Individualized parcellation of the subthalamic nucleus in patients with Parkinson's disease with 7T MRI.
Deep brain stimulation of the subthalamic nucleus (STN) is a widely performed surgical treatment for patients with Parkinson's disease. The goal of the surgery is to place an electrode centered in the motor region of the STN while lowering the effects of electrical stimulation on the non-motor regions. However, distinguishing the motor region from the neighboring associative and limbic areas in individual patients using imaging modalities was until recently difficult to obtain in vivo. Here, using ultra-high field MR imaging, we have performed a dissection of the subdivisions of the STN of individual Parkinson's disease patients. We have acquired 7T diffusion-weighted images of seventeen patients with Parkinson's disease scheduled for deep brain stimulation surgery. Using a structural connectivity-based parcellation protocol, the STN's connections to the motor, limbic, and associative cortical areas were used to map the individual subdivisions of the nucleus. A reproducible patient-specific parcellation of the STN into a posterolateral motor and gradually overlapping central associative area was found in all STNs, taking up on average 55.3% and 55.6% of the total nucleus volume. The limbic area was found in the anteromedial part of the nucleus. Our results suggest that 7T MR imaging may facilitate individualized and highly specific planning of deep brain stimulation surgery of the STN.
Departments of Neuroscience, Maastricht University, Maastricht, Netherlands; Department of Biomedical Image Analysis, Eindhoven University of Technology, Eindhoven, Netherlands.
Birgit R
BR
Plantinga
Departments of Neuroscience, Maastricht University, Maastricht, Netherlands; Department of Neurosurgery, Maastricht University Medical Center, Maastricht, Netherlands. Electronic address: y.temel@maastrichtuniversity.nl.
Yasin
Y
Temel
Center for Magnetic Resonance Research, University of Minnesota Medical School, Minneapolis, MN, USA.
Yuval
Y
Duchin
Department of Cognitive Neuroscience, Maastricht University, Maastricht, Netherlands.
Kâmil
K
Uludağ
Center for Magnetic Resonance Research, University of Minnesota Medical School, Minneapolis, MN, USA.
Rémi
R
Patriat
Department of Cognitive Neuroscience, Maastricht University, Maastricht, Netherlands.
Alard
A
Roebroeck
Department of Neurology, Maastricht University Medical Center, Maastricht, Netherlands.
Mark
M
Kuijf
Department of Neurosurgery, Maastricht University Medical Center, Maastricht, Netherlands.
Ali
A
Jahanshahi
Department of Biomedical Image Analysis, Eindhoven University of Technology, Eindhoven, Netherlands; Northeastern University, Shenyang, China.
Bart
B
Ter Haar Romenij
Department of Neurology, University of Minnesota, Minneapolis, MN, USA.
Jerrold
J
Vitek
Center for Magnetic Resonance Research, University of Minnesota Medical School, Minneapolis, MN, USA. Electronic address: harel002@umn.edu.
Noam
N
Harel
D000368:Aged; D046690:Deep Brain Stimulation; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods* / Q000592:standards; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods* / Q000592:standards; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000000981:diagnostic imaging*; D015203:Reproducibility of Results; D020531:Subthalamic Nucleus / Q000033:anatomy & histology* / Q000000981:diagnostic imaging*
Deep brain stimulation; Parcellation; Parkinson's disease; Patient-specific; Subthalamic nucleus; Ultra-high field MRI
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