Tractography patterns of subthalamic nucleus deep brain stimulation
Nora Vanegas-Arroyave,Peter M. Lauro,Ling Huang,Mark Hallett,Silvina G. Horovitz,Kareem A. Zaghloul,Codrin Lungu +6 more
TLDR
The connectivity patterns observed in this study suggest that the modulation of white matter tracts directed to the superior frontal gyrus and the thalamus is associated with favourable clinical outcomes and may contribute to the therapeutic effects of deep brain stimulation.Abstract:
Deep brain stimulation therapy is an effective symptomatic treatment for Parkinson's disease, yet the precise mechanisms responsible for its therapeutic effects remain unclear. Although the targets of deep brain stimulation are grey matter structures, axonal modulation is known to play an important role in deep brain stimulation's therapeutic mechanism. Several white matter structures in proximity to the subthalamic nucleus have been implicated in the clinical benefits of deep brain stimulation for Parkinson's disease. We assessed the connectivity patterns that characterize clinically beneficial electrodes in Parkinson's disease patients, after deep brain stimulation of the subthalamic nucleus. We evaluated 22 patients with Parkinson's disease (11 females, age 57 ± 9.1 years, disease duration 13.3 ± 6.3 years) who received bilateral deep brain stimulation of the subthalamic nucleus at the National Institutes of Health. During an initial electrode screening session, one month after deep brain stimulation implantation, the clinical benefits of each contact were determined. The electrode was localized by coregistering preoperative magnetic resonance imaging and postoperative computer tomography images and the volume of tissue activated was estimated from stimulation voltage and impedance. Brain connectivity for the volume of tissue activated of deep brain stimulation contacts was assessed using probabilistic tractography with diffusion-tensor data. Areas most frequently connected to clinically effective contacts included the thalamus, substantia nigra, brainstem and superior frontal gyrus. A series of discriminant analyses demonstrated that the strength of connectivity to the superior frontal gyrus and the thalamus were positively associated with clinical effectiveness. The connectivity patterns observed in our study suggest that the modulation of white matter tracts directed to the superior frontal gyrus and the thalamus is associated with favourable clinical outcomes and may contribute to the therapeutic effects of deep brain stimulation. Our method can be further developed to reliably identify effective deep brain stimulation contacts and aid in the programming process.read more
Citations
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Journal ArticleDOI
Connectivity Predicts deep brain stimulation outcome in Parkinson disease.
Andreas Horn,Martin M. Reich,Johannes Vorwerk,Ningfei Li,Gregor Wenzel,Qianqian Fang,Tanja Schmitz-Hübsch,Robert Nickl,Andreas Kupsch,Jens Volkmann,Andrea A. Kühn,Michael D. Fox +11 more
TL;DR: The structural and functional connectivity profile of effective DBS to the subthalamic nucleus (STN) is identified and its ability to predict outcome in an independent cohort is tested.
Journal ArticleDOI
Lead-DBS v2: Towards a comprehensive pipeline for deep brain stimulation imaging.
Andreas Horn,Ningfei Li,Till A. Dembek,Ari D Kappel,Chadwick B. Boulay,Siobhan Ewert,Anna Tietze,Andreas Husch,Thushara Perera,Wolf-Julian Neumann,Marco Reisert,Hang Si,Robert Oostenveld,Chris Rorden,Fang-Cheng Yeh,Qianqian Fang,Todd M. Herrington,Johannes Vorwerk,Andrea A. Kühn +18 more
TL;DR: This work represents a multi‐institutional collaborative effort to develop a comprehensive, open source pipeline for DBS imaging and connectomics, which has already empowered several studies, and may facilitate a variety of future studies in the field.
Journal ArticleDOI
A unified connectomic target for deep brain stimulation in obsessive-compulsive disorder
Ningfei Li,Juan Carlos Baldermann,Astrid Kibleur,Svenja Treu,Harith Akram,Gavin J B Elias,Alexandre Boutet,Alexandre Boutet,Andres M. Lozano,Bassam Al-Fatly,Bryan A. Strange,Juan A. Barcia,Ludvic Zrinzo,Eileen M. Joyce,Stephan Chabardes,Veerle Visser-Vandewalle,Mircea Polosan,Mircea Polosan,Jens Kuhn,Andrea A. Kühn,Andreas Horn +20 more
TL;DR: Structural connectivity of deep brain stimulation electrodes in 50 patients suffering from obsessive-compulsive disorder operated at four centers showed connectivity to a specific tract within the anterior limb of the internal capsule was associated with optimal treatment response across cohorts, surgeons and centers.
Journal ArticleDOI
Subthalamic deep brain stimulation sweet spots and hyperdirect cortical connectivity in Parkinson's disease.
Harith Akram,Stamatios N. Sotiropoulos,Stamatios N. Sotiropoulos,Saâd Jbabdi,Dejan Georgiev,P Mahlknecht,Jonathan Hyam,Thomas Foltynie,Patricia Limousin,Enrico De Vita,Enrico De Vita,Marjan Jahanshahi,Marwan Hariz,Marwan Hariz,John Ashburner,Timothy E.J. Behrens,Timothy E.J. Behrens,Ludvic Zrinzo +17 more
TL;DR: These findings support the presence of overlapping stimulation sites within the subthalamic nucleus and its superior border, with different cortical connectivity patterns, associated with maximum improvement in tremor, rigidity and bradykinesia.
Journal ArticleDOI
White matter tractography for neurosurgical planning: A topography-based review of the current state of the art.
Walid Ibn Essayed,Fan Zhang,Prashin Unadkat,G. Rees Cosgrove,Alexandra J. Golby,Lauren J. O'Donnell +5 more
TL;DR: It is found that tractography is a valuable tool in variable situations in modern neurosurgery, with progress towards overcoming clinical challenges of standardization and interpretation.
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