Targeting for thalamic deep brain stimulator implantation without computer guidance: assessment of targeting accuracy.
The authors assess the accuracy of targeting nucleus ventralis intermedius (Vim) with fast spin echo inversion recovery (FSE/IR) magnetic resonance imaging (MRI) in 18 successful deep brain stimulator (DBS) implants for medically refractory tremor. FSE/IR-MRI-derived coordinates are compared to the final coordinates employed for DBS lead placement, selected with intraoperative neurophysiology. The authors conclude that FSE/IR MRI is sufficiently reliable to serve as the sole means of anatomically targeting Vim for DBS lead placement. An independent computer workstation is not required for accurate targeting; however, intraoperative neurophysiology remains essential.
Alterman
R L
RL
Institute for Neurology and Neurosurgery, Beth Israel Medical Center, New York, NY 10128, USA. ralterma@bethisraelny.org
Reiter
G T
GT
Shils
J
J
Skolnick
B
B
Arle
J E
JE
Lesutis
M
M
Simuni
T
T
Colcher
A
A
Stern
M
M
Hurtig
H
H
D001931:Brain Mapping / Q000295:instrumentation / Q000379:methods*; D004599:Electric Stimulation Therapy / Q000295:instrumentation*; D004567:Electrodes, Implanted; D005069:Evaluation Studies as Topic; D006801:Humans; D008279:Magnetic Resonance Imaging; D008839:Microelectrodes; D016343:Monitoring, Intraoperative / Q000295:instrumentation / Q000379:methods*; D009103:Multiple Sclerosis / Q000150:complications; D010300:Parkinson Disease / Q000628:therapy*; D011300:Preoperative Care / Q000379:methods*; D013238:Stereotaxic Techniques; D014202:Tremor / Q000209:etiology / Q000628:therapy; D014584:User-Computer Interface; D020651:Ventral Thalamic Nuclei / Q000473:pathology*