1
|
Gulberti A, Schneider TR, Galindo-Leon EE, Heise M, Pino A, Westphal M, Hamel W, Buhmann C, Zittel S, Gerloff C, Pötter-Nerger M, Engel AK, Moll CKE. Premotor cortical beta synchronization and the network neuromodulation of externally paced finger tapping in Parkinson's disease. Neurobiol Dis 2024; 197:106529. [PMID: 38740349 DOI: 10.1016/j.nbd.2024.106529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Revised: 04/30/2024] [Accepted: 05/10/2024] [Indexed: 05/16/2024] Open
Abstract
Parkinson's disease (PD) is characterized by the disruption of repetitive, concurrent and sequential motor actions due to compromised timing-functions principally located in cortex-basal ganglia (BG) circuits. Increasing evidence suggests that motor impairments in untreated PD patients are linked to an excessive synchronization of cortex-BG activity at beta frequencies (13-30 Hz). Levodopa and subthalamic nucleus deep brain stimulation (STN-DBS) suppress pathological beta-band reverberation and improve the motor symptoms in PD. Yet a dynamic tuning of beta oscillations in BG-cortical loops is fundamental for movement-timing and synchronization, and the impact of PD therapies on sensorimotor functions relying on neural transmission in the beta frequency-range remains controversial. Here, we set out to determine the differential effects of network neuromodulation through dopaminergic medication (ON and OFF levodopa) and STN-DBS (ON-DBS, OFF-DBS) on tapping synchronization and accompanying cortical activities. To this end, we conducted a rhythmic finger-tapping study with high-density EEG-recordings in 12 PD patients before and after surgery for STN-DBS and in 12 healthy controls. STN-DBS significantly ameliorated tapping parameters as frequency, amplitude and synchrony to the given auditory rhythms. Aberrant neurophysiologic signatures of sensorimotor feedback in the beta-range were found in PD patients: their neural modulation was weaker, temporally sluggish and less distributed over the right cortex in comparison to controls. Levodopa and STN-DBS boosted the dynamics of beta-band modulation over the right hemisphere, hinting to an improved timing of movements relying on tactile feedback. The strength of the post-event beta rebound over the supplementary motor area correlated significantly with the tapping asynchrony in patients, thus indexing the sensorimotor match between the external auditory pacing signals and the performed taps. PD patients showed an excessive interhemispheric coherence in the beta-frequency range during the finger-tapping task, while under DBS-ON the cortico-cortical connectivity in the beta-band was normalized. Ultimately, therapeutic DBS significantly ameliorated the auditory-motor coupling of PD patients, enhancing the electrophysiological processing of sensorimotor feedback-information related to beta-band activity, and thus allowing a more precise cued-tapping performance.
Collapse
Affiliation(s)
- Alessandro Gulberti
- Department of Neurophysiology and Pathophysiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - Till R Schneider
- Department of Neurophysiology and Pathophysiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Edgar E Galindo-Leon
- Department of Neurophysiology and Pathophysiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Miriam Heise
- Department of Neurosurgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Alessandro Pino
- Department of Aerospace Science and Technology, Politecnico di Milano, Milan, Italy
| | - Manfred Westphal
- Department of Neurosurgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Wolfgang Hamel
- Department of Neurosurgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Carsten Buhmann
- Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Simone Zittel
- Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Christian Gerloff
- Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Monika Pötter-Nerger
- Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Andreas K Engel
- Department of Neurophysiology and Pathophysiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Christian K E Moll
- Department of Neurophysiology and Pathophysiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| |
Collapse
|
2
|
Béreau M, Kibleur A, Servant M, Clément G, Dujardin K, Rolland AS, Wirth T, Lagha-Boukbiza O, Voirin J, Santin MDN, Hainque E, Grabli D, Comte A, Drapier S, Durif F, Marques A, Eusebio A, Azulay JP, Giordana C, Houeto JL, Jarraya B, Maltete D, Rascol O, Rouaud T, Tir M, Moreau C, Danaila T, Prange S, Tatu L, Tranchant C, Corvol JC, Devos D, Thobois S, Desmarets M, Anheim M. Motivational and cognitive predictors of apathy after subthalamic nucleus stimulation in Parkinson's disease. Brain 2024; 147:472-485. [PMID: 37787488 DOI: 10.1093/brain/awad324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 07/13/2023] [Accepted: 08/21/2023] [Indexed: 10/04/2023] Open
Abstract
Postoperative apathy is a frequent symptom in Parkinson's disease patients who have undergone bilateral deep brain stimulation of the subthalamic nucleus. Two main hypotheses for postoperative apathy have been suggested: (i) dopaminergic withdrawal syndrome relative to postoperative dopaminergic drug tapering; and (ii) direct effect of chronic stimulation of the subthalamic nucleus. The primary objective of our study was to describe preoperative and 1-year postoperative apathy in Parkinson's disease patients who underwent chronic bilateral deep brain stimulation of the subthalamic nucleus. We also aimed to identify factors associated with 1-year postoperative apathy considering: (i) preoperative clinical phenotype; (ii) dopaminergic drug management; and (iii) volume of tissue activated within the subthalamic nucleus and the surrounding structures. We investigated a prospective clinical cohort of 367 patients before and 1 year after chronic bilateral deep brain stimulation of the subthalamic nucleus. We assessed apathy using the Lille Apathy Rating Scale and carried out a systematic evaluation of motor, cognitive and behavioural signs. We modelled the volume of tissue activated in 161 patients using the Lead-DBS toolbox and analysed overlaps within motor, cognitive and limbic parts of the subthalamic nucleus. Of the 367 patients, 94 (25.6%) exhibited 1-year postoperative apathy: 67 (18.2%) with 'de novo apathy' and 27 (7.4%) with 'sustained apathy'. We observed disappearance of preoperative apathy in 22 (6.0%) patients, who were classified as having 'reversed apathy'. Lastly, 251 (68.4%) patients had neither preoperative nor postoperative apathy and were classified as having 'no apathy'. We identified preoperative apathy score [odds ratio (OR) 1.16; 95% confidence interval (CI) 1.10, 1.22; P < 0.001], preoperative episodic memory free recall score (OR 0.93; 95% CI 0.88, 0.97; P = 0.003) and 1-year postoperative motor responsiveness (OR 0.98; 95% CI 0.96, 0.99; P = 0.009) as the main factors associated with postoperative apathy. We showed that neither dopaminergic dose reduction nor subthalamic stimulation were associated with postoperative apathy. Patients with 'sustained apathy' had poorer preoperative fronto-striatal cognitive status and a higher preoperative action initiation apathy subscore. In these patients, apathy score and cognitive status worsened postoperatively despite significantly lower reduction in dopamine agonists (P = 0.023), suggesting cognitive dopa-resistant apathy. Patients with 'reversed apathy' benefited from the psychostimulant effect of chronic stimulation of the limbic part of the left subthalamic nucleus (P = 0.043), suggesting motivational apathy. Our results highlight the need for careful preoperative assessment of motivational and cognitive components of apathy as well as executive functions in order to better prevent or manage postoperative apathy.
