Subthalamic Nucleus Deep Brain Stimulation for Parkinson’s Disease: Magnetic Resonance Imaging Targeting Using Visible Anatomical Landmarks

2003 ◽  
Vol 80 (1-4) ◽  
pp. 76-81 ◽  
Author(s):  
Claudio Pollo ◽  
Reto Meuli ◽  
Philippe Maeder ◽  
François Vingerhoets ◽  
Joseph Ghika ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Deep Brain Stimulation ◽  
Magnetic Resonance ◽  
Subthalamic Nucleus ◽  
Brain Stimulation ◽  
Anatomical Landmarks ◽  
Resonance Imaging ◽  
Deep Brain

Performing functional magnetic resonance imaging in patients with Parkinson's disease treated with deep brain stimulation

2006 ◽  
Vol 21 (8) ◽  
pp. 1154-1162 ◽  
Author(s):  
Paula R. Arantes ◽  
Ellison F. Cardoso ◽  
Maria Â. Barreiros ◽  
Manoel J. Teixeira ◽  
Márcia R. Gonçalves ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Deep Brain Stimulation ◽  
Magnetic Resonance ◽  
Functional Magnetic Resonance Imaging ◽  
Brain Stimulation ◽  
Functional Magnetic Resonance ◽  
Resonance Imaging ◽  
Deep Brain

ISOLATION OF THE BRAIN‐RELATED FACTOR OF THE ERROR BETWEEN INTENDED AND ACHIEVED POSITION OF DEEP BRAIN STIMULATION ELECTRODES IMPLANTED INTO THE SUBTHALAMIC NUCLEUS FOR THE TREATMENT OF PARKINSON'S DISEASE

2009 ◽  
Vol 64 (suppl_5) ◽  
pp. ons374-ons384 ◽  
Author(s):  
Slawomir Daniluk ◽  
Keith G. Davies ◽  
Peter Novak ◽  
Thai Vu ◽  
Jules M. Nazzaro ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Deep Brain Stimulation ◽  
Magnetic Resonance ◽  
Subthalamic Nucleus ◽  
Brain Stimulation ◽  
Related Factor ◽  
Technical Error ◽  
Resonance Imaging ◽  
Computed Tomographic ◽  
Deep Brain

Abstract OBJECTIVE Although a few studies have quantified errors in the implantation of deep brain stimulation electrodes into the subthalamic nucleus (STN), a significant trend in error direction has not been reported. We have previously found that an error in axial plane, which is of most concern because it cannot be compensated for during deep brain stimulation programming, had a posteromedial trend. We hypothesized that this trend results from a predominance of a directionally oriented error factor of brain origin. Accordingly, elimination of nonbrain (technical) error factors could augment this trend. Thus, implantation accuracy could be improved by anterolateral compensation during target planning. METHODS Surgical technique was revised to minimize technical error factors. During 22 implantations, targets were selected on axial magnetic resonance imaging scans up to 1.5 mm anterolateral from the STN center. Using fusion of postoperative computed tomographic and preoperative magnetic resonance imaging scans, implantation errors in the axial plane were obtained and compared with distances from the lead to the STN to evaluate the benefit of anterolateral compensation. RESULTS Twenty errors and the mean error had a posteromedial direction. The average distances from the lead to the target and to the STN were 1.7 mm (range, 0.8–3.1 mm) and 1.1 mm (range, 0.1–1.9 mm), respectively. The difference between the 2 distances was significant (paired t test, P < 0.0001). The lower parts of the lead were consistently bent in the posteromedial direction on postoperative scout computed tomographic scans, suggesting that a brain-related factor is responsible for the reported error. CONCLUSION Elimination of the technical factors of error during STN deep brain stimulation implantation can result in a consistent posteromedial error. Implantation accuracy may be improved by compensation for this error in advance.

