that STN DBS can induce modifications in all components of emotion, and neuroimaging studies have shown that the metabolic modifications correlated with these emotional d...

Objective: The decrease in verbal fluency in patients with Parkinson's disease (PD) undergoing subthalamic nucleus deep brain stimulation (STN-DBS) is usually assumed to reflect a frontal lobe-related cognitive dysfunction, although evidence for this is lacking. Methods: To explore its underlying mechanisms, we combined neuropsychological, psych...

Purpose: Automatic methods for preoperative trajectory planning of electrodes in deep brain stimulation are usually based on the search for a path that resolves a set of surgical constraints to propose an optimal trajectory. The relative importance of each surgical constraint is usually defined as weighting parameters that are empirically set befo...

BACKGROUND AND AIM: In general, DBS has been demonstrated to be effective for PD symptom relief; however, improvement of FOG remains under debate. Whereas some studies support the idea that FOG is alleviated after STN-DBS, STN-DBS has also been associated with worsening of gait and balance and, in some patients, STN-DBS even induces FOG. The VANTAG...

A rare case of intradiploic growing fracture of the occipital bone is presented. Examination of this case and literature review was carried out to find significant specific features of such a rare condition. A 4-year-old boy was operated on for a huge occipital intradiploic growing skull fracture. His medical history, surgical management, and posto...

High-frequency deep brain stimulation (DBS) with a single electrical source is effective for motor symptom relief in patients with Parkinson's disease. We postulated that a multiple-source, constant-current device that permits well defined distribution of current would lead to motor improvement in patients with Parkinson's disease. We did a prospec...

Subthalamic nucleus deep brain stimulation (STN-DBS) has been proven to improve health-related quality of life (HRQoL) in patients with Parkinson’s disease (PD) presenting medically refractory motor complications and dyskinesia. However, some patients fail to benefit from STN-DBS despite rigorous preoperative selection. We postulated that they have...

Several hypotheses have been put forward to explain weight gain after deep brain stimulation (DBS), but none provides a fully satisfactory account of this adverse effect. We analyzed the correlation between changes in brain metabolism (using positron emission tomography [PET] imaging) and weight gain after bilateral subthalamic nucleus DBS in patie...

Background: The expansion of endovascular techniques for intracranial aneurysms has led to a global decrease in vascular neurosurgery activity. This situation might impact neurosurgeons' level of expertise, even though they all might have to deal with this surgically challenging pathology. In that context, we wanted to assess the impact of cumulat...

Subthalamic nucleus (STN) deep brain stimulation (DBS) is an effective surgical therapy to treat Parkinson's disease (PD). Conventional methods employ standard atlas coordinates to target the STN, which, along with the adjacent red nucleus (RN) and substantia nigra (SN), are not well visualized on conventional T1w MRIs. However, the positions and s...

Background High-frequency deep brain stimulation (DBS) represents a major stake for treatment for treatment-resistant depression (TRD). We describe a preliminary trial of DBS of two potential brain targets in chronic TRD: the nucleus accumbens (Acb) and, in the event of failure, the caudate nucleus. Experimental procedures Patients were followed f...

Deep brain stimulation (DBS) is a surgical procedure for treating motor-related neurological disorders. DBS clinical efficacy hinges on precise surgical planning and accurate electrode placement, which in turn call upon several image processing and visualization tasks, such as image registration, image segmentation, image fusion, and 3D visualizati...

Rationale, aims, and objectives: The management of non-technical skills is a major factor affecting teamwork quality and patient safety. This article presents a Behavioral Marker System for assessing Neurosurgical Non-Technical Skills (BMS-NNTS). We tested the BMS during Deep Brain Stimulation surgery. Method: We developed the BMS in three stages....

This paper presents a fully automatic procedure for optimization of depth electrode implantation planning in epilepsy. To record intracranial EEG in some patients with intractable epilepsy, depth electrodes are implanted through holes in the skull. The proposed fully automatic procedure maximizes recording coverage of the target volume by estimatin...

We report 3 cases of intracerebral cyst revealed by an unusual evolution of extrapyramidal symptoms. Diagnosis was based on MRI and the patients were treated by a cystoperitoneal or a cysto-atrial shunt. The surgical procedure was successful in the 3 cases, resulting in the rapid disappearance of symptoms. Copyright © 2014 Elsevier Masson SAS. All...

Nous rapportons les observations de 3 patientes ayant eu un volumineux kyste intracérébral révélé de façon inhabituelle par des symptômes extrapyramidaux. Le diagnostic de kyste intracérébral a été fait par une IRM et le traitement a consisté en une dérivation péritonéale ou atriale du kyste. Dans les 3 cas, tous les symptômes ont disparu rapidemen...

Purpose: Deep brain stimulation (DBS) surgery is used to reduce motor symptoms when movement disorders are refractory to medical treatment. Post-operative brain morphology can induce electrode deformations as the brain recovers from an intervention. The inverse brain shift has a direct impact on accuracy of the targeting stage, so analysis of elec...

The logistic model is widely used to assess the risk factors for surgical site infections (SSIs). An alternative to the logistic model is the Cox model. The objective of this study was to compare these 2 models to identify the risk factors of SSIs in neurosurgery. The Cox model is a valid alternative for assessing the risk factors of SSIs.

The goal of this study was to find a registration technique to improve the alignment of ultrasound images taken before and after brain tumor resection. Validation was performed on 16 tumor cases in 2 ways: (1) manually selected tags on pre- and postresection ultrasounds were used to compute the mean Euclidean distance between corresponding points i...

