Diffusion Tractography in Deep Brain Stimulation Surgery: A Review.
Diffusion Tractography in Deep Brain Stimulation Surgery: A Review.
复制标题
DOI：
10.3389/fnana.2016.00045
复制
发表时间：
2016
影响因子：
2.9
通讯作者：
Calabrese E
中科院分区：
文献类型：
--
作者：
Calabrese E
脑深部电刺激（DBS）被认为是通过调节脑回路发挥其治疗效果，但传统的术前计划不允许直接靶向或可视化的白色物质途径。弥散磁共振纤维束成像（DT）实际上是唯一的非侵入性方法可视化结构连接在大脑中，导致许多人建议使用它来指导DBS的目标。DT引导DBS不仅有可能允许直接白色物质靶向用于已建立的应用[例如，帕金森病（PD）、特发性震颤（ET）、肌张力障碍]，而且还可以帮助发现用于各种其他神经和精神疾病的新的治疗靶点。尽管有这些令人兴奋的机会，DT缺乏标准化和严格的解剖学验证，提高了在立体定向脑外科手术中使用这些数据的重大关注。本综述涵盖了DBS手术中使用DT的技术细节、拟定方法和初始临床数据。而不是专注于特定的疾病应用，这篇评论的重点是方法，可以适用于几乎任何DBS的目标。
Deep brain stimulation (DBS) is believed to exert its therapeutic effects through modulation of brain circuitry, yet conventional preoperative planning does not allow direct targeting or visualization of white matter pathways. Diffusion MRI tractography (DT) is virtually the only non-invasive method of visualizing structural connectivity in the brain, leading many to suggest its use to guide DBS targeting. DT-guided DBS not only has the potential to allow direct white matter targeting for established applications [e.g., Parkinson’s disease (PD), essential tremor (ET), dystonia], but may also aid in the discovery of new therapeutic targets for a variety of other neurologic and psychiatric diseases. Despite these exciting opportunities, DT lacks standardization and rigorous anatomic validation, raising significant concern for the use of such data in stereotactic brain surgery. This review covers the technical details, proposed methods, and initial clinical data for the use of DT in DBS surgery. Rather than focusing on specific disease applications, this review focuses on methods that can be applied to virtually any DBS target.