MRI anatomical mapping and direct stereotactic targeting in the subthalamic region: functional and anatomical correspondence in Parkinson’s disease

• Published in: International journal for computer assisted radiology and surgery Vol. 2; no. 2; pp. 75 - 85
• Main Authors: Lemaire, Jean-Jacques, Coste, Jérôme, Ouchchane, Lemlih, Hemm, Simone, Derost, Philippe, Ulla, Miguel, Siadoux, Séverine, Gabrillargues, Jean, Durif, Franck, Chazal, Jean
• Format: Journal Article
• Language: English
• Published: Springer Verlag 2007
• Subjects: Bioengineering; Human health and pathology; Imaging; Life Sciences; Neurons and Cognition
• ISSN: 1861-6410; 1861-6429
• DOI: 10.1007/s11548-007-0124-2

Object Relationships between clinical effects, anatomy, and electrophysiology are not fully understood in DBS of the subthalamic region in Parkinson's disease. We proposed an anatomic study based on direct image-guided stereotactic surgery with a multiple source data analysis.Materials and Methods A manual anatomic mapping was realized on coronal 1.5-Tesla MRI of 15 patients. Biological data were collected under local anesthesia: the spontaneous neu-ron activities and the clinical efficiency and the appearance of adverse effects. They were related to relevant current values (mA), the benefit threshold (bt, minimal current leading an clear efficiency), the adverse effect threshold (at, minimal current leading an adverse effect) and the stimulation margin (sm = at − bt); they were matched with anatomy.Results We found consistent relationships between anatomy and biological data. The optimal stimulation parameters (low bt + high sm) were noted in the dorsolateral STN. The highest spontaneous neuron activity was found in the ventromedial STN. Dorsolateral (sensorimotor) STN seems the main DBS effector. The highest spontaneous neuron activity seems related to the anterior (rostral) ventromedial (limbic) STN.Conclusion 1.5 Tesla images provide sufficiently detailed sub-thalamic anatomy for image-guided stereotactic surgery and may aid in understanding DBS mechanisms.