Ventralis intermedius nucleus anatomical variability assessment by MRI structural connectivity.
Ventralis intermedius nucleus anatomical variability assessment by MRI structural connectivity.
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DOI：
10.1016/j.neuroimage.2021.118231
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发表时间：
2021-09
期刊：
影响因子：
5.7
通讯作者：
Lambert C
中科院分区：
文献类型：
--
作者：
Ferreira F;Akram H;Ashburner J;Zrinzo L;Zhang H;Lambert C
基于连接性的 Vim 位置在受试者之间以及与图集定义的坐标之间存在显着差异。这种位置变异与测试的任何方法学混淆无关。在基于连接的 Vim 位置中观察到半球不对称。我们假设小脑功能（例如语言）的偏侧化可能导致不对称。了解 Vim 位置变异性有助于为震颤治疗的神经外科规划提供信息。腹中间核 (Vim) 位于齿状丘脑皮质通路 (DTCp) 的中心，是治疗严重医学难治性震颤的关键手术靶点。它在传统 MRI 序列上不可见；因此，立体定向瞄准目前依赖于基于地图集的坐标。这无法捕捉个体解剖变异性，这可能导致长期临床疗效不佳。概率纤维束成像与已知的解剖连接性相结合，能够在个体受试者水平上定位丘脑核。然而，该技术存在许多可能影响结果的混杂因素。在这里，我们重点关注一种既定的方法，使用概率纤维束成像重建 DTCp，以识别体内连接定义的 Vim (cd-Vim)。使用人类连接组项目的 100 名健康个体，我们的目的是量化该人群中 cd-Vim 的变异性，测量与图谱定义的 Vim (ad-Vim) 的差异，并评估潜在方法学混淆的影响。我们发现任何混杂因素都没有显着影响。平均 cd-Vim 坐标位于平均中点 1.88 毫米（左）和 2.12 毫米（右）范围内，距 ad-Vim 坐标 3.98 毫米（左）和 5.41 毫米（右）范围内。 cd-Vim 的位置在右侧变化更大，这反映了重建的概率 DTC 中的半球不对称性。该方法具有可重复性，在单独的重测队列中没有显着的 cd-Vim 位置差异。小脑上脚被认为是人工方差的潜在来源。这项工作证明了 cd-Vim 显着的个体解剖变异性，而基于图谱的坐标靶向无法捕获这种变异性。这种变异性与测试的任何方法学混淆无关。小脑功能（例如言语）的偏侧化可能导致观察到的不对称性。基于纤维束成像的方法似乎对个体解剖变异很敏感，而传统的神经外科靶向治疗则忽略了这一点；这些发现可能构成转化工具的基础，以提高丘脑震颤手术的疗效并减少副作用。
Connectivity-based Vim position varied markedly between subjects and from atlas-defined coordinates. This positional variability was not related to any methodological confound tested. Hemispheric asymmetry was observed in connectivity-based Vim position. We hypothesise lateralization of cerebellar functions, such as language, may contribute to asymmetry. Knowledge of Vim position variability could help inform neurosurgical planning in the management of tremor. The ventralis intermedius nucleus (Vim) is centrally placed in the dentato-thalamo-cortical pathway (DTCp) and is a key surgical target in the treatment of severe medically refractory tremor. It is not visible on conventional MRI sequences; consequently, stereotactic targeting currently relies on atlas-based coordinates. This fails to capture individual anatomical variability, which may lead to poor long-term clinical efficacy. Probabilistic tractography, combined with known anatomical connectivity, enables localisation of thalamic nuclei at an individual subject level. There are, however, a number of confounds associated with this technique that may influence results. Here we focused on an established method, using probabilistic tractography to reconstruct the DTCp, to identify the connectivity-defined Vim (cd-Vim) in vivo. Using 100 healthy individuals from the Human Connectome Project, our aim was to quantify cd-Vim variability across this population, measure the discrepancy with atlas-defined Vim (ad-Vim), and assess the influence of potential methodological confounds. We found no significant effect of any of the confounds. The mean cd-Vim coordinate was located within 1.88 mm (left) and 2.12 mm (right) of the average midpoint and 3.98 mm (left) and 5.41 mm (right) from the ad-Vim coordinates. cd-Vim location was more variable on the right, which reflects hemispheric asymmetries in the probabilistic DTC reconstructed. The method was reproducible, with no significant cd-Vim location differences in a separate test-retest cohort. The superior cerebellar peduncle was identified as a potential source of artificial variance. This work demonstrates significant individual anatomical variability of the cd-Vim that atlas-based coordinate targeting fails to capture. This variability was not related to any methodological confound tested. Lateralisation of cerebellar functions, such as speech, may contribute to the observed asymmetry. Tractography-based methods seem sensitive to individual anatomical variability that is missed by conventional neurosurgical targeting; these findings may form the basis for translational tools to improve efficacy and reduce side-effects of thalamic surgery for tremor.
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