Collapse
Affiliation(s)
- Matthieu Béreau
- Department of Neurology, NS-PARK/F-CRIN network, University Hospital of Besançon, 25030 Besançon Cedex, France
- UR LINC 481, Université de Franche-Comté, F-2500 Besançon, France
| | - Astrid Kibleur
- LIP/PC2S, Université Grenoble Alpes, Université Savoie Mont Blanc, 38040 Grenoble Cedex 9, France
| | - Mathieu Servant
- UR LINC 481, Université de Franche-Comté, F-2500 Besançon, France
| | - Gautier Clément
- Department of Neurology, NS-PARK/F-CRIN network, University Hospital of Besançon, 25030 Besançon Cedex, France
| | - Kathy Dujardin
- Lille Neurosciences and Cognition, CHU-Lille, Neurology and Movement Disorders department, NS-Park/F-CRIN network, Univ. Lille, 59037 Lille, France
| | - Anne-Sophie Rolland
- Lille Neurosciences and Cognition, CHU-Lille, Department of Medical Pharmacology, NS-Park/F-CRIN, Univ. Lille, Inserm, 59045 Lille, France
| | - Thomas Wirth
- Service de Neurologie, NS-Park/F-CRIN network, Hôpitaux Universitaires de Strasbourg et Fédération de Médecine Translationnelle de Médecine de Strasbourg, 67200 Strasbourg, France
- Institut de Génétique et de Biologie Moléculaire et Cellulaire, INSERM-U964/CNRS-UMR7104/Université de Strasbourg, 67400 Illkirch, France
| | - Ouhaid Lagha-Boukbiza
- Service de Neurologie, NS-Park/F-CRIN network, Hôpitaux Universitaires de Strasbourg et Fédération de Médecine Translationnelle de Médecine de Strasbourg, 67200 Strasbourg, France
| | - Jimmy Voirin
- Department of Neurosurgery, NS-PARK/F-CRIN network, Strasbourg University Hospital, 67200 Strasbourg, France
| | - Marie des Neiges Santin
- Department of Neurosurgery, NS-PARK/F-CRIN network, Strasbourg University Hospital, 67200 Strasbourg, France
| | - Elodie Hainque
- Assistance publique Hôpitaux de Paris, Inserm, CNRS, Hôpital Pitié-Salpêtrière, Department of Neurology, NS-Park/F-CRIN network, Sorbonne Université, Paris Brain Institute-ICM, 75014 Paris, France
| | - David Grabli
- Assistance publique Hôpitaux de Paris, Inserm, CNRS, Hôpital Pitié-Salpêtrière, Department of Neurology, NS-Park/F-CRIN network, Sorbonne Université, Paris Brain Institute-ICM, 75014 Paris, France
| | - Alexandre Comte
- UR LINC 481, Université de Franche-Comté, F-2500 Besançon, France
- Centre d'investigation clinique Inserm CIC 1431, CHU Besançon, F-25000 Besançon, France
| | - Sophie Drapier
- Department of Neurology, NS-PARK/F-CRIN network, University Hospital of Rennes, 35000 Rennes, France
| | - Franck Durif
- CNRS, Clermont Auvergne INP, Institut Pascal, Clermont-Ferrand University Hospital, Neurology department, NS-Park/F-CRIN network, Université Clermont Auvergne, 63000 Clermont-Ferrand, France
| | - Ana Marques
- CNRS, Clermont Auvergne INP, Institut Pascal, Clermont-Ferrand University Hospital, Neurology department, NS-Park/F-CRIN network, Université Clermont Auvergne, 63000 Clermont-Ferrand, France
| | - Alexandre Eusebio
- Department of Neurology and Movement Disorders, APHM, Hôpital Universitaire Timone, 13005 Marseille, France
- CNRS, Institut de Neurosciences de la Timone, Aix Marseille Univ., 13005 Marseille, France
| | - Jean-Philippe Azulay
- Department of Neurology and Movement Disorders, APHM, Hôpital Universitaire Timone, 13005 Marseille, France
- CNRS, Institut de Neurosciences de la Timone, Aix Marseille Univ., 13005 Marseille, France
| | - Caroline Giordana
- Department of Neurology, NS-Park/F-CRIN network, Centre Hospitalier Universitaire de Nice, 06002 Nice, France
| | - Jean-Luc Houeto
- Department of Neurology, NS-Park/F-CRIN network, Limoges University Hospital, Inserm, U1094, EpiMaCT-Epidemiology of chronic diseases in tropical zone, Limoges University Hospital,87042 Limoges, France
| | - Béchir Jarraya
- Neuroscience Pole, NS-Park/F-CRIN network, Hôpital Foch, Suresnes, University of Versailles Paris-Saclay, INSERM-CEA NeuroSpin, 91191 Gif-sur-Yvette, France
| | - David Maltete
- Department of Neurology, NS-Park/F-CRIN network, Rouen University Hospital and University of Rouen, 76000 Rouen, France
- INSERM U1239, Laboratory of Neuronal and Neuroendocrine Differentiation and Communication, 76130 Mont-Saint-Aignan, France
| | - Olivier Rascol
