Artikel
Diffusion connectivity parcellation based analysis of electrode positions in the subthalamic nucleus
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Autoren
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Amir Zolal
- Uniklinikum Dresden, Dresden, Deutschland
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Witold Polanski
- Universitätsklinik Dresden, Carl-Gustav-Carus Universitätsklinikum an der Technischen Universität Dresden, Dresden, Deutschland
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Gabriele Schackert
- Klinikum Carl Gustav Carus, Klinik und Poliklinik für Neurochirurgie, Carl-Gustav-Carus Universitätsklinikum an der Technischen Universität Dresden, Dresden, Deutschland
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Stephan B. Sobottka
- Carl-Gustav-Carus Universitätsklinikum an der Technischen Universität Dresden, Klinkum Carls Gustav Carus, Klinik und Poliklinik für Neurochirurgie, Dresden, Deutschland
| Veröffentlicht: | 9. Juni 2017 |
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Gliederung
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Objective: The functional specialization of various regions within the subthalamic nucleus (STN) seems to play a role in the effectivity of treatment with deep brain stimulation (DBS). Diffusion tensor based analyses have been shown to enable the parcellation of the STN into distinct subregions. We attempted to evaluate the utility of connectivity based parcellation for the evaluation of the deep brain stimulation electrode positions in the subthalamic nucleus.
Methods: The location of the DBS electrodes has been studied in relation to the connectivity based parcellation of the STN in four hemispheres. Segmentations of cortical regions corresponding to the BA 4 and 6 and the pallidum have been obtained using Freesurfer. STN was segmented manually using preoperative T2 scans. Probabilistic fiber tracking parcellation using FSL was used to create a parcellation of the subthalamic nucleus. The resulting images were fused with the postoperative CT scan in order to evaluate the position of the electrode in relationship to the individual parcellations.
Results: Connectivity based parcellation was possible in all four hemispheres and showed a distinct pattern of STN subregions. The region with predominantly pallidal connections was the largest with approximately 74% (average 1091 mm³) of the total volume of the STN, the region connecting mostly to BA6 occupied 22% (average 323 mm³) of the total STN volume, and the region connecting predominantly to the BA4 occupied approximately 4% (average 53 mm³) of STN volume. In all four cases, the electrodes were located at the boundary between the pallidal subregion and the BA6 subregion within the STN.
Conclusion: Probabilistic diffusion based connectivity parcellation of the STN can be combined with postoperative CT scans in order to obtain information on electrode location in relationship to STN subregions. Further analysis of available data is needed to evaluate the potential utility of this technique in MRI-based targeting of the electrodes.
