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Fiber tractography of the axonal pathways linking the basal ganglia and cerebellum in Parkinson disease: implications for targeting in deep brain stimulation
- Source :
- Journal of Neurosurgery. 120:988-996
- Publication Year :
- 2014
- Publisher :
- Journal of Neurosurgery Publishing Group (JNSPG), 2014.
-
Abstract
- Object Stimulation of white matter pathways near targeted structures may contribute to therapeutic effects of deep brain stimulation (DBS) for patients with Parkinson disease (PD). Two tracts linking the basal ganglia and cerebellum have been described in primates: the subthalamopontocerebellar tract (SPCT) and the dentatothalamic tract (DTT). The authors used fiber tractography to evaluate white matter tracts that connect the cerebellum to the region of the basal ganglia in patients with PD who were candidates for DBS. Methods Fourteen patients with advanced PD underwent 3-T MRI, including 30-directional diffusion-weighted imaging sequences. Diffusion tensor tractography was performed using 2 regions of interest: ipsilateral subthalamic and red nuclei, and contralateral cerebellar hemisphere. Nine patients underwent subthalamic DBS, and the course of each tract was observed relative to the location of the most effective stimulation contact and the volume of tissue activated. Results In all patients 2 distinct tracts were identified that corresponded closely to the described anatomical features of the SPCT and DTT, respectively. The mean overall distance from the active contact to the DTT was 2.18 ± 0.35 mm, and the mean proportional distance relative to the volume of tissue activated was 1.35 ± 0.48. There was a nonsignificant trend toward better postoperative tremor control in patients with electrodes closer to the DTT. Conclusions The SPCT and the DTT may be related to the expression of symptoms in PD, and this may have implications for DBS targeting. The use of tractography to identify the DTT might assist with DBS targeting in the future.
- Subjects :
- Male
Cerebellum
Pathology
medicine.medical_specialty
Deep brain stimulation
Deep Brain Stimulation
medicine.medical_treatment
Dentatothalamic tract
Stimulation
Basal Ganglia
Article
White matter
Cerebellar hemisphere
Neural Pathways
Basal ganglia
medicine
Humans
Aged
business.industry
Parkinson Disease
Middle Aged
Axons
Diffusion Tensor Imaging
Treatment Outcome
medicine.anatomical_structure
Female
business
Neuroscience
Diffusion MRI
Subjects
Details
- ISSN :
- 19330693 and 00223085
- Volume :
- 120
- Database :
- OpenAIRE
- Journal :
- Journal of Neurosurgery
- Accession number :
- edsair.doi.dedup.....f24ecebf112b40dc062708f6d73a6fa9
- Full Text :
- https://doi.org/10.3171/2013.12.jns131537