- Department of Clinical Pharmacology and Neuroscience, CIC1436, NS-Park/F-CRIN network, NeuroToul Center of Excellence, Toulouse University Hospital, INSERM, CHU of Toulouse, 31000 Toulouse, France
| | - Tiphaine Rouaud
- Department of Neurology, Centre Expert Parkinson, NS-Park/F-CRIN network, CHU Nantes, 44093 Nantes, France
| | - Mélissa Tir
- Department of Neurology, NS-Park/F-CRIN network, Amiens University Hospital, 80000 Amiens, France
| | - Caroline Moreau
- Lille Neurosciences and Cognition, CHU-Lille, Neurology and Movement Disorders department, NS-Park/F-CRIN network, Univ. Lille, 59037 Lille, France
| | - Teodor Danaila
- Department of Neurology, NS-Park/F-CRIN network, Amiens University Hospital, 80000 Amiens, France
| | - Stéphane Prange
- Department of Neurology, NS-Park/F-CRIN network, Amiens University Hospital, 80000 Amiens, France
- Service de Neurologie C, NS-Park/F-CRIN network, Hospices Civils de Lyon, Hôpital Neurologique Pierre Wertheimer, 69500 Bron, France
| | - Laurent Tatu
- Department of Neurology, NS-PARK/F-CRIN network, University Hospital of Besançon, 25030 Besançon Cedex, France
| | - Christine Tranchant
- Service de Neurologie, NS-Park/F-CRIN network, Hôpitaux Universitaires de Strasbourg et Fédération de Médecine Translationnelle de Médecine de Strasbourg, 67200 Strasbourg, France
| | - Jean-Christophe Corvol
- Assistance publique Hôpitaux de Paris, Inserm, CNRS, Hôpital Pitié-Salpêtrière, Department of Neurology, NS-Park/F-CRIN network, Sorbonne Université, Paris Brain Institute-ICM, 75014 Paris, France
| | - David Devos
- Lille Neurosciences and Cognition, CHU-Lille, Neurology and Movement Disorders department, NS-Park/F-CRIN network, Univ. Lille, 59037 Lille, France
- Lille Neurosciences and Cognition, CHU-Lille, Department of Medical Pharmacology, NS-Park/F-CRIN, Univ. Lille, Inserm, 59045 Lille, France
| | - Stephane Thobois
- Service de Neurologie C, NS-Park/F-CRIN network, Hospices Civils de Lyon, Hôpital Neurologique Pierre Wertheimer, 69500 Bron, France
- Institut des Sciences Cognitives Marc Jeannerot, CNRS, UMR5229, 69675 Bron, France
| | - Maxime Desmarets
- Centre d'investigation clinique Inserm CIC 1431, CHU Besançon, F-25000 Besançon, France
- Université de Franche-Comté, EFS, INSERM, UMR RIGHT, 25000 Besançon, France
| | - Mathieu Anheim
- Service de Neurologie, NS-Park/F-CRIN network, Hôpitaux Universitaires de Strasbourg et Fédération de Médecine Translationnelle de Médecine de Strasbourg, 67200 Strasbourg, France
- Institut de Génétique et de Biologie Moléculaire et Cellulaire, INSERM-U964/CNRS-UMR7104/Université de Strasbourg, 67400 Illkirch, France
| |
Collapse
|
3
|
Taha A, Gilmore G, Abbass M, Kai J, Kuehn T, Demarco J, Gupta G, Zajner C, Cao D, Chevalier R, Ahmed A, Hadi A, Karat BG, Stanley OW, Park PJ, Ferko KM, Hemachandra D, Vassallo R, Jach M, Thurairajah A, Wong S, Tenorio MC, Ogunsanya F, Khan AR, Lau JC. Magnetic resonance imaging datasets with anatomical fiducials for quality control and registration. Sci Data 2023; 10:449. [PMID: 37438367 DOI: 10.1038/s41597-023-02330-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 06/26/2023] [Indexed: 07/14/2023] Open
Abstract
Tools available for reproducible, quantitative assessment of brain correspondence have been limited. We previously validated the anatomical fiducial (AFID) placement protocol for point-based assessment of image registration with millimetric (mm) accuracy. In this data descriptor, we release curated AFID placements for some of the most commonly used structural magnetic resonance imaging datasets and templates. The release of our accurate placements allows for rapid quality control of image registration, teaching neuroanatomy, and clinical applications such as disease diagnosis and surgical targeting. We release placements on individual subjects from four datasets (N = 132 subjects for a total of 15,232 fiducials) and 14 brain templates (4,288 fiducials), totalling more than 300 human rater hours of annotation. We also validate human rater accuracy of released placements to be within 1 - 2 mm (using more than 45,000 Euclidean distances), consistent with prior studies. Our data is compliant with the Brain Imaging Data Structure allowing for facile incorporation into neuroimaging analysis pipelines.
