gms | German Medical Science

63rd Annual Meeting of the German Society of Neurosurgery (DGNC)
Joint Meeting with the Japanese Neurosurgical Society (JNS)

German Society of Neurosurgery (DGNC)

13 - 16 June 2012, Leipzig

Localization of DBS electrodes in a 3D atlas of the basal ganglia

Meeting Abstract

  • J. Sarnthein - Klinik für Neurochirurgie, UniversitätsSpital Zürich
  • D. Péus - Klinik für Neurochirurgie, UniversitätsSpital Zürich
  • H. Vogel - Klinik für Neurologie, UniversitätsSpital Zürich
  • C.R. Baumann - Klinik für Neurologie, UniversitätsSpital Zürich
  • O. Sürücü - Klinik für Neurochirurgie, UniversitätsSpital Zürich

Deutsche Gesellschaft für Neurochirurgie. Japanische Gesellschaft für Neurochirurgie. 63. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie (JNS). Leipzig, 13.-16.06.2012. Düsseldorf: German Medical Science GMS Publishing House; 2012. DocFR.10.05

DOI: 10.3205/12dgnc248, URN: urn:nbn:de:0183-12dgnc2487

Published: June 4, 2012

© 2012 Sarnthein et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.


Outline

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Objective: Deep Brain Stimulation (DBS) has been established as an invasive therapy for the treatment of severe forms of movement disorders such as Parkinson's Disease (PD). Most patients with PD are treated by DBS in the area of the subthalamic nucleus (STN). However, the exact location of the best target site is still under debate.

Methods: In a consecutive patient series (Zurich University Hospital, 2009–2011), we compared preoperative MRI planning, intraoperative target adjustment and postoperative CT reconstruction. The localizations of the DBS electrodes were documented in a 3-dimensional atlas of the basal ganglia and the thalamus (Morel-Atlas).

Results: The series includes 21 patients (6 female / 15 male; 42 implantations). For the implantations in 47.6% of cases, the central trajectory was chosen and in 38.1% the medial trajectory. Posterior, anterior and lateral trajectories were rarely chosen (each 4.8%) There was a significant difference between the planning coordinates and the coordinates of the definitive stimulation site. On the average, the definitive stimulation site was more anterior and more superior. Of 24 implanted electrodes, 21 (87.5%) were within the averaged STN volume provided by the atlas. The mean penetration depth amounted to 4.00 ± 1.96 mm.

Conclusions: The deviation between preoperative planning and postoperative CT reconstruction demonstrated the importance of intraoperative recording of neuronal activity and clinical testing of stimulation efficiency. The documentation of the DBS electrodes in a three-dimensional atlas was used to investigate the anatomical structures, which are stimulated by the DBS. The variability between the individual anatomical STN-configurations is sufficiently small to permit the application of the averaged atlas.