Toward defining deep brain stimulation targets in MNI space: A subcortical atlas based on multimodal MRI, histology and structural connectivity

Abstract

Three-dimensional atlases of subcortical brain structures are valuable tools to reference anatomy in neuroscience and neurology. For instance, they can be used to study the position and shape of the three most common deep brain stimulation (DBS) targets, the subthalamic nucleus (STN), internal part of the pallidum (GPi) and ventral intermediate nucleus of the thalamus (VIM) in spatial relationship to DBS electrodes. Here, we present a composite atlas based on manual segmentations of a multimodal high resolution brain template, histology and structural connectivity. In a first step, four key structures were defined on the template itself using a combination of multispectral image analysis and manual segmentation. Second, these structures were used as anchor points to coregister a detailed histological atlas into standard space. Results show that this approach significantly improved coregistration accuracy over previously published methods. Finally, a sub-segmentation of STN and GPi into functional zones was achieved based on structural connectivity. The result is a composite atlas that defines key nuclei on the template itself, fills the gaps between them using histology and further subdivides them using structural connectivity. We show that the atlas can be used to segment DBS targets in single subjects, yielding more accurate results compared to priorly published atlases. The atlas will be made publicly available and constitutes a resource to study DBS electrode localizations in combination with modern neuroimaging methods.

Connectivity Predicts deep brain stimulation outcome in Parkinson disease

“…Subcortical gray matter nuclei were defined by the DISTAL atlas. 29 Conductivities of 0.33 and 0.14S/m were assigned to gray and white matter, respectively. 30 For the platinum/iridium contacts and insulated parts of the electrodes, values of 10 8 S/m and 10 −16 S/m were used, respectively.…”

Automatic localization of the subthalamic nucleus on patient‐specific clinical MRI by incorporating 7 T MRI and machine learning: Application in deep brain stimulation

“…Our 7 T-ML method is compared with the following publicly available STN atlases in the literature to validate its reliability for patient-specific clinical MRI based STN-DBS targeting: (1) 7 T MRI STN atlas for use with 3 T MRI (7 T3 T) (Milchenko et al, 2018); (2) ultrahighfield atlas (UHFA) (Wang et al, 2016); (3) DBS intrinsic template atlas (DISTAL) (Ewert et al, 2017; Horn, Neumann, Degen, Schneider, & Kühn, 2017); and (4) population-averaged atlas that was made with 3 T MRI of 25 PD patients (MNIPD25) (Xiao et al, 2017). Data acquisition and template images for these atlases are summarized in Table 4.…”

“…A probabilistic approach to map DBS electrode coordinates onto the MNI space was presented in Horn, Kühn, et al (2017). More recently, to achieve anatomical precision in the MNI space, a histological atlas (Chakravarty, Bertrand, Hodge, Sadikot, & Collins, 2006) was merged with subcortical atlases based on multiple contrast 3 T MR sequences from PD patients (Xiao et al, 2017) and high resolution multimodal MRIs and structural connectivity data (Ewert et al, 2017). …”

Reply: Oscillatory coupling of the subthalamic nucleus in obsessive compulsive disorder

“…Taken together, the evidence does not lead to the conclusion that beta oscillations per se are related to motor processing alone, but only that they have a distinctive significance within the motor system, as they are consistently found to mediate synchronization between cortical motor regions and major subcortical motor hubs including the internal pallidum (Neumann et al, 2015), the STN (Hirschmann et al, 2011;Litvak et al, 2011), the thalamus (Marsden et al, 2000) and the pedunculopontine nucleus (Jha et al, 2017). One influential account on physiological and pathophysiological beta activity may be summarized in the hypothesis that beta activity is related to the maintenance of the current cognitive or motor state (Engel and Fries, 2010).…”

“…On the other hand, this line of research opens up new avenues for understanding human basal ganglia function and improve treatment options. Going from dorsolateral to ventromedial within the nucleus, beta power and connectivity to the sensorimotor cortex gradually declines (Accolla et al, 2016;Ewert et al, 2017;Horn et al, 2017a, b).…”