Collapse
Affiliation(s)
- Alaa Taha
- Imaging Research Laboratories, Robarts Research Institute, Western University, London, Canada
- School of Biomedical Engineering, Western University, London, Canada
| | - Greydon Gilmore
- Imaging Research Laboratories, Robarts Research Institute, Western University, London, Canada
- School of Biomedical Engineering, Western University, London, Canada
- Department of Clinical Neurological Sciences, Division of Neurosurgery, Western University, London, Canada
| | - Mohamad Abbass
- Imaging Research Laboratories, Robarts Research Institute, Western University, London, Canada
- Department of Clinical Neurological Sciences, Division of Neurosurgery, Western University, London, Canada
- Graduate Program in Neuroscience, Schulich School of Medicine and Dentistry, Western University, London, Canada
| | - Jason Kai
- Imaging Research Laboratories, Robarts Research Institute, Western University, London, Canada
- Department of Medical Biophysics, Schulich School of Medicine and Dentistry, Western University, London, Canada
| | - Tristan Kuehn
- Imaging Research Laboratories, Robarts Research Institute, Western University, London, Canada
- School of Biomedical Engineering, Western University, London, Canada
| | - John Demarco
- Imaging Research Laboratories, Robarts Research Institute, Western University, London, Canada
- Department of Anatomy and Cell Biology, Schulich School of Medicine and Dentistry, Western University, London, Canada
| | - Geetika Gupta
- Imaging Research Laboratories, Robarts Research Institute, Western University, London, Canada
- Graduate Program in Neuroscience, Schulich School of Medicine and Dentistry, Western University, London, Canada
| | - Chris Zajner
- Imaging Research Laboratories, Robarts Research Institute, Western University, London, Canada
- Department of Clinical Neurological Sciences, Division of Neurosurgery, Western University, London, Canada
| | - Daniel Cao
- Imaging Research Laboratories, Robarts Research Institute, Western University, London, Canada
- Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Canada
| | - Ryan Chevalier
- Department of Clinical Neurological Sciences, Division of Neurosurgery, Western University, London, Canada
| | - Abrar Ahmed
- Imaging Research Laboratories, Robarts Research Institute, Western University, London, Canada
- Department of Clinical Neurological Sciences, Division of Neurosurgery, Western University, London, Canada
| | - Ali Hadi
- Imaging Research Laboratories, Robarts Research Institute, Western University, London, Canada
- Department of Clinical Neurological Sciences, Division of Neurosurgery, Western University, London, Canada
| | - Bradley G Karat
- Imaging Research Laboratories, Robarts Research Institute, Western University, London, Canada
- Graduate Program in Neuroscience, Schulich School of Medicine and Dentistry, Western University, London, Canada
| | - Olivia W Stanley
- Imaging Research Laboratories, Robarts Research Institute, Western University, London, Canada
- Department of Medical Biophysics, Schulich School of Medicine and Dentistry, Western University, London, Canada
| | - Patrick J Park
- Imaging Research Laboratories, Robarts Research Institute, Western University, London, Canada
- School of Biomedical Engineering, Western University, London, Canada
| | - Kayla M Ferko
- Imaging Research Laboratories, Robarts Research Institute, Western University, London, Canada
- Graduate Program in Neuroscience, Schulich School of Medicine and Dentistry, Western University, London, Canada
| | - Dimuthu Hemachandra
- Imaging Research Laboratories, Robarts Research Institute, Western University, London, Canada
- School of Biomedical Engineering, Western University, London, Canada
| | - Reid Vassallo
- School of Biomedical Engineering, Faculty of Applied Science and Faculty of Medicine, The University of British Columbia, Vancouver, Canada
| | - Magdalena Jach
- Department of Clinical Neurological Sciences, Division of Neurosurgery, Western University, London, Canada
| | - Arun Thurairajah
- Imaging Research Laboratories, Robarts Research Institute, Western University, London, Canada
