丘脑底核
脑深部刺激
帕金森病
原发性震颤
磁共振成像
功能磁共振成像
弹道
神经科学
医学
运动障碍
心理学
物理医学与康复
疾病
放射科
物理
病理
天文
作者
Lisa Verlaat,Niels Rijks,José Dilai,Marjolein M. Admiraal,Martijn Beudel,Rob M.A. de Bie,Wietske van der Zwaag,Rick Schuurman,Pepijn van den Munckhof,Maarten Bot
摘要
Abstract Background Identifying the dorsolateral subthalamic nucleus (STN) for deep brain stimulation (DBS) in Parkinson's disease (PD) can be challenging due to the size and double‐oblique orientation. Since 2015 we implemented 7‐Tesla T2 weighted magnetic resonance imaging (7 T T2) for improving visualization and targeting of the dorsolateral STN. We describe the changes in surgical planning and outcome since implementation of 7 T T2 for DBS in PD. Methods By comparing two cohorts of STN DBS patients in different time periods we evaluated the influence of 7 T T2 on STN target planning, the number of microelectrode recording (MER) trajectories, length of STN activity and the postoperative motor (UPDRS) improvement. Results From February 2007 to January 2014, 1.5 and 3‐Tesla T2 guided STN DBS with 3 MER channels was performed in 76 PD patients. Average length of recorded STN activity in the definite electrode trajectory was 3.9 ± 1.5 mm. From January 2015 to January 2022 7 T T2 and MER‐guided STN DBS was performed in 182 PD patients. Average length of recorded STN activity in the definite electrode trajectory was 5.1 ± 1.3 mm and used MER channels decreased from 3 to 1. Average UPDRS improvement was comparable. Conclusion Implementation of 7 T T2 for STN DBS enabled a refinement in targeting. Combining classical DBS targeting with dorsolateral STN alignment may be used to determine the optimal trajectory. The improvement in dorsolateral STN visualization can be used for further target refinements, for example adding probabilistic subthalamic connectivity, to enhance clinical outcome of STN DBS.
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