Correspondence of microelectrode mapping with magnetic resonance imaging for subthalamic nucleus procedures.
BACKGROUND
Magnetic resonance imaging (MRI) and microelectrode recording (MER) are commonly used to guide stereotactic procedures on the subthalamic nucleus (STN). Little is known about the correlation between the position of the STN as seen on MRI and that as determined by MER mapping. We compared these in 10 patients with Parkinson's disease.


METHODS
The position of the STN was determined by intraoperative MER findings and stereotactic axial T2 magnetic resonance images with 2-mm slice thickness. Images were reconstructed in a 3-dimensional workstation. The anterior, posterior, medial, lateral, dorsal, and ventral borders of the STN defined with the MRI were measured relative to the midcommissural point. The location of STN activity during MER was reconstructed relative to the midcommissural point for comparison.


RESULTS
Twenty-nine tracks recorded with microelectrodes provided clear spans of STN-like activity in 18 STN nuclei. The coordinates of MER were, in general, within the borders of the STN defined with the MRI. However, when analyzed individually, some of the tracks had STN-like activity outside the borders of the MRI-defined nucleus (mostly <1 mm). Three tracks had STN-like activity recorded between 2 and 3 mm more anterior than the anterior border of the nucleus defined with the MRI.


CONCLUSIONS
There was a good correlation between MER and the borders of the STN defined in the MRI, except for the anterior-posterior axis, in which MER indicated that the STN extended more anteriorly than as suggested by MRI. This should be taken into account in STN surgery.
Hamani
Clement
C
Division of Neurosurgery, University of Toronto, Toronto, ON M5T 2S8, Canada. c.hamani@sympatico.ca
Richter
Erich O
EO
Andrade-Souza
Yuri
Y
Hutchison
William
W
Saint-Cyr
Jean A
JA
Lozano
Andres M
AM
D000200:Action Potentials / Q000502:physiology; D001931:Brain Mapping / Q000295:instrumentation / Q000379:methods*; D004594:Electrophysiology / Q000295:instrumentation / Q000379:methods; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods; D008279:Magnetic Resonance Imaging / Q000295:instrumentation / Q000379:methods*; D008488:Medical Illustration; D008839:Microelectrodes / Q000592:standards; D009434:Neural Pathways / Q000503:physiopathology; D009474:Neurons / Q000502:physiology; D010300:Parkinson Disease / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D015203:Reproducibility of Results; D012189:Retrospective Studies; D013223:Statistics as Topic; D013238:Stereotaxic Techniques / Q000295:instrumentation*; D020531:Subthalamic Nucleus / Q000033:anatomy & histology* / Q000503:physiopathology / Q000601:surgery*