Postmortem diffusion MRI of the human brainstem and thalamus for deep brain stimulator electrode localization.
Postmortem diffusion MRI of the human brainstem and thalamus for deep brain stimulator electrode localization.
复制标题
DOI：
10.1002/hbm.22836
复制
发表时间：
2015-08
影响因子：
4.8
通讯作者：
Johnson GA
中科院分区：
文献类型：
--
作者：
Calabrese E;Hickey P;Hulette C;Zhang J;Parente B;Lad SP;Johnson GA
脑深部电刺激（DBS）是一种已确立的治疗难治性震颤疾病（包括原发性震颤（ET））的手术疗法，目前正在研究用于各种其他神经系统和精神疾病。越来越多的证据表明，DBS对ET的抗震颤作用与齿状核-红丘脑束（DRT）的调节直接相关，DRT是连接小脑、红核和丘脑腹侧中间核的白色物质通路。DBS的新兴白色靶点（如DRT）将需要改进深部脑解剖结构和结构连接的3D参考图，以实现准确的电极靶向。死后脑标本的高分辨率弥散MRI可以提供重要脑深部核团的详细体积图像和概率纤维束成像技术的白色物质通路的3D重建。我们提出了一个高空间和角分辨率的扩散MRI模板的死后人类脑干和丘脑的核团和白色物质束参与ET电路的三维重建。我们证明了这些数据在体内的准确注册，从接受DBS治疗的患者的临床图像，并与电极接近DRT的纤维束成像与ET症状的改善。
Deep brain stimulation (DBS) is an established surgical therapy for medically refractory tremor disorders including essential tremor (ET) and is currently under investigation for use in a variety of other neurologic and psychiatric disorders. There is growing evidence that the anti-tremor effects of DBS for ET are directly related to modulation of the dentatorubrothalamic tract (DRT), a white matter pathway that connects the cerebellum, red nucleus, and ventral intermediate nucleus of the thalamus. Emerging white matter targets for DBS, like the DRT, will require improved 3D reference maps of deep brain anatomy and structural connectivity for accurate electrode targeting. High-resolution diffusion MRI of postmortem brain specimens can provide detailed volumetric images of important deep brain nuclei and 3D reconstructions of white matter pathways with probabilistic tractography techniques. We present a high spatial and angular resolution diffusion MRI template of the postmortem human brainstem and thalamus with 3D reconstructions of the nuclei and white matter tracts involved in ET circuitry. We demonstrate accurate registration of these data to in vivo, clinical images from patients receiving DBS therapy, and correlate electrode proximity to tractography of the DRT with improvement of ET symptoms.