The variability of atlas-based targets in relation to surrounding major fibre tracts in thalamic deep brain stimulation

Anthofer, Judith; Steib, Kathrin; Fellner, Claudia; Lange, Max; Brawanski, Alexander; Schlaier, J.

doi:10.1007/s00701-014-2103-z

Cited by 55 publications

(48 citation statements)

References 28 publications

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“…We fully agree with the concerns regarding the limitations of tractography, as already discussed in our article [1] and earlier reports by our group [2,6,10]. His own work constitutes a further valuable contribution to the topic [3].…”

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confidence: 87%

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Letter of response to “Individualization of deep brain stimulation targets for movement disorders”

et al. 2015

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Dear Editor, We would like to thank Josue M. Avecillas-Chasin for his appreciation of our study BThe variability of atlas-based targets in relation to surrounding major fibre tracts in thalamic deep brain stimulation^[1] and for his valuable comments on the study.We fully agree with the concerns regarding the limitations of tractography, as already discussed in our article [1] and earlier reports by our group [2,6,10]. His own work constitutes a further valuable contribution to the topic [3]. Several studies in the past have used diffusion tensor imaging (DTI) and tractography to visualise fibre tracts in the region of the ventro-lateral thalamus [5,7,8,11]. However the reliability of the depicted connections is yet unclear. First approaches to comparing diffusion tensor imaging-based fibre tracts with clinical effects have been made [3-5, 10] and have shown promising results. But, as demanded by Avecillas-Chasin, the method needs to be optimised and standardised. Optimal parameters for data acquisition (number of read-out directions, field strengths of MR scanner or voxel size) have to be generated, as well as optimal algorithms such as a mixture of tensors, Q-ball imaging, diffusion spectrum imaging and others [10]. As also mentioned by Avecillas-Chasin, it will be necessary in the future to compare deterministic algorithms with the probabilistic method, especially in tracts such as the dentate-rubro-thalamic tract (DRTT) that intersect regions with multiple fibre orientations. Furthermore, different software packages lead to different results in the depiction of chosen fibre tracts [6].We are aware that the used method of DTI with deterministic tractography has its limitations and is not yet elaborate and reliable enough for implementation in routine clinical use as a standard tool. Therefore, today we still depend on neurophysiological and clinical information for targeting by means of micro-electrode recording (MER) and clinical testing in the setting of awake-surgeries [9]. Conflict of interest None. References 1. Anthofer J, Steib K, Fellner C, Lange M, Brawanski A, Schlaier J (2014) The variability of atlas-based targets in relation to surrounding major fibre tracts in thalamic deep brain stimulation. Acta Neurochir 156:1497-1504, discussion 1504 2. Anthofer JM, Steib K, Fellner C, Lange M, Brawanski A, Schlaier J (2015) DTI-based deterministic fibre tracking of the medial forebrain bundle. Acta Neurochir 157:469-477 3. Avecillas-Chasin JM, Alonso-Frech F, Parras O, Del Prado N, Barcia JA (2015) Assessment of a method to determine deep brain stimulation targets using deterministic tractography in a navigation system. Neurosurg Rev.

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confidence: 87%

“…Dear Editor, We would like to thank Josue M. Avecillas-Chasin for his appreciation of our study BThe variability of atlas-based targets in relation to surrounding major fibre tracts in thalamic deep brain stimulation^ [1] and for his valuable comments on the study.…”

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Letter of response to “Individualization of deep brain stimulation targets for movement disorders”

et al. 2015

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“…We do not think so. Even with our standardized protocol we observed a significant variability in the course of the detected fiber tracts between left and right hemispheres and between different patients . The resolution of fibertracking is limited in areas of the brain where fibers of different functional tracts are getting in close contact or even cross each other.…”

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confidence: 79%

Deep Brain Stimulation for Essential Tremor: Targeting the Dentato-Rubro-Thalamic Tract?

Schlaier

Anthofer

Steib

et al. 2015

Neuromodulation: Technology at the Neural Interface

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“…Overall, the T‐VIM target is more lateral and anterior than the conventional targeting method. Anthofer and colleagues recently compared the atlas‐based VIM target with the location of the DRT (as determined by deterministic tractography) in a cohort of tremor patients . They concluded that the optimal site for DBS implantation was more lateral than the planned atlas‐based trajectory.…”

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confidence: 99%

Tractography‐Based Ventral Intermediate Nucleus Targeting: Novel Methodology and Intraoperative Validation

et al. 2016

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Backgro und: The ventral intermediate nucleus of the thalamus is not readily visible on structural magnetic resonance imaging. Therefore, a method for its visualization for stereotactic targeting is desirable. Objective: The objective of this study was to define a tractography-based methodology for the stereotactic targeting of the ventral intermediate nucleus. Methods:The lateral and posterior borders of the ventral intermediate nucleus were defined by tracking the pyramidal tract and medial lemniscus, respectively. A thalamic seed was then created 3 mm medial and anterior to these borders, and its structural connections were analyzed. The application of this method was assessed in an imaging cohort of 14 tremor patients and 15 healthy controls, in which we compared the tractography-based targeting to conventional targeting. In a separate surgical cohort (3 tremor and 3 tremor-dominant Parkinson's disease patients), we analyzed the accuracy of this method by correlating it with intraoperative neurophysiology.

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The variability of atlas-based targets in relation to surrounding major fibre tracts in thalamic deep brain stimulation

Cited by 55 publications

References 28 publications

Letter of response to “Individualization of deep brain stimulation targets for movement disorders”

Letter of response to “Individualization of deep brain stimulation targets for movement disorders”

Deep Brain Stimulation for Essential Tremor: Targeting the Dentato-Rubro-Thalamic Tract?

Tractography‐Based Ventral Intermediate Nucleus Targeting: Novel Methodology and Intraoperative Validation

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