Multiple sequential image-fusion and direct MRI localisation of the subthalamic nucleus for deep brain stimulation.

Abstract:

AIM:Deep brain stimulation (DBS) is the treatment of choice for advanced Parkinson's disease. The target co-ordinates are traditionally calculated in relation to the intercommissural distance. Anterior (AC) and posterior commissures (PC) may be visualised by the means of ventriculography, CT or MRI. METHODS:We have studied the efficacy of direct visualisation of the subthalamic-red nucleus complex on MRI, the advantage of fusion of stereotactic CT and MR images (Multiple Sequences Image Fusion - MuSIF). These methods are combined with double check of indirect calculation of the target co-ordinates based on AC-PC line, as well as the corrispondence to the stereotactic electronic atlas. RESULTS:Subthalamic nucleus (STN) was well recognisable in fused images in all 22 sides. At 3 months from surgery it was possible to reduce 76% of L-dopa equivalent daily dose. Dyskine-sias reduced to 50% and motor fluctuation up to 45%. CONCLUSION:In our experience MuSIF offers very high rate of accuracy in calculation of target co-ordinates. Direct visualisation of STN in MR and MuSIF are reliable and facilitate the accuracy of identification of target co-ordinates. Intraoperative neurophysiological recording increases the accuracy of microelectrode position.

journal_name

J Neurosurg Sci

authors

Rampini PM,Locatelli M,Alimehmeti R,Tamma F,Caputo E,Priori A,Pesenti A,Rohr M,Egidi M

keywords:

subject

Has Abstract

pub_date

2003-03-01 00:00:00

pages

33-9

issue

1

eissn

0390-5616

issn

1827-1855

journal_volume

47

pub_type

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