Direct stereotactic targeting of the ventrointermediate nucleus of the thalamus based on anatomic 1.5-T MRI mapping with a white matter attenuated inversion recovery (WAIR) sequence

Vassal, François; Coste, Jérôme; Derost, Philippe; Mendes, Vivien; Gabrillargues, Jean; Nuti, C.; Durif, Franck; Lemaire, Jean‐Jacques

doi:10.1016/j.brs.2011.10.007

Cited by 73 publications

(51 citation statements)

References 28 publications

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“…This hypothesis would confirm previously published data: parts of the InL have been earlier mentioned for tremor reduction (Hirai and Jones, 1989) and several authors (Spiegelmann et al, 2006; Vassal et al, 2012) have reported that chronic stimulation of PLR works very well. Some authors (Caparros-Lefebvre et al, 1999; Vassal et al, 2012) already suggested that parts of the VO or of the zona incerta (Fytagoridis et al, 2012) could be appropriate targets as well. Recently Groppa et al (2014) proposed the dentatothalamic tract as key therapeutic DBS target structure.…”

Section: Discussionsupporting

confidence: 92%

“…Using a stereotactic planning software (iPlan 3, Brainlab, Feldkirchen, Germany), the VIM and its anatomic neighbors were carefully identified and manually outlined on the coronal plane of the WAIR sequence (Lemaire et al, 2010; Zerroug et al, 2016). The nuclei identification followed the previously published nomenclature (Lemaire et al, 2010; Vassal et al, 2012) based on their relative positions, intrinsic MRI tissue contrasts on 1.5T WAIR images (see Figure 6 in Zerroug et al, 2016) and an in-house microscopic 4.7T 3D T1 MRI atlas (see Figure 1 in Vassal et al, 2012). Target coordinates and two parallel trajectories were defined according to the stereotactic reference system, without AC-PC referencing.…”

Section: Methodsmentioning

confidence: 99%

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Patient-Specific Electric Field Simulations and Acceleration Measurements for Objective Analysis of Intraoperative Stimulation Tests in the Thalamus

Hemm

Pison

Alonso

et al. 2016

Front. Hum. Neurosci.

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Despite an increasing use of deep brain stimulation (DBS) the fundamental mechanisms of action remain largely unknown. Simulation of electric entities has previously been proposed for chronic DBS combined with subjective symptom evaluations, but not for intraoperative stimulation tests. The present paper introduces a method for an objective exploitation of intraoperative stimulation test data to identify the optimal implant position of the chronic DBS lead by relating the electric field (EF) simulations to the patient-specific anatomy and the clinical effects quantified by accelerometry. To illustrate the feasibility of this approach, it was applied to five patients with essential tremor bilaterally implanted in the ventral intermediate nucleus (VIM). The VIM and its neighborhood structures were preoperatively outlined in 3D on white matter attenuated inversion recovery MR images. Quantitative intraoperative clinical assessments were performed using accelerometry. EF simulations (n = 272) for intraoperative stimulation test data performed along two trajectories per side were set-up using the finite element method for 143 stimulation test positions. The resulting EF isosurface of 0.2 V/mm was superimposed to the outlined anatomical structures. The percentage of volume of each structure’s overlap was calculated and related to the corresponding clinical improvement. The proposed concept has been successfully applied to the five patients. For higher clinical improvements, not only the VIM but as well other neighboring structures were covered by the EF isosurfaces. The percentage of the volumes of the VIM, of the nucleus intermediate lateral of the thalamus and the prelemniscal radiations within the prerubral field of Forel increased for clinical improvements higher than 50% compared to improvements lower than 50%. The presented new concept allows a detailed and objective analysis of a high amount of intraoperative data to identify the optimal stimulation target. First results indicate agreement with published data hypothesizing that the stimulation of other structures than the VIM might be responsible for good clinical effects in essential tremor. (Clinical trial reference number: Ref: 2011-A00774-37/AU905)

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Section: Discussionsupporting

confidence: 92%

Section: Methodsmentioning

confidence: 99%

Patient-Specific Electric Field Simulations and Acceleration Measurements for Objective Analysis of Intraoperative Stimulation Tests in the Thalamus

Hemm

Pison

Alonso

et al. 2016

Front. Hum. Neurosci.

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“…Recent advances in imaging technology have enabled the direct anatomical localization of Vim, such as 3-T MRI (Spiegelmann et al 2006 ), diffusion tensor imaging (Ziyan et al 2006 ;Yamada et al 2010 ), and 1.5-T white matter-attenuated inversion recovery (Vassal et al 2012 ) although these technologies…”

Section: Surgical Procedures Of Vim-dbsmentioning

confidence: 99%

Thalamic Stimulation for Parkinson’s Disease: Clinical Studies on DBS

Miyagi

2014

Deep Brain Stimulation for Neurological Disorders

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“…Since the functionally important thalamic nuclei are difficult to identify with conventional imaging modalities, several novel approaches have been developed [4,24,25,26,27,28,29,30,31,32]. Magnetic resonance diffusion tractography (probabilistic tractography) and colored FA maps can be used to visualize white matter fibers in vivo and have many applications in neurosurgery.…”

Section: Discussionmentioning

confidence: 99%

Prelemniscal Radiations: A New Reliable Landmark of the Thalamic Nucleus Ventralis Intermedius Location?

Lefranc

Carron²,

Régis³

2015

Stereotact Funct Neurosurg

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Background: The thalamic nucleus ventralis intermedius (Vim nucleus) is the main surgical target for the management of intractable tremor. The Vim nucleus cannot be reliably located with routine stereotactic imaging, and so targeting relies on indirect coordinates. Objective: We propose to investigate if colored fractional anisotropy (FA) mapping can help to locate the Vim nucleus by identifying its borders, particularly the prelemniscal radiations (Raprl) that lie below and behind the nucleus. Method: We retrospectively reviewed the colored FA maps for 18 consecutive patients having undergone gamma knife stereotactic Vim thalamotomy for disabling tremor. Results: The Raprl were easily located on colored FA maps and enabled the identification of the lower and posterior borders of the Vim nucleus in all patients. In the medial plane, the mean distance ± SD between the Raprl and Vim nucleus was 0.77 ± 1.19 mm (range: 0.1-3.3). The Raprl were located 1.35 ± 1.33 mm (range: 0.2-3.9) behind the Vim nucleus and 1.99 ± 1.23 mm (range: 0.7-4.4) below it. The mean vector distance ± SD between the Vim nucleus and the Raprl was 3 ± 1.38 mm (range: 1.25-5.2). Conclusion: The Raprl can be easily seen on colored FA maps and constitute a reliable landmark for the borders of the Vim nucleus.

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Direct stereotactic targeting of the ventrointermediate nucleus of the thalamus based on anatomic 1.5-T MRI mapping with a white matter attenuated inversion recovery (WAIR) sequence

Abstract: 1.5-T MRI with WAIR sequence provides high-quality images of Vim suitable in DBS surgery, for accurate preoperative planning, direct targeting and anatomic analysis.

Cited by 73 publications

References 28 publications

Patient-Specific Electric Field Simulations and Acceleration Measurements for Objective Analysis of Intraoperative Stimulation Tests in the Thalamus

Patient-Specific Electric Field Simulations and Acceleration Measurements for Objective Analysis of Intraoperative Stimulation Tests in the Thalamus

Thalamic Stimulation for Parkinson’s Disease: Clinical Studies on DBS

Prelemniscal Radiations: A New Reliable Landmark of the Thalamic Nucleus Ventralis Intermedius Location?

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