In vivoExploration of the Connectivity between the Subthalamic Nucleus and the Globus Pallidus in the Human Brain Using Multi-Fiber Tractography.
The basal ganglia is part of a complex system of neuronal circuits that play a key role in the integration and execution of motor, cognitive and emotional function in the human brain. Parkinson's disease is a progressive neurological disorder of the motor circuit characterized by tremor, rigidity, and slowness of movement. Deep brain stimulation (DBS) of the subthalamic nucleus and the globus pallidus pars interna provides an efficient treatment to reduce symptoms and levodopa-induced side effects in Parkinson's disease patients. While the underlying mechanism of action of DBS is still unknown, the potential modulation of white matter tracts connecting the surgical targets has become an active area of research. With the introduction of advanced diffusion MRI acquisition sequences and sophisticated post-processing techniques, the architecture of the human brain white matter can be exploredin vivo. The goal of this study is to investigate the white matter connectivity between the subthalamic nucleus and the globus pallidus. Two multi-fiber tractography methods were used to reconstruct pallido-subthalamic, subthalamo-pallidal and pyramidal fibers in five healthy subjects datasets of the Human Connectome Project. The anatomical accuracy of the tracts was assessed by four judges with expertise in neuroanatomy, functional neurosurgery, and diffusion MRI. The variability among subjects was evaluated based on the fractional anisotropy and mean diffusivity of the tracts. Both multi-fiber approaches enabled the detection of complex fiber architecture in the basal ganglia. The qualitative evaluation by experts showed that the identified tracts were in agreement with the expected anatomy. Tract-derived measurements demonstrated relatively low variability among subjects. False-negative tracts demonstrated the current limitations of both methods for clinical decision-making. Multi-fiber tractography methods combined with state-of-the-art diffusion MRI data have the potential to help identify white matter tracts connecting DBS targets in functional neurosurgery intervention.
Surgical Planning Laboratory, Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston MA, USA.
Sonia
S
Pujol
Department of Computer Science, Brown University, Providence RI, USA.
Ryan
R
Cabeen
Institut du Cerveau et de la Moëlle Epinière, INSERM U 1127, CNRS UMR 7225, Sorbonne Universités, University of Paris 06, UMR S 1127 Paris, France.
Sophie B
SB
Sébille
Institut du Cerveau et de la Moëlle Epinière, INSERM U 1127, CNRS UMR 7225, Sorbonne Universités, University of Paris 06, UMR S 1127 Paris, France.
Jérôme
J
Yelnik
Institut du Cerveau et de la Moëlle Epinière, INSERM U 1127, CNRS UMR 7225, Sorbonne Universités, University of Paris 06, UMR S 1127 Paris, France.
Chantal
C
François
Institut du Cerveau et de la Moëlle Epinière, INSERM U 1127, CNRS UMR 7225, Sorbonne Universités, University of Paris 06, UMR S 1127Paris, France; Centre de Neuro-Imagerie de Recherche, Institut du Cerveau et de la Moëlle EpinièreParis, France.
Sara
S
Fernandez Vidal
Institut du Cerveau et de la Moëlle Epinière, INSERM U 1127, CNRS UMR 7225, Sorbonne Universités, University of Paris 06, UMR S 1127Paris, France; Department of Neurosurgery, Pitié-Salpêtrière HospitalParis, France.
Carine
C
Karachi
LTSI, Inserm UMR 1099 - Université de Rennes Rennes, France.
Yulong
Y
Zhao
Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston MA, USA.
G Rees
GR
Cosgrove
LTSI, Inserm UMR 1099 - Université de Rennes Rennes, France.
Pierre
P
Jannin
Surgical Planning Laboratory, Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston MA, USA.
Ron
R
Kikinis
Institut du Cerveau et de la Moëlle Epinière, INSERM U 1127, CNRS UMR 7225, Sorbonne Universités, University of Paris 06, UMR S 1127Paris, France; Centre de Neuro-Imagerie de Recherche, Institut du Cerveau et de la Moëlle EpinièreParis, France.
Eric
E
Bardinet
deep brain stimulation; diffusion MRI; globus pallidus; human neuroanatomy; multi-fiber tractography; subthalamic nucleus