Active Brain & Nervous System NIHR-supported project Psychology & Behaviour

Detecting Imaging Biomarkers of Deep Brain Stimulation Outcome in Paediatric Dystonia

In plain English

AI plain-English summary

Deep brain stimulation can dramatically improve severe movement disorders in children, but doctors currently have no reliable way to predict which patients will benefit before surgery. Dystonia causes painful, uncontrollable muscle contractions that can make walking, eating, or even sitting still impossible. For children with the most severe forms, deep brain stimulation—implanting electrodes to regulate faulty neural signals—is often the best option. Yet the procedure carries risks, and roughly a third of patients see little improvement. The problem is that surgeons lack clear biomarkers to guide patient selection. This project mines existing MRI and CT scans from children treated at Alder Hey Children’s Hospital, searching for patterns in brain structure and electrode placement that correlate with good outcomes. The scans are already collected as routine clinical practice, so the research adds no extra burden on patients. If successful, the work could give clinicians a practical tool to identify which children are most likely to respond to deep brain stimulation. That would spare non-responders unnecessary surgery, reduce waiting times for those who would benefit, and help families make informed decisions about a life-altering treatment. The research is applied and directly clinical—its value lies in improving a specific medical decision that affects dozens of severely ill children each year.

View original technical description
Dystonia is a movement disorder that involves excessive muscular contractions, resulting in abnormal posturing, pain and impairs day-to-day living. Dystonia in paediatric patients can be severely debilitating, severely diminishing quality of life. Paediatric patients with debilitating dystonia are often treated with deep brain stimulation (DBS), a neurosurgical procedure that can significantly improve symptoms, and improve daily life. Preoperative brain Magnetic Resonance Imaging (MRI) scans together with the fusion with peri-operative Computed Tomography (CT) head scans are routinely acquired for DBS planning and assessment. This imaging practice offers great potential to identify biomarkers that can be used to predict the outcome of motor and non-motor symptoms. We aim to investigate novel biomarkers from data that has been already acquired from paediatric patients with dystonia from the Alder Hey Children’s hospital to predict DBS outcome efficacy. Using patient scans, we aim to identify who will benefit the most from DBS. This will help to offer insight into the best management of these complex group of patients and will aid in the optimal selection of potential DBS candidates.

Researchers

Jonathan Ellenbogen (Principal Investigator)

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