Variability in subthalamic nucleus targeting for deep brain stimulation with 3 and 7 Tesla magnetic resonance imaging

Isaacs, Bethany R.; Heijmans, Margot; Kuijf, Mark L.; Kubben, Pieter L.; Ackermans, Linda; Temel, Yasin; Keuken, Max C.; Forstmann, Birte U.

doi:10.1016/j.nicl.2021.102829

Cited by 10 publications

(11 citation statements)

References 69 publications

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“…3 . The use of 7 Tesla imaging also recently showed that this new field led to determining the localization of the STN’s entry more dorsally than determined from MERs ( Bot et al, 2019 ), or to identifying the standard target as more ventral than expected with 3 Tesla imaging ( Isaacs et al, 2021 ). This could reflect a low density of cells at the STN’s border that can correspond to the usual increases in background “noise” activity in the MERs observed on the borders of the STN.…”

Section: Discussionmentioning

confidence: 99%

Electrophysiological confrontation of Lead-DBS-based electrode localizations in patients with Parkinson’s disease undergoing deep brain stimulation

Awadhi

Tyrand

Horn

et al. 2022

NeuroImage: Clinical

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Section: Discussionmentioning

confidence: 99%

Electrophysiological confrontation of Lead-DBS-based electrode localizations in patients with Parkinson’s disease undergoing deep brain stimulation

Awadhi

Tyrand

Horn

et al. 2022

NeuroImage: Clinical

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“…Preoperative patient-specific MRI (direct targeting), standardized atlases (indirect targeting) or hybrid targeting aid in optimal target location 40 . The feasibility and accuracy of direct targeting is mainly dependent on the quality of the MRI 38 , 41 , 42 . Most targets used in functional neurosurgery are suboptimally visualized on routine low field 1.5 Tesla or 3 Tesla MRI 43 , 44 .…”

Section: Target Visualization and Programming Accuracy (Image-based)mentioning

confidence: 99%

“…Advances in neuroimaging technology over the past decades may overcome this limitation with the availability of ultra-high-field (UHF)-MRI and the use of new sequences resulting from changes in MRI acquisition parameters 38 , 43 , 44 . Low field MRI is associated with limited contrast and signal to noise ratios and generates images that lack sharp and clear borders for small deep brain structures 42 , 45 . UHF MRI systems (7T and above) can obtain submillimeter anatomical information 46 .…”

Section: Target Visualization and Programming Accuracy (Image-based)mentioning

confidence: 99%

Deep brain stimulation in Parkinson’s disease: state of the art and future perspectives

França

Carra

Diniz

et al. 2022

Arq. Neuro-Psiquiatr.

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For more than 30 years, Deep Brain Stimulation (DBS) has been a therapeutic option for Parkinson’s disease (PD) treatment. However, this therapy is still underutilized mainly due to misinformation regarding risks and clinical outcomes. DBS can ameliorate several motor and non-motor symptoms, improving patients’ quality of life. Furthermore, most of the improvement after DBS is long-lasting and present even in advanced PD. Adequate patient selection, precise electric leads placement, and correct DBS programming are paramount for good surgical outcomes. Nonetheless, DBS still has many limitations: axial symptoms and signs, such as speech, balance and gait, do not improve to the same extent as appendicular symptoms and can even be worsened as a direct or indirect consequence of surgery and stimulation. In addition, there are still unanswered questions regarding patient’s selection, surgical planning and programming techniques, such as the role of surgicogenomics, more precise imaging-based lead placement, new brain targets, advanced programming strategies and hardware features. The net effect of these innovations should not only be to refine the beneficial effect we currently observe on selected symptoms and signs but also to improve treatment resistant facets of PD, such as axial and non-motor features. In this review, we discuss the current state of the art regarding DBS selection, implant, and programming, and explore new advances in the DBS field.

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“…The most frequently targeted brain region in DBS is the subthalamic nucleus (STN), which is an integral hub within the motor circuitry [ 10 ]. Since its initial implantation in the 1990s, DBS of the STN has been recognized as an effective treatment approach for PD [ 16 ]. By modulating neural pathways, DBS has been shown to make improvements in motor dysfunctions and, in certain cases, reduce the need for medication [ 19 , 23 , 24 ].…”

Section: Introductionmentioning

confidence: 99%

Utility of diffusion tensor imaging and generalized q-sampling imaging for predicting short-term clinical effect of deep brain stimulation in Parkinson’s disease

Yuzkan,

Hasimoglu,

Balsak

et al. 2024

Acta Neurochir

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Purpose To assess whether diffusion tensor imaging (DTI) and generalized q-sampling imaging (GQI) metrics could preoperatively predict the clinical outcome of deep brain stimulation (DBS) in patients with Parkinson’s disease (PD). Methods In this single-center retrospective study, from September 2021 to March 2023, preoperative DTI and GQI examinations of 44 patients who underwent DBS surgery, were analyzed. To evaluate motor functions, the Unified Parkinson’s Disease Rating Scale (UPDRS) during on- and off-medication and Parkinson’s Disease Questionnaire-39 (PDQ-39) scales were used before and three months after DBS surgery. The study population was divided into two groups according to the improvement rate of scales: ≥ 50% and < 50%. Five target regions, reported to be affected in PD, were investigated. The parameters having statistically significant difference were subjected to a receiver operating characteristic (ROC) analysis. Results Quantitative anisotropy (qa) values from globus pallidus externus, globus pallidus internus (qa_Gpi), and substantia nigra exhibited significant distributional difference between groups in terms of the improvement rate of UPDRS-3 scale during on-medication (p = 0.003, p = 0.0003, and p = 0.0008, respectively). In ROC analysis, the best parameter in predicting DBS response included qa_Gpi with a cut-off value of 0.01370 achieved an area under the ROC curve, accuracy, sensitivity, and specificity of 0.810, 73%, 62.5%, and 85%, respectively. Optimal cut-off values of ≥ 0.01864 and ≤ 0.01162 yielded a sensitivity and specificity of 100%, respectively. Conclusion The imaging parameters acquired from GQI, particularly qa_Gpi, may have the ability to non-invasively predict the clinical outcome of DBS surgery.

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Variability in subthalamic nucleus targeting for deep brain stimulation with 3 and 7 Tesla magnetic resonance imaging

Cited by 10 publications

References 69 publications

Electrophysiological confrontation of Lead-DBS-based electrode localizations in patients with Parkinson’s disease undergoing deep brain stimulation

Electrophysiological confrontation of Lead-DBS-based electrode localizations in patients with Parkinson’s disease undergoing deep brain stimulation

Deep brain stimulation in Parkinson’s disease: state of the art and future perspectives

Utility of diffusion tensor imaging and generalized q-sampling imaging for predicting short-term clinical effect of deep brain stimulation in Parkinson’s disease

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