Stimulation sites in the subthalamic nucleus projected onto a mean 3-D atlas of the thalamus and basal ganglia

Sarnthein, Johannes; Péus, Dominik; Baumann‐Vogel, Heide; Baumann, Christian; Sürücü, Oǧuzkan

doi:10.1007/s00701-013-1780-3

Cited by 7 publications

(5 citation statements)

References 22 publications

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“…As verified by post-operative reconstruction of the electrode position, the second lowest contact ( Fig. 1D , Sarnthein et al, 2013 ) was located in the motor part of the STN in all patients and taken for further analysis. To reduce movement and electrode artifacts, we digitally re-referenced all signals to a Laplacian montage with weighted averages of the surrounding deep brain electrodes (for LFP channels) and surface electrodes (for EEG channels).…”

Section: Methodsmentioning

confidence: 91%

“…acceleration in Z direction) for upwards (black) and downwards (gray) directed movement in one patient during the shaking task (C) behavioral data (grip force GF and loading force LF) and electrophysiological data (local field potentials LFP and surface EEG) were recorded simultaneously. (D) Projection of the reconstructed electrode position onto a 3D-Atlas ( Sarnthein et al, 2013 ). The second lowest contact (red) of the electrode (blue) is located in the dorsal STN (green) and this signal was used for subsequent analyses.…”

Section: Figmentioning

confidence: 99%

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Adaptive grip force is modulated by subthalamic beta activity in Parkinson's disease patients

Imbach

Baumann‐Vogel

Baumann

et al. 2015

NeuroImage: Clinical

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IntroductionHealthy subjects scale grip force to match the load defined by physical object properties such as weight, or dynamic properties such as inertia. Patients with Parkinson's disease (PD) show an elevated grip force in dynamic object handling, but temporal aspects of anticipatory grip force control are relatively preserved. In PD patients, beta frequency oscillatory activity in the basal ganglia is suppressed prior to externally paced movements. However, the role of the subthalamic nucleus (STN) in anticipatory grip force control is not known.MethodsAfter implantation of deep brain stimulation (DBS) electrodes in the STN, PD patients performed adaptive and voluntary grip force tasks, while we recorded subthalamic local field potentials (LFP) and scalp EEG.ResultsDuring adaptive grip force control (Shake), we found event related desynchronization (ERD) in the beta frequency band, which was time-locked to the grip force. In contrast, during voluntary grip force control (Press) we recorded a biphasic ERD, corresponding to peak grip force and grip force release. Beta synchronization between STN and cortical EEG was reduced during adaptive grip force control.ConclusionThe time-locked suppression of beta oscillatory activity in the STN is in line with previous reports of beta ERD prior to voluntary movements. Our results show that the STN is involved in anticipatory grip force control in PD patients. The difference in the phasic beta ERD between the two tasks and the reduction of cortico-subthalamic synchronization suggests that qualitatively different neuronal network states are involved in different grip force control tasks.

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Section: Methodsmentioning

confidence: 91%

Section: Figmentioning

confidence: 99%

Adaptive grip force is modulated by subthalamic beta activity in Parkinson's disease patients

Imbach

Baumann‐Vogel

Baumann

et al. 2015

NeuroImage: Clinical

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“…The use of the patient-specific MR-WAIR sequence together with a 4.7 T in-house atlas as reference and stereotactic books make an approximate identification of the structures possible (Zerroug et al, 2016). Other groups have proposed various approaches (Caire et al, 2013) among them projecting the position of the active contact(s) directly onto anatomical images (Vayssiere et al, 2004), onto anatomical (Saint-Cyr et al, 2002; Sarnthein et al, 2013) or probabilistic functional atlases (Lalys et al, 2013), or linking them to MER results (Zonenshayn et al, 2004) sometimes combined with imaging data (Weise et al, 2013) and white matter tracking (Coenen et al, 2012). To analyze the relationship between the anatomical location of stimulating contacts and the clinical effectiveness of stimulation, we have decided to take into account the extent of stimulation by using EF simulations (Åström et al, 2012) as discussed in detail in the next paragraph.…”

Section: Discussionmentioning

confidence: 99%

Patient-Specific Electric Field Simulations and Acceleration Measurements for Objective Analysis of Intraoperative Stimulation Tests in the Thalamus

Hemm

Pison

Alonso

et al. 2016

Front. Hum. Neurosci.