Targeting Accuracy of the Subthalamic Nucleus in Deep Brain Stimulation Surgery: Comparison Between 3 T T2-Weighted Magnetic Resonance Imaging and Microelectrode Recording Results

2017 ◽  
Vol 15 (1) ◽  
pp. 66-71 ◽  
Author(s):  
Andreas Nowacki ◽  
Ines Debove ◽  
Michael Fiechter ◽  
Frédéric Rossi ◽  
Markus Florian Oertel ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Deep Brain Stimulation ◽  
Magnetic Resonance ◽  
Subthalamic Nucleus ◽  
Brain Stimulation ◽  
Microelectrode Recording ◽  
Resonance Imaging ◽  
Entry Points ◽  
Targeting Accuracy ◽  
Deep Brain

Abstract BACKGROUND Targeting accuracy in deep brain stimulation (DBS) surgery can be defined as the level of accordance between selected and anatomic real target reflected by characteristic electrophysiological results of microelectrode recording (MER). OBJECTIVE To determine the correspondence between the preoperative predicted target based on modern 3-T magnetic resonance imaging (MRI) and intraoperative MER results separately on the initial and consecutive second side of surgery. METHODS Retrospective cohort study of 86 trajectories of DBS electrodes implanted into the subthalamic nucleus (STN) of patients with Parkinson's disease. The entrance point of the electrode into the STN and the length of the electrode trajectory crossing the STN were determined by intraoperative MER findings and 3 T T2-weighted magnetic resonance images with 1-mm slice thickness. RESULTS Average difference between MRI- and MER-based trajectory lengths crossing the STN was 0.28 ± 1.02 mm (95% CI: −0.51 to −0.05 mm). There was a statistically significant difference between the MRI- and MER-based entry points on the initial and second side of surgery (P = .04). Forty-three percent of the patients had a difference of more than ±1 mm of the MRI-based-predicted and the MER-based-determined entry points into the STN with values ranging from −3.0 to + 4.5 mm. CONCLUSION STN MRI-based targeting is accurate in the majority of cases on the first and second side of surgery. In 43% of implanted electrodes, we found a relevant deviation of more than 1 mm, supporting the concept of MER as an important tool to guide and optimize targeting and electrode placement.

Comparison of Three Methods of Targeting the Subthalamic Nucleus for Chronic Stimulation in Parkinson's Disease

2005 ◽  
Vol 56 (suppl_4) ◽  
pp. ONS-360-ONS-368 ◽  
Author(s):  
Yuri M. Andrade-Souza ◽  
Jason M. Schwalb ◽  
Clement Hamani ◽  
Hazem Eltahawy ◽  
Tasnuva Hoque ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Deep Brain Stimulation ◽  
Magnetic Resonance ◽  
Fiducial Marker ◽  
Resonance Imaging ◽  
The Mean ◽  
Direct Target ◽  
Deep Brain

Abstract OBJECTIVE: The success of subthalamic nucleus (STN) surgery for Parkinson's disease depends on accuracy in target determination. The objective of this study was to determine which of the following techniques was most accurate and precise in identifying the location for stimulation in STN deep brain stimulation surgery that is most clinically effective: direct targeting, indirect targeting using the positions of the anterior and posterior commissures, or a technique using the red nucleus (RN) as an internal fiducial marker. METHODS: We reviewed 14 patients with Parkinson's disease treated with bilateral STN deep brain stimulation (28 STN targets). Electrode implantation was based on direct and indirect targeting using two-dimensional magnetic resonance imaging with refinement using microelectrode recording. Optimal settings, including the contacts used, were determined during the clinical follow-up. The position of the best contact was defined with postoperative magnetic resonance imaging. This location was compared with the modified direct, indirect, and RN-based targets. The mean distances between the targets and the final position of the optimal contact were calculated. The accuracy and variance of each target were analyzed. RESULTS: The mean position of the best contact was x = 12.12 (standard deviation [SD], 1.45 mm), y = −2.41 (SD, 1.63 mm), and z = −2.39 (SD, 1.49 mm) relative to the midcommissural point. The mean distance between the optimal contact position and the planned target was 3.19 mm (SD, 1.19 mm) using the RN-based method, 3.42 mm (SD, 1.34 mm) using indirect targeting, and 4.66 mm (SD, 1.33 mm) using a modified direct target. The mean distance between the optimal contact and the RN-based target was significantly smaller than the mean distance between the optimal contact and the direct target (post hoc with Tamhane's correction, P < 0.001) but not between the optimal contact and the indirect target. The RN-based target had the smallest variance (F test, P < 0.001), indicating greater precision. CONCLUSION: The use of the RN as an internal fiducial marker for targeting the optimal region of STN stimulation was reliable and closely approximates the position of the electrode contact that provides the optimal clinical results.

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