Correlation of Active Contact Positions with the Electrophysiological and Anatomical Subdivisions of the Subthalamic Nucleus in Deep Brain Stimulation

Weise, Lutz; Seifried, Carola; Eibach, Sebastian; Gasser, Thomas; Roeper, Jochen; Seifert, Volker; Hilker, Rüdiger

doi:10.1159/000345259

Cited by 26 publications

(27 citation statements)

References 54 publications

(36 reference statements)

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“…While numerous studies have suggested that the stimulation site correlated with the best clinical results in PD patients is located in the superior and lateral part of the STN [27,28,29,30], PSA DBS in PD patients have also suggested a positive effect on rigidity and bradykinesia. These findings should, however, be taken cautiously since the experience with PSA DBS is limited.…”

Section: Discussionmentioning

confidence: 99%

Deep Brain Stimulation for Tremor: Is There a Common Structure?

Fiechter¹,

Nowacki²,

Oertel³

et al. 2017

Stereotact Funct Neurosurg

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Background: Subthalamic nucleus (STN) stimulation has been recognized to control resting tremor in Parkinson disease. Similarly, thalamic stimulation (ventral intermediate nucleus; VIM) has shown tremor control in Parkinson disease, essential, and intention tremors. Recently, stimulation of the posterior subthalamic area (PSA) has been associated with excellent tremor control. Thus, the optimal site of stimulation may be located in the surrounding white matter. Aims: The objective of this work was to investigate the area of stimulation by determining the contact location correlated with the best tremor control in STN/VIM patients. Methods: The mean stimulation site and related volume of tissue activated (VTA) of 25 tremor patients (STN or VIM) were projected on the Morel atlas and compared to stimulation sites from other tremor studies. Results: All patients showed a VTA that covered ≥50% of the area superior and medial to the STN or inferior to the VIM. Our stimulation areas suggest involvement of the more lateral and superior part of the dentato-rubro-thalamic tract (DRTT), whereas targets described in other studies seem to involve the DRTT in its more medial and inferior part when it crosses the PSA. Conclusions: According to anatomical and diffusion tensor imaging data, the DRTT might be the common structure stimulated at different portions within the PSA/caudal zona incerta.

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Section: Discussionmentioning

confidence: 99%

Deep Brain Stimulation for Tremor: Is There a Common Structure?

Fiechter¹,

Nowacki²,

Oertel³

et al. 2017

Stereotact Funct Neurosurg

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“…Recent clinical studies indicate that there is a distinct relationship between specific electrode location within the STN and the corresponding therapeutic outcome (35, 36). Our finding of predominant activation in motor networks with associated limbic activation might be attributed to current spread into ventral STN and nearby associated regions (37, 38).…”

Section: Discussionmentioning

confidence: 99%

Subthalamic Nucleus Deep Brain Stimulation Induces Motor Network BOLD Activation: Use of a High Precision MRI Guided Stereotactic System for Nonhuman Primates

et al. 2014

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Background Functional magnetic resonance imaging (fMRI) is a powerful method for identifying in vivo network activation evoked by deep brain stimulation (DBS). Objective Identify the global neural circuitry effect of subthalamic nucleus (STN) DBS in nonhuman primates (NHP). Method An in-house developed MR image-guided stereotactic targeting system delivered a mini-DBS stimulating electrode, and blood oxygenation level-dependent (BOLD) activation during STN DBS in healthy NHP was measured by combining fMRI with a normalized functional activation map and general linear modeling. Results STN DBS significantly increased BOLD activation in the sensorimotor cortex, supplementary motor area, caudate nucleus, pedunculopontine nucleus, cingulate, insular cortex, and cerebellum (FDR < 0.001). Conclusion Our results demonstrate that STN DBS evokes neural network grouping within the motor network and the basal ganglia. Taken together, these data highlight the importance and specificity of neural circuitry activation patterns and functional connectivity.

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“…Further studies incorporating MER reported even more detailed somatotopic organization, and revealed that arm-related STN cells were located laterally and at the rostral and caudal poles, whereas leg-related cells were located medially and centrally (Rodriguez-Oroz et al, 2001; Theodosopoulos et al, 2003; Romanelli et al, 2004). Clinically, most effective DBS treatment is associated with stimulation of the dorsal STN region (Godinho et al, 2006; Weise et al, 2013). Neural activity of the anterior-medial area of the STN can be correlated with checking behavior in the STN of patients with OCD (Burbaud et al, 2013).…”

Section: Discussionmentioning

confidence: 99%

Asymmetric right/left encoding of emotions in the human subthalamic nucleus

Eitan

Shamir

Linetsky

et al. 2013

Front. Syst. Neurosci.

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Emotional processing is lateralized to the non-dominant brain hemisphere. However, there is no clear spatial model for lateralization of emotional domains in the basal ganglia. The subthalamic nucleus (STN), an input structure in the basal ganglia network, plays a major role in the pathophysiology of Parkinson's disease (PD). This role is probably not limited only to the motor deficits of PD, but may also span the emotional and cognitive deficits commonly observed in PD patients. Beta oscillations (12–30 Hz), the electrophysiological signature of PD, are restricted to the dorsolateral part of the STN that corresponds to the anatomically defined sensorimotor STN. The more medial, more anterior and more ventral parts of the STN are thought to correspond to the anatomically defined limbic and associative territories of the STN. Surprisingly, little is known about the electrophysiological properties of the non-motor domains of the STN, nor about electrophysiological differences between right and left STNs. In this study, microelectrodes were utilized to record the STN spontaneous spiking activity and responses to vocal non-verbal emotional stimuli during deep brain stimulation (DBS) surgeries in human PD patients. The oscillation properties of the STN neurons were used to map the dorsal oscillatory and the ventral non-oscillatory regions of the STN. Emotive auditory stimulation evoked activity in the ventral non-oscillatory region of the right STN. These responses were not observed in the left ventral STN or in the dorsal regions of either the right or left STN. Therefore, our results suggest that the ventral non-oscillatory regions are asymmetrically associated with non-motor functions, with the right ventral STN associated with emotional processing. These results suggest that DBS of the right ventral STN may be associated with beneficial or adverse emotional effects observed in PD patients and may relieve mental symptoms in other neurological and psychiatric diseases.

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Correlation of Active Contact Positions with the Electrophysiological and Anatomical Subdivisions of the Subthalamic Nucleus in Deep Brain Stimulation

Cited by 26 publications

References 54 publications

Deep Brain Stimulation for Tremor: Is There a Common Structure?

Deep Brain Stimulation for Tremor: Is There a Common Structure?

Subthalamic Nucleus Deep Brain Stimulation Induces Motor Network BOLD Activation: Use of a High Precision MRI Guided Stereotactic System for Nonhuman Primates

Asymmetric right/left encoding of emotions in the human subthalamic nucleus

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