title: Stereotactic anatomy of the human subthalamic nucleus: providing coordinates for accurate electrode placement.
abstract: OBJECTIVE
  Stereotactic targeting of the subthalamic nucleus (STN) for insertion of deep brain stimulation (DBS) electrodes became popular in the last two decades. We present a study focused on the detailed stereotactic anatomy of the STN with respect to its targeting.
  
  
  METHODS
  We used cerebral magnetic resonance (MR) images from 26 patients (50 STNs) for the imaging study. The material of the anatomical study consisted of 24 cerebral hemispheres (24 STNs) from 16 normal human brains. We measured and analyzed the X, X', Y, Y', and Z, Z' stereotactic coordinates of the STN at specific clinically important transverse, coronal, and sagittal planes.
  
  
  RESULTS
  The STN extended almost 1.5 mm more lateral and almost 1 mm more posterior in patients < 60 years of age. The Y coordinate was more posterior and the X coordinate more lateral on MRI than in anatomical specimens. The left STN was located more lateral than the right STN. Analyzing our data we found a standard coronal zone 1.1 mm wide (zone T), a standard coronal plane (thus providing the most accurate Y target coordinate, plane M), and a standard transverse area (area C) for accurate right STN targeting.
  
  
  CONCLUSIONS
  Our study offers new insights into the stereotactic anatomy of the human STN. These data should be taken into account if performing STN DBS.
authors.affiliation: Department of Anatomy, University of Athens School of Medicine, Athens, Greece.
authors.forename: Ioannis
authors.initials: I
authors.lastname: Mavridis
authors.affiliation: 2nd Department of Neurosurgery, University of Athens School of Medicine, Attikon Hospital, Athens, Greece.
authors.forename: Efstathios
authors.initials: E
authors.lastname: Boviatsis
authors.affiliation: Department of Anatomy, University of Athens School of Medicine, Athens, Greece.
authors.forename: Sophia
authors.initials: S
authors.lastname: Anagnostopoulou
mesh_terms: D000369:Aged, 80 and over; D001931:Brain Mapping; D046690:Deep Brain Stimulation; D004567:Electrodes, Implanted; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D020531:Subthalamic Nucleus / Q000033:anatomy & histology* / Q000601:surgery