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

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Abstract

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 neuron 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 subthalamic anatomy for image-guided stereotactic surgery and may aid in understanding DBS mechanisms.

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Authors and Affiliations

  1. Service de Neurochirurgie A, CHU Clermont-Ferrand, Hôpital Gabriel Montpied, Clermont-Ferrand, 63003, France

    Jean-Jacques Lemaire, Jérôme Coste & Jean Chazal

  2. Service de Neurologie A, CHU Clermont-Ferrand, Hôpital Gabriel Montpied, Clermont-Ferrand, 63003, France

    Philippe Derost, Miguel Ulla & Franck Durif

  3. Service de Radiologie A, CHU Clermont-Ferrand, Hôpital Gabriel Montpied, Clermont-Ferrand, 63003, France

    Séverine Siadoux & Jean Gabrillargues

  4. Unité de Bio statistiques, télématique et traitement d’image, Univ Clermont 1, UFR Médecine, Clermont-Ferrand, 63001, France

    Lemlih Ouchchane

  5. Inserm, ERI 14, Clermont-Ferrand, 63001, France

    Jean-Jacques Lemaire, Jérôme Coste, Lemlih Ouchchane, Simone Hemm & Jean Gabrillargues

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  1. Jean-Jacques Lemaire
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Correspondence to Jean-Jacques Lemaire.

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Lemaire, JJ., Coste, J., Ouchchane, L. et al. MRI anatomical mapping and direct stereotactic targeting in the subthalamic region: functional and anatomical correspondence in Parkinson’s disease. Int J CARS 2, 75–85 (2007). https://doi.org/10.1007/s11548-007-0124-2

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  • DOI: https://doi.org/10.1007/s11548-007-0124-2

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