Brain vascularization in deep brain stimulation surgeries: epilepsy, Parkinson's disease and obsessive-compulsive disorder

BACKGROUND: In our experience, we encountered more blood vessels during deep brain stimulation (DBS) surgeries in epilepsy. In this study, we have quantified and compared the cerebral vascularization in epilepsy, Parkinson's Disease (PD) and Obsessive-Compulsive Disorder (OCD).

METHODS: A retrospective observational study in 15 epilepsy and 15 PD patients was performed. The amount, location and size of blood vessels within 5 millimeter (mm) of all DBS electrode trajectories (n=120) for both targets (anterior nucleus of the thalamus: ANT and subthalamic nucleus: STN) in both patient groups were quantified and compared on a Medtronic workstation. Additionally, blood vessels in the trajectories (n=120) of another group of 15 PD (STN) and 15 OCD (Ventral Capsule-Ventral Striatum, VC-VS) patients were quantified and compared (trajectories n=120), also to the first group. Statistical analyses were performed with SPSS version 27.0 (descriptive statistics, independent samples T-tests, Mann Whitney U tests, ANOVA test and post-hoc Tukey test). A P-value < 0.05 was considered statistically significant.

RESULTS: Our results showed a significant greater amount of cerebral blood vessels in epilepsy patients (10 SD ± 4) compared to PD (PD1 6 SD ± 1 and PD2 5 SD ± 3) and OCD (5 SD ± 1) with P <0.0001. Also, all other subanalyses showed more vascularization in the epilepsy group.

CONCLUSIONS: Our results show that the brain of epilepsy patients seems to be more vascularized compared to PD and OCD patients. This can make the surgical planning for DBS more challenging and the use of multiple trajectories limited.