- Graduate Program in Neuroscience, Schulich School of Medicine and Dentistry, Western University, London, Canada
| | - Sandy Wong
- Imaging Research Laboratories, Robarts Research Institute, Western University, London, Canada
- Department of Clinical Neurological Sciences, Division of Neurosurgery, Western University, London, Canada
| | - Mauricio C Tenorio
- Imaging Research Laboratories, Robarts Research Institute, Western University, London, Canada
- School of Biomedical Engineering, Western University, London, Canada
| | - Feyi Ogunsanya
- Imaging Research Laboratories, Robarts Research Institute, Western University, London, Canada
- Department of Medical Biophysics, Schulich School of Medicine and Dentistry, Western University, London, Canada
| | - Ali R Khan
- Imaging Research Laboratories, Robarts Research Institute, Western University, London, Canada
- School of Biomedical Engineering, Western University, London, Canada
- Graduate Program in Neuroscience, Schulich School of Medicine and Dentistry, Western University, London, Canada
- Department of Medical Biophysics, Schulich School of Medicine and Dentistry, Western University, London, Canada
- Centre for Functional and Metabolic Mapping, Robarts Research Institute, Western University, London, Canada
| | - Jonathan C Lau
- Imaging Research Laboratories, Robarts Research Institute, Western University, London, Canada.
- School of Biomedical Engineering, Western University, London, Canada.
- Department of Clinical Neurological Sciences, Division of Neurosurgery, Western University, London, Canada.
- Graduate Program in Neuroscience, Schulich School of Medicine and Dentistry, Western University, London, Canada.
- Centre for Functional and Metabolic Mapping, Robarts Research Institute, Western University, London, Canada.
| |
Collapse
|
4
|
Hou X, Mo Y, Zhu Z, Zhang H, Liu X, Zou Z, He X, Xue S, Li J, Li M, Zhang S. Technical Issues of Vim–PSA Double-Target DBS for Essential Tremor. Brain Sci 2023; 13:brainsci13040566. [PMID: 37190531 DOI: 10.3390/brainsci13040566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Revised: 03/10/2023] [Accepted: 03/20/2023] [Indexed: 03/30/2023] Open
Abstract
Background: Deep brain stimulation (DBS) is an effective surgical treatment for essential tremor (ET), with the ventral intermediate nucleus (Vim) and posterior subthalamic area (PSA) as the most common targets. The stimulation efficacy of ET with Vim–PSA double-target DBS has been reported. Herein, we aim to propose surgical techniques for Vim–PSA double-target DBS surgery. Methods: This study enrolled six patients with ET who underwent Vim–PSA double-target electrode implantation from October 2019 to May 2022. The targets were located and adjusted using coordinates and multimodality MRI images. A burr hole was accurately drilled in line with the electrode trajectory under the guidance of a stereotactic frame. Novel approaches were adopted during the electrode implantation process for pneumocephalus reduction, including “arachnoid piamater welding” and “water sealing”. Electrophysiological recording was used to identify the implantation sites of the electrodes. A 3D reconstruction model of electrodes and nuclei was established to facilitate programming. Results: The combination of coordinates and multimodality MRI images for target location and adjustment enabled the alignment of Vim and PSA. Postoperative CT scanning showed that the electrode was precisely implanted. Stereotactic guidance facilitated accurate burr hole drilling. “Arachnoid piamater welding” and “water sealing” were efficient in reducing pneumocephalus. Intraoperative electrophysiological verified the efficacy of Vim–PSA double-target DBS surgery. Conclusions: The methods for target location and adjustment, accurate drilling of the burr hole, reduction in pneumocephalus, and intraoperative electrophysiological verification are key issues in DBS surgery targeting both the Vim and PSA. This study may provide technical support for Vim–PSA DBS, especially for surgeons with less experience in functional neurosurgery.
