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01-12-2011 | Clinical Article

Discrepancies between the MRI- and the electrophysiologically defined subthalamic nucleus

Authors: Juergen Ralf Schlaier, Christine Habermeyer, Jan Warnat, Max Lange, Annette Janzen, Andreas Hochreiter, Martin Proescholdt, Alexander Brawanski, Claudia Fellner

Published in: Acta Neurochirurgica | Issue 12/2011

Abstract

Background

The aim of our study was to evaluate discrepancies between the electrophysiologically and MRI-defined subthalamic nucleus (STN) in order to contribute to the ongoing debate of whether or not microelectrode recording (MER) provides additional information to image-guided targeting in deep brain stimulation.

Methods

Forty-four STNs in 22 patients with Parkinson’s disease were investigated. The three-dimensional MRI-defined 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 MER-STN 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 high-resolution anatomical MR images and may help to detect the amount and direction of brain shift.

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Title: Discrepancies between the MRI- and the electrophysiologically defined subthalamic nucleus
Authors: Juergen Ralf Schlaier
Christine Habermeyer
Jan Warnat
Max Lange
Annette Janzen
Andreas Hochreiter
Martin Proescholdt
Alexander Brawanski
Claudia Fellner
Publication date: 01-12-2011
Publisher: Springer Vienna
Published in: Acta Neurochirurgica / Issue 12/2011
Print ISSN: 0001-6268
Electronic ISSN: 0942-0940
DOI: https://doi.org/10.1007/s00701-011-1081-7

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Discrepancies between the MRI- and the electrophysiologically defined subthalamic nucleus

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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