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64th Annual Meeting of the German Society of Neurosurgery (DGNC)

German Society of Neurosurgery (DGNC)

26 - 29 May 2013, Düsseldorf

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DTI-based probabilistic thalomo-cortical connectivity of the thalamus for deep brain stimulation surgery

Meeting Abstract

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  • Florian Grimm - Klinik für Neurochirurgie, Universitätsklinikum Tübingen
  • Michaela Walcker - Klinik für Neurochirurgie, Universitätsklinikum Tübingen
  • Georgios Naros - Klinik für Neurochirurgie, Universitätsklinikum Tübingen
  • Rejko Krüger - Klinik für Neurologie, Universitätsklinikum Tübingen
  • Stefan Heckl - Klinik für Neuroradiologie, Universitätsklinikum Tübingen
  • Alireza Gharabaghi - Klinik für Neuroradiologie, Universitätsklinikum Tübingen

Deutsche Gesellschaft für Neurochirurgie. 64. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC). Düsseldorf, 26.-29.05.2013. Düsseldorf: German Medical Science GMS Publishing House; 2013. DocP 045

doi: 10.3205/13dgnc462, urn:nbn:de:0183-13dgnc4622

Published: May 21, 2013

© 2013 Grimm 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: Probabilistic DTI-based thalamo-cortical connectivity has been used to identify different thalamic subnuclei according to their connectivity profiles. Probablisitc tractography based thalamic segmentation has been validated by electrophysiological data, recently. We explore this technique in the context of deep brain stimulation of the thalamus (VIM) for tremor.

Method: Preoperative MR images (T1, diffusion-weighted images) and postoperative CT scans were acquired and co-registered in 8 patients undergoing thalamic DBS therapy. Electrode-contact specific connectivity profiles were calculated on the basis of probabilistic DTI-backtracking and individual AAL-Atlas-based target-masks using a nonlinear fusion technique. For each electrode contact we computed a connectivity profile to 128 cortical targets and compared it to the clinical response pattern.

Results: For each individual electrode contact a specific DTI-connectivity profile to cortical areas was determined. Cortical areas showed specific probabilities for their connectivity to individual contacts. Those electrode contacts with the strongest thalamo-cortical connection to cortical motor areas were those which showed the best clinical outcome in tremor patients.

Conclusions: Probabilistic DTI-based thalamo-cortical connectivity might serve as a targeting tool for VIM-DBS-surgery to optimize electrode positioning for the best clinical outcome.