Prospective study of the supraorbital foramina topography for inserting microelectrode neurostimulator applied to neuromodulation
Authors: Barros Mirna Duarte , Saleh Kassem Samir , Casella Marcela Santarelli , Liquidato Bianca Maria , Trevizol Alisson Paulino , Mendes Carlos José Lazzarini 
Published: June 2021

INTRODUCTIONPsychiatric patients classically receive pharmacological treatment which proved promote mood stability around six weeks. However, considering individuals unresponsive to drug treatment, there is the search for an alternative therapeutic approach. Among them are noninvasive brain stimulation techniques. Considering the topography of the nerve branches to be stimulated by this therapeutic approach, especially that emerges by the supraorbital foramina, the possibility of performing this procedure by the patient or family and that technology has allowed size electrodes increasingly smaller, justifying the study of the supraorbital foramina topography (Figure 1).OBJECTIVEDelimit topographically the positioning of the supraorbital foramina to the proper placement of electrodes in the noninvasive technique neuromodulation.METHODWe performed measurements in 60 skulls of the Department of Morphology, from Santa Casa de Sao Paulo School of Medical Sciences. Exclusion criteria: evidence of surgery or trauma.Used caliper model: INOXdigitalLeeTOOLS, resolution 0.01mm/0.005IN, precision + −0.02mm/0.001IN (<100mm), repeatability of + − 0.03mm/0.001IN (> 100 ~ 200mm) with linear measuring system.Two observers, known as Observer 1 and 2, independent, obtained the measurements for three consecutive times. The intra and interobserver measures correlation, as well as the mean and standard deviation of the measurements, were calculated. The measures were as follows:

Distance in millimeters, from the lateral to medial orbital border bilaterally (OD ‐ orbital distance).
Distance in millimeters, from medial orbital border to a perpendicular plane to the central point of the supraorbital foramina bilaterally (MB ‐ medial border of orbital foramina) (Figure 2).
RESULTSStatistical analysis was performed using SPSS version 21(SPSSInc. Released 2009 PASW Statistics for Windows, Version 18.0 Chicago. SPSS Inc.). We obtained that the orbital distance was x=42.8 mm and the medial border of the orbital foramina was x=14,75mm, so the foramina is located in the middle third of the orbital distance.Statistical analysis of agreement between observers was obtained by the intraclass correlation coefficient (ICC) inter and intraobserver. The measurements taken by two observers showed an ICC inter and intraobserver strong positive (r > 0.831). The only moderately positive step was found in Observer 2, measuring the medial border distance of the right side, r = 0.629 (Figure 3).The scatter plots demonstrate the correlation between measurements of observers (Figure 4, 5, 6).CONCLUSIONThe measures were possible. The measuring data suggesting that the better place to affix the electrode on the supraorbital foramina during the neurostimulation is in the medial third of the orbital distance. That information is an important anatomical landmark to patients and health professionals that use neurostimulation devices.This abstract is from the Experimental Biology 2018 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.