Discrepancies between the MRI- and the electrophysiologically defined subthalamic nucleus
- نوع فایل : کتاب
- زبان : انگلیسی
- مؤلف : Juergen Ralf Schlaier & Christine Habermeyer & Jan Warnat &Max Lange & Annette Janzen & Andreas Hochreiter & Martin Proescholdt & Alexander Brawanski
- چاپ و سال / کشور: 2011
Description
Background The aim of our study was to evaluate discrepancies between the electrophysiologically and MRIdefined subthalamic nucleus (STN) in order to contribute to the ongoing debate of whether or not microelectrode recording (MER) provides additional information to imageguided targeting in deep brain stimulation. Methods Forty-four STNs in 22 patients with Parkinson’s disease were investigated. The three-dimensional MRIdefined STN was derived from segmentations of axial and coronal T2-weighted images. The electrophysiological STNs were generated from intraoperative MERs in 1,487 locations. The stereotactical coordinates of positive and negative STN recordings were re-imported to the planning software, where a three-dimensional reconstruction of the electrophysiological STN was performed and fused to the MRI data set. The estimated borders of the MRI- and MERSTN were compared. For statistical analysis Student's t, Mann-Whitney rank sum and Fisher's exact tests were used. Results MER-STN volumes, which were found outside the MRI-STN, ranged from 0 mm3 to 87 mm3 (mean: 45 mm3). A mean of 44% of the MER-STN volumes exceeded the MRI-STN (maximum: 85.1%; minimum: 15.1 %); 53.4% (n=793) of the microelectrode recordings were concordant and 46.6% (n=694) discordant with the MRI-defined anatomical STN. Regarding the dorsal borders, we found discrepancies between the MER- and MRI-STN of 0.27 mm (= mean; SD: 0.51 mm) on the first operated side and 1.51 mm (SD: 1.5 mm) on the second (p=0.010, t-test). Conclusions MER provides additional information to highresolution anatomical MR images and may help to detect the amount and direction of brain shift
Acta Neurochir DOI 10.1007/s00701-011-1081-7 Received: 12 March 2011 / Accepted: 22 June 2011
