title: Targeting for thalamic deep brain stimulator implantation without computer guidance: assessment of targeting accuracy.
abstract: 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.
authors.affiliation: Institute for Neurology and Neurosurgery, Beth Israel Medical Center, New York, NY 10128, USA. ralterma@bethisraelny.org
authors.forename: R L
authors.initials: RL
authors.lastname: Alterman
authors.forename: G T
authors.initials: GT
authors.lastname: Reiter
authors.forename: J
authors.initials: J
authors.lastname: Shils
authors.forename: B
authors.initials: B
authors.lastname: Skolnick
authors.forename: J E
authors.initials: JE
authors.lastname: Arle
authors.forename: M
authors.initials: M
authors.lastname: Lesutis
authors.forename: T
authors.initials: T
authors.lastname: Simuni
authors.forename: A
authors.initials: A
authors.lastname: Colcher
authors.forename: M
authors.initials: M
authors.lastname: Stern
authors.forename: H
authors.initials: H
authors.lastname: Hurtig
mesh_terms: 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*