Purpose: Removal of areas generating high-frequency oscillations (HFOs) recorded from the intracerebral electroencephalography (iEEG) of patients with medically intractable epilepsy has been found to be correlated with improved surgical outcome. However, whether differences exist according to the type of epilepsy is largely unknown. We performed a...

Stimulation of the centromedian thalamic nucleus (CM) was performed during presurgical depth recordings in a patient with drug-resistant partial epilepsy related to premotor focal cortical dysplasia. Low- and high-frequency stimulation of the ipsilateral CM reproducibly suppressed the interictal spikes and fast rhythms. This is the first time that...

For patients suffering from Parkinson's disease with severe movement disorders, functional surgery may be required when medical therapy isn't effective. In Deep Brain Stimulation (DBS), electrodes are implanted within the brain to stimulate deep structures such as SubThalamic Nucleus (STN). The quality of patient surgical outcome is generally relat...

One of the important challenges in the field of medical imaging is finding real clinical images with which to validate new image processing algorithms. This is particularly true for tracked 3D ultrasound images of the brain. In 2010, pre- and postoperative magnetic resonance and intraoperative ultrasound images were acquired from brain tumor patien...

The mechanisms behind weight gain following deep brain stimulation (DBS) surgery seem to be multifactorial and suspected depending on the target, either the subthalamic nucleus (STN) or the globus pallidus internus (GPi). Decreased energy expenditure following motor improvement and behavioral and/or metabolic changes are possible explanations. Focu...

Purpose Template-based segmentation techniques have been developed to facilitate the accurate targeting of deep brain structures in patients with movement disorders. Three template-based brain MRI segmentation techniques were compared to determine the best strategy for segmenting the deep brain structures of patients with Parkinson’s disease. Metho...

Deep brain stimulation (DBS) is used to reduce the motor symptoms such as rigidity or bradykinesia, in patients with Parkinson's disease (PD). The Subthalamic Nucleus (STN) has emerged as prime target of DBS in idiopathic PD. However, DBS surgery is a difficult procedure requiring the exact positioning of electrodes in the pre-operative selected ta...

I tumori spinali e intrarachidei sono suscettibili di causare una morbilità neurologica importante. Questi tumori si rivelano, il più delle volte, con un dolore vertebrale, vero e proprio sintomo cardine che può associarsi a un deficit motorio e/o sensitivo di comparsa progressiva o subacuta e associato a disturbi vescicosfinterici. La risonanza ma...

Understanding the vascular variability of the inferior temporal occipital regions is essential for microsurgical approaches to this cerebral zone. To this end, we carried out a microanatomical study of the inferior temporal cortical branches of the posterior cerebral artery (PCA) in order to define their vascularisation territories. We studied 40 c...

In this paper we present the methods implemented in the CLARCS (C++ Library for Automated Registration and Comparison of Surfaces) library. This library allows some basic and high level processing on free-form surfaces, represented as point sets or meshes. Three methods are the "building bricks" of CLARCS; they allow (i) the rigid/affine/non-linear...

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...

Subthalamic nucleus (STN) deep brain stimulation (DBS) has been demonstrated as an efficient surgical treatment in patients with Parkinson's disease suffering from severe disabilities in their motor symptoms (tremor, akinesia, rigidity) [1]. Sometimes, patients with STN DBS have secondary neuropsychological and/or psychiatric effects because the ST...

Movement disorders in patients with Parkinson’s disease may require functional surgery, when medical therapy isn’t effective. In Deep Brain Stimulation (DBS), electrodes are implanted within the brain to stimulate deep structures such as SubThalamic Nucleus (STN). This paper describes successive steps for constructing digital atlases gathering pati...

We present a new technique for registering magnetic resonance (MR) and ultrasound images in the context of neurosurgery. It involves generating a pseudo-ultrasound (pseudo-US) from a segmented MR image and uses cross-correlation as the cost function to register the pseudo-US to the real ultrasound data. The algorithm's performance is compared with...

Introduction Using an anonymous questionnaire, this study aimed to assess hopes and perceptions of second-year medical school students faced to gross anatomy dissections and to appreciate the status of dissection within the others anatomical teaching tools. Materials and methods The questionnaire was distributed among 210 second-year medical stude...

In simultaneous scalp electroencephalography (EEG) and functional magnetic resonance imaging (fMRI), blood oxygen level dependent (BOLD) changes occurring before the spike have been sometimes described but could not be explained. To characterize the origin of this prespike BOLD signal change, we looked for electrographic changes in stereo-EEG (SEEG...

Using an anonymous questionnaire, this study aimed to assess hopes and perceptions of second-year medical school students faced to gross anatomy dissections and to appreciate the status of dissection within the others anatomical teaching tools. The questionnaire was distributed among 210 second-year medical students during gross anatomy dissections...

This article describes a two-year surveillance of neurosurgical site infections and an outbreak of infections in deep brain stimulation (DBS) cases. From April to December 2008, six patients had a DBS surgical site infection (SSI). Audits of hygiene practices, infection control of the healthcare environment, and preoperative antimicrobial prophylax...

In this monocentric study, the median delay between deep brain stimulation implantation and infection was 28 days (range, 8–820). Infections limited to generator (n = 4) required partial hardware removal, whereas infections involving frontal or retroauricular sites (n = 7) required total removal. Surgical samples yielded Staphylococcus aureus (n =...