Individualized parcellation of the subthalamic nucleus in patients with Parkinson's disease with 7T MRI

Birgit R. Plantinga, Yasin Temel, Yuval Duchin, Kâmil Uludağ, Rémi Patriat, Alard Roebroeck, Mark Kuijf, Ali Jahanshahi, Bart ter Haar Romenij, Jerrold Vitek, Noam Harel

Research output: Contribution to journalArticlepeer-review

40 Scopus citations

Abstract

Deep brain stimulation of the subthalamic nucleus (STN) is a widely performed surgical treatment for patients with Parkinson's disease. The goal of the surgery is to place an electrode centered in the motor region of the STN while lowering the effects of electrical stimulation on the non-motor regions. However, distinguishing the motor region from the neighboring associative and limbic areas in individual patients using imaging modalities was until recently difficult to obtain in vivo. Here, using ultra-high field MR imaging, we have performed a dissection of the subdivisions of the STN of individual Parkinson's disease patients. We have acquired 7 T diffusion-weighted images of seventeen patients with Parkinson's disease scheduled for deep brain stimulation surgery. Using a structural connectivity-based parcellation protocol, the STN's connections to the motor, limbic, and associative cortical areas were used to map the individual subdivisions of the nucleus. A reproducible patient-specific parcellation of the STN into a posterolateral motor and gradually overlapping central associative area was found in all STNs, taking up on average 55.3% and 55.6% of the total nucleus volume. The limbic area was found in the anteromedial part of the nucleus. Our results suggest that 7T MR imaging may facilitate individualized and highly specific planning of deep brain stimulation surgery of the STN.

Original languageEnglish (US)
Pages (from-to)403-411
Number of pages9
JournalNeuroImage
Volume168
DOIs
StatePublished - Mar 2018

Bibliographical note

Funding Information:
This study was supported by grants of the Netherlands Organisation for Scientific Research (NWO, Grant no. 452-11-002), the Netherlands Organisation for Health Research and Development (ZonMW, Grant no. ZonMW/116350003/JSTP), the National Institutes of Health (NIH, Grant nos. R01-NS085188, P41-EB015894 and P30-NS076408), and the University of Minnesota Udall center (P50NS098573). The authors would like to thank Dimo Ivanov for his help with the scans.

Funding Information:
This study was supported by grants of the Netherlands Organisation for Scientific Research (NWO, Grant no. 452-11-002 ), the Netherlands Organisation for Health Research and Development (ZonMW, Grant no. ZonMW/116350003/JSTP ), the National Institutes of Health (NIH, Grant nos. R01-NS085188 , P41-EB015894 and P30-NS076408 ), and the University of Minnesota Udall center (P50NS098573). The authors would like to thank Dimo Ivanov for his help with the scans.

Publisher Copyright:
© 2016 Elsevier Inc.

Keywords

  • Deep brain stimulation
  • Parcellation
  • Parkinson's disease
  • Patient-specific
  • Subthalamic nucleus
  • Ultra-high field MRI

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