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subthalamic_deep_brain_stimulation

Subthalamic deep brain stimulation

Indications

Parkinson's disease

Obsessive compulsive disorder

Technique

The susceptibility weighted imaging with 3 Tesla MRI-based subthalamic nucleus localization shows the best accuracy compared with T2-weighted and fluid-attenuated inversion recovery 3-T MRI. Therefore, the susceptibility-weighted 3-T MRI should be preferred for surgical planning when the operation procedure is performed under general anesthesia without microelectrode recordings 1).


To answer the question of whether the anatomical center of the subthalamic nucleus (STN), as calculated indirectly from stereotactic atlases or by direct visualization on magnetic resonance imaging (MRI), corresponds to the best functional target.

The functional STN target is located in direct proximity to its anatomical center. During preoperative targeting, Rabie et al., recommend using the “direct” method, and taking into consideration the relationships of the final target to the mid-commissural point (MCP) and the different red nucleus (RN) borders 2).

1)
Polanski WH, Martin KD, Engellandt K, von Kummer R, Klingelhoefer L, Fauser M, Storch A, Schackert G, Sobottka SB. Accuracy of subthalamic nucleus targeting by T2, FLAIR and SWI-3-Tesla MRI confirmed by microelectrode recordings. Acta Neurochir (Wien). 2015 Mar;157(3):479-86. doi: 10.1007/s00701-014-2328-x. Epub 2015 Jan 18. PubMed PMID: 25596640.
2)
Rabie A, Verhagen Metman L, Slavin KV. Using “Functional” Target Coordinates of the Subthalamic Nucleus to Assess the Indirect and Direct Methods of the Preoperative Planning: Do the Anatomical and Functional Targets Coincide? Brain Sci. 2016 Dec 21;6(4). pii: E65. doi: 10.3390/brainsci6040065. PubMed PMID: 28009826.
subthalamic_deep_brain_stimulation.txt · Last modified: 2019/02/01 15:18 by administrador