Stereotactic Targeting of the Ventrointermediate Nucleus of the Thalamus by Direct Visualization with High-Field MRI

Abstract

Objective: To evaluate the ability of high-field MRI to consistently produce high-resolution, anatomical images of the thalamic ventrointermediate nucleus (Vim) suitable for stereotactic targeting. Methods: MR images of the thalamus of patients treated for essential tremor were acquired prior to treatment using a 3-tesla MR system. Similar images were acquired in 6 volunteers using, for comparison, both a 1.5-tesla and a 3.0-tesla system. Results: The thalamic Vim was clearly and consistently delineated on the 3-tesla images. These images were successfully used for target localization in essential tremor patients. In the volunteers data, images acquired using the 1.5-tesla system were inferior to those acquired using the 3-tesla system, lacking the ability to consistently provide reliably defined borders of the Vim. Conclusion: 3-tesla MRI can provide high-quality depiction of the Vim, potentially enabling accurate treatment planning by direct visualization and definition of the targeted Vim.

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

“…Following our preliminary results such structures could be the InL or especially the fiber tracks FF/PLR. 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.…”

MR Anatomy of Deep Brain Nuclei with Special Reference to Specific Diseases and Deep Brain Stimulation Localization

“…The ventral intermediate nucleus (VIM) is commonly targeted with deep brain stimulation (DBS) for the treatment of essential tremor ( Figure 2C). The VIM is located laterally within the thalamus and is situated between the ventral lateral (VL) and the ventral posteromedial (VPM) nuclei 1 . Figure 1 3 Tesla axial T2 MR image of a healthy subject shows the head of the caudate (C) and putamen (P), which together make up the striatum.…”

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

“…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…”