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Despite an increasing use of deep brain stimulation (DBS) the fundamental mechanisms of action remain largely unknown. Simulation of electric entities has previously been proposed for chronic DBS combined with subjective symptom evaluations, but not for intraoperative stimulation tests. The present paper introduces a method for an objective exploitation of intraoperative stimulation test data to identify the optimal implant position of the chronic DBS lead by relating the electric field (EF) simulations to the patient-specific anatomy and the clinical effects quantified by accelerometry. To illustrate the feasibility of this approach, it was applied to five patients with essential tremor bilaterally implanted in the ventral intermediate nucleus (VIM). The VIM and its neighborhood structures were preoperatively outlined in 3D on white matter attenuated inversion recovery MR images. Quantitative intraoperative clinical assessments were performed using accelerometry. EF simulations (n = 272) for intraoperative stimulation test data performed along two trajectories per side were set-up using the finite element method for 143 stimulation test positions. The resulting EF isosurface of 0.2 V/mm was superimposed to the outlined anatomical structures. The percentage of volume of each structure’s overlap was calculated and related to the corresponding clinical improvement. The proposed concept has been successfully applied to the five patients. For higher clinical improvements, not only the VIM but as well other neighboring structures were covered by the EF isosurfaces. The percentage of the volumes of the VIM, of the nucleus intermediate lateral of the thalamus and the prelemniscal radiations within the prerubral field of Forel increased for clinical improvements higher than 50% compared to improvements lower than 50%. The presented new concept allows a detailed and objective analysis of a high amount of intraoperative data to identify the optimal stimulation target. First results indicate agreement with published data hypothesizing that the stimulation of other structures than the VIM might be responsible for good clinical effects in essential tremor. (Clinical trial reference number: Ref: 2011-A00774-37/AU905)

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“…Twenty-two long-term studies were excluded (Fig. 1) due to insufficient number of patients included [38][39][40][41], absence of STN segmentation [41][42][43][44][45][46], use of planar X-rays for contact location [9,39,44,[47][48][49], lead localization method not described andabsence of contact location [22], motor assessment performed ON medication [50][51][52], medication status not specified [53], and use of bilateral motor scores to analyse bilateral stimulation [26,41,[54][55][56][57][58]. More details can be found in Suppl.…”

Section: Excluded Studies After Methodological Assessmentmentioning

confidence: 99%

“…Study from Sarnthein et al[51] is a feasibility study about the use of Morel atlas for the visualization of stimulation site.…”

mentioning

confidence: 99%

Stimulation Sweet Spot in Subthalamic Deep Brain Stimulation – Myth or Reality? A Critical Review of Literature

Roquemaurel

Wirth

Vijiaratnam

et al. 2021

Stereotact Funct Neurosurg

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Introduction: While deep brain stimulation (DBS) of the subthalamic nucleus (STN) has been extensively used for more than 20 years in Parkinson’s disease (PD), the optimal area of stimulation to relieve motor symptoms remains elusive. Objective: We aimed at localizing the sweet spot within the subthalamic region by performing a systematic review of the literature. Method: PubMed database was searched for published studies exploring optimal stimulation location for STN DBS in PD, published between 2000 and 2019. A standardized assessment procedure based on methodological features was applied to select high-quality publications. Studies conducted more than 3 months after the DBS procedure, employing lateralized scores and/or stimulation condition, and reporting the volume of tissue activated or the position of the stimulating contact within the subthalamic region were considered in the final analysis. Results: Out of 439 references, 24 were finally retained, including 21 studies based on contact location and 3 studies based on volume of tissue activated (VTA). Most studies (all VTA-based studies and 13 of the 21 contact-based studies) suggest the superior-lateral STN and the adjacent white matter as the optimal sites for stimulation. Remaining contact-based studies were either inconclusive (5/21), favoured the caudal zona incerta (1/21), or suggested a better outcome of STN stimulation than adjacent white matter stimulation (2/21). Conclusion: Using a standardized methodological approach, our review supports the presence of a sweet spot located within the supero-lateral STN and extending to the adjacent white matter.

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Stimulation sites in the subthalamic nucleus projected onto a mean 3-D atlas of the thalamus and basal ganglia

Abstract: Background: In patients with severe forms of Parkinson's disease (PD), deep brain

Cited by 7 publications

References 22 publications

Adaptive grip force is modulated by subthalamic beta activity in Parkinson's disease patients

Adaptive grip force is modulated by subthalamic beta activity in Parkinson's disease patients

Patient-Specific Electric Field Simulations and Acceleration Measurements for Objective Analysis of Intraoperative Stimulation Tests in the Thalamus

Stimulation Sweet Spot in Subthalamic Deep Brain Stimulation – Myth or Reality? A Critical Review of Literature

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