An assessment of current brain targets for deep brain stimulation surgery with susceptibility-weighted imaging at 7 tesla.
BACKGROUND
Deep brain stimulation (DBS) surgery is used for treating movement disorders, including Parkinson disease, essential tremor, and dystonia. Successful DBS surgery is critically dependent on precise placement of DBS electrodes into target structures. Frequently, DBS surgery relies on normalized atlas-derived diagrams that are superimposed on patient brain magnetic resonance imaging (MRI) scans, followed by microelectrode recording and macrostimulation to refine the ultimate electrode position. Microelectrode recording carries a risk of hemorrhage and requires active patient participation during surgery.


OBJECTIVE
To enhance anatomic imaging for DBS surgery using high-field MRI with the ultimate goal of improving the accuracy of anatomic target selection.


METHODS
Using a 7-T MRI scanner combined with an array of acquisition schemes using multiple image contrasts, we obtained high-resolution images of human deep nuclei in healthy subjects.


RESULTS
Superior image resolution and contrast obtained at 7 T in vivo using susceptibility-weighted imaging dramatically improved anatomic delineation of DBS targets and allowed the identification of internal architecture within these targets. A patient-specific, 3-dimensional model of each target area was generated on the basis of the acquired images.


CONCLUSIONS
Technical developments in MRI at 7 T have yielded improved anatomic resolution of deep brain structures, thereby holding the promise of improving anatomic-based targeting for DBS surgery. Future study is needed to validate this technique in improving the accuracy of targeting in DBS surgery.
Department of Neurosurgery, University of Minnesota Medical School, Minneapolis, Minnesota 55455, USA. aabosch@umn.edu
Aviva
A
Abosch
Essa
E
Yacoub
Kamil
K
Ugurbil
Noam
N
Harel
D001921:Brain / Q000033:anatomy & histology* / Q000502:physiology*; D001931:Brain Mapping; D046690:Deep Brain Stimulation / Q000379:methods*; D005917:Globus Pallidus / Q000033:anatomy & histology / Q000502:physiology; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods; D008279:Magnetic Resonance Imaging / Q000379:methods*; D010743:Phospholipids; D013238:Stereotaxic Techniques; D013459:Sulfur Hexafluoride; D013788:Thalamus / Q000033:anatomy & histology / Q000502:physiology
D010743:Phospholipids; C420843:contrast agent BR1; D013459:Sulfur Hexafluoride