A role of diffusion tensor imaging in movement disorder surgery. Barkhoudarian, G., Klochkov, T., Sedrak, M., Frew, A., Gorgulho, A., Behnke, E., & De Salles, A. Acta Neurochirurgica.
Paper doi abstract bibtex Abstract The safe and reversible nature of deep brain stimulation (DBS) has allowed movement disorder neurosurgery to become commonplace throughout the world. Fundamental understanding of individual patient’s anatomy is critical for optimizing the effects and side effects of DBS surgery. Three patients undergoing stereotactic surgery for movement disorders, at the institution’s intraoperative magnetic resonance imaging operating suite, were studied with fiber tractography. Stereotactic targets and fiber tractography were determined on preoperative magnetic resonance imagings using the Schaltenbrand–Wahren atlas for definition in the BrainLab iPlan software (BrainLAB Inc., Feldkirchen, Germany). Subthalamic nucleus, globus pallidus interna, and ventral intermediate nucleus targets were studied. Diffusion tensor imaging parameters used ranged from 2 to 8 mm for volume of interest in the x/y/z planes, fiber length was kept constant at 30 mm, and fractional anisotropy threshold varied from 0.20 to 0.45. Diffusion tensor imaging tractography allowed reliable and reproducible visualization and correlation between frontal eye field, premotor, primary motor, and primary sensory cortices via corticospinal tracts and corticopontocerebellar tracts. There is an apparent increase in the number of cortical regions targeted by the fiber tracts as the region of interest is enlarged. This represents a possible mechanism of the increased effects and side effects observed with higher stimulation voltages. Currently available diffusion tensor imaging techniques allow potential methods to characterize the effects and side effects of DBS. This technology has the potential of being a powerful tool to optimize DBS neurosurgery.
@article{barkhoudarian_role_nodate,
title = {A role of diffusion tensor imaging in movement disorder surgery},
url = {http://dx.doi.org.login.ezproxy.library.ualberta.ca/10.1007/s00701-010-0742-2},
doi = {10.1007/s00701-010-0742-2},
abstract = {Abstract The safe and reversible nature of deep brain stimulation (DBS) has allowed movement disorder neurosurgery to become commonplace
throughout the world. Fundamental understanding of individual patient’s anatomy is critical for optimizing the effects and
side effects of DBS surgery. Three patients undergoing stereotactic surgery for movement disorders, at the institution’s intraoperative
magnetic resonance imaging operating suite, were studied with fiber tractography. Stereotactic targets and fiber tractography
were determined on preoperative magnetic resonance imagings using the Schaltenbrand–Wahren atlas for definition in the BrainLab
iPlan software (BrainLAB Inc., Feldkirchen, Germany). Subthalamic nucleus, globus pallidus interna, and ventral intermediate
nucleus targets were studied. Diffusion tensor imaging parameters used ranged from 2 to 8 mm for volume of interest in the
x/y/z planes, fiber length was kept constant at 30 mm, and fractional anisotropy threshold varied from 0.20 to 0.45. Diffusion
tensor imaging tractography allowed reliable and reproducible visualization and correlation between frontal eye field, premotor,
primary motor, and primary sensory cortices via corticospinal tracts and corticopontocerebellar tracts. There is an apparent
increase in the number of cortical regions targeted by the fiber tracts as the region of interest is enlarged. This represents
a possible mechanism of the increased effects and side effects observed with higher stimulation voltages. Currently available
diffusion tensor imaging techniques allow potential methods to characterize the effects and side effects of DBS. This technology
has the potential of being a powerful tool to optimize DBS neurosurgery.},
urldate = {2010-07-28},
journal = {Acta Neurochirurgica},
author = {Barkhoudarian, Garni and Klochkov, Tony and Sedrak, Mark and Frew, Andrew and Gorgulho, Alessandra and Behnke, Eric and De Salles, Antonio},
}
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Three patients undergoing stereotactic surgery for movement disorders, at the institution’s intraoperative magnetic resonance imaging operating suite, were studied with fiber tractography. Stereotactic targets and fiber tractography were determined on preoperative magnetic resonance imagings using the Schaltenbrand–Wahren atlas for definition in the BrainLab iPlan software (BrainLAB Inc., Feldkirchen, Germany). Subthalamic nucleus, globus pallidus interna, and ventral intermediate nucleus targets were studied. Diffusion tensor imaging parameters used ranged from 2 to 8 mm for volume of interest in the x/y/z planes, fiber length was kept constant at 30 mm, and fractional anisotropy threshold varied from 0.20 to 0.45. Diffusion tensor imaging tractography allowed reliable and reproducible visualization and correlation between frontal eye field, premotor, primary motor, and primary sensory cortices via corticospinal tracts and corticopontocerebellar tracts. There is an apparent increase in the number of cortical regions targeted by the fiber tracts as the region of interest is enlarged. This represents a possible mechanism of the increased effects and side effects observed with higher stimulation voltages. Currently available diffusion tensor imaging techniques allow potential methods to characterize the effects and side effects of DBS. 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Fundamental understanding of individual patient’s anatomy is critical for optimizing the effects and\nside effects of DBS surgery. Three patients undergoing stereotactic surgery for movement disorders, at the institution’s intraoperative\nmagnetic resonance imaging operating suite, were studied with fiber tractography. Stereotactic targets and fiber tractography\nwere determined on preoperative magnetic resonance imagings using the Schaltenbrand–Wahren atlas for definition in the BrainLab\niPlan software (BrainLAB Inc., Feldkirchen, Germany). Subthalamic nucleus, globus pallidus interna, and ventral intermediate\nnucleus targets were studied. Diffusion tensor imaging parameters used ranged from 2 to 8 mm for volume of interest in the\nx/y/z planes, fiber length was kept constant at 30 mm, and fractional anisotropy threshold varied from 0.20 to 0.45. 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