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Kinesthetic Cells within the Subthalamic Nucleus and Deep Brain Stimulation for Parkinson Disease.

Abstract：

OBJECTIVE:We sought to determine the location of kinesthetic cell clusters within the subthalamic nucleus (STN) on magnetic resonance imaging, adjusted for interindividual anatomic variability by employing the medial STN border as a reference point. METHODS:We retrospectively localized microelectrode recording-defined kinesthetic cells on 3-Tesla T2-weighted and susceptibility-weighted images in patients who underwent STN deep brain stimulation for Parkinson disease and averaged the stereotactic coordinates. These locations were calculated relative to the nonindividualized midcommissural point (MCP) and, in order to account for interindividual anatomic variability, also calculated relative to the patient-specific intersection of Bejjani line with the medial STN border. Two example patients were selected in order to visualize the discrepancies between the adjusted and nonadjusted theoretic kinesthetic cell clusters on magnetic resonance imaging. RESULTS:Relative to the MCP, average kinesthetic cell coordinates were 12.3 ± 1.2 mm lateral, 1.7 ± 1.4 mm posterior, and 2.3 ± 1.5 mm inferior. Relative to the medial STN border, mean coordinates were 3.4 ± 1.0 mm lateral, 1.0 ± 1.4 mm anterior, and 1.7 ± 1.5 mm superior on T2-sequences, and on susceptibility-weighted images mean coordinates were 3.2 ± 1.1 mm lateral, 0.8 ± 1.5 mm anterior, and 2.1 ± 1.5 mm superior. The theoretic kinesthetic cell clusters may appear outside the sensorimotor STN when using the MCP, whereas these clusters fall well within the sensorimotor STN when employing the medial STN border as a reference point. CONCLUSIONS:By using the medial STN border as a patient-specific anatomic reference point in STN deep brain stimulation for Parkinson disease, we accounted for interindividual anatomic variability and provided accurate insight in the clustering of kinesthetic cells within the dorsolateral STN.

journal_name

World Neurosurg

journal_title

World neurosurgery

authors

Bolier E,Bot M,van den Munckhof P,Pal G,Sani S,Stebbins GT,Verhagen Metman L

doi

10.1016/j.wneu.2020.04.160

subject

Has Abstract

pub_date

2020-07-01 00:00:00

pages

e784-e791

eissn

1878-8750

issn

1878-8769

pii

S1878-8750(20)30869-X

journal_volume

139

pub_type

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