Collapse
|
5
|
In vivo probabilistic atlas of white matter tracts of the human subthalamic area combining track density imaging and optimized diffusion tractography. Brain Struct Funct 2022; 227:2647-2665. [PMID: 36114861 PMCID: PMC9618529 DOI: 10.1007/s00429-022-02561-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Accepted: 08/29/2022] [Indexed: 11/18/2022]
Abstract
The human subthalamic area is a region of high anatomical complexity, tightly packed with tiny fiber bundles. Some of them, including the pallidothalamic, cerebello-thalamic, and mammillothalamic tracts, are relevant targets in functional neurosurgery for various brain diseases. Diffusion-weighted imaging-based tractography has been suggested as a useful tool to map white matter pathways in the human brain in vivo and non-invasively, though the reconstruction of these specific fiber bundles is challenging due to their small dimensions and complex anatomy. To the best of our knowledge, a population-based, in vivo probabilistic atlas of subthalamic white matter tracts is still missing. In the present work, we devised an optimized tractography protocol for reproducible reconstruction of the tracts of subthalamic area in a large data sample from the Human Connectome Project repository. First, we leveraged the super-resolution properties and high anatomical detail provided by short tracks track-density imaging (stTDI) to identify the white matter bundles of the subthalamic area on a group-level template. Tracts identification on the stTDI template was also aided by visualization of histological sections of human specimens. Then, we employed this anatomical information to drive tractography at the subject-level, optimizing tracking parameters to maximize between-subject and within-subject similarities as well as anatomical accuracy. Finally, we gathered subject level tracts reconstructed with optimized tractography into a large-scale, normative population atlas. We suggest that this atlas could be useful in both clinical anatomy and functional neurosurgery settings, to improve our understanding of the complex morphology of this important brain region.
Collapse
|
6
|
Casamitjana A, Iglesias JE. High-resolution atlasing and segmentation of the subcortex: Review and perspective on challenges and opportunities created by machine learning. Neuroimage 2022; 263:119616. [PMID: 36084858 DOI: 10.1016/j.neuroimage.2022.119616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 08/30/2022] [Accepted: 09/05/2022] [Indexed: 11/17/2022] Open
Abstract
This paper reviews almost three decades of work on atlasing and segmentation methods for subcortical structures in human brain MRI. In writing this survey, we have three distinct aims. First, to document the evolution of digital subcortical atlases of the human brain, from the early MRI templates published in the nineties, to the complex multi-modal atlases at the subregion level that are available today. Second, to provide a detailed record of related efforts in the automated segmentation front, from earlier atlas-based methods to modern machine learning approaches. And third, to present a perspective on the future of high-resolution atlasing and segmentation of subcortical structures in in vivo human brain MRI, including open challenges and opportunities created by recent developments in machine learning.
Collapse
Affiliation(s)
- Adrià Casamitjana
- Centre for Medical Image Computing, Department of Medical Physics and Biomedical Engineering, University College London, UK.
| | - Juan Eugenio Iglesias
- Centre for Medical Image Computing, Department of Medical Physics and Biomedical Engineering, University College London, UK; Martinos Center for Biomedical Imaging, Massachusetts General Hospital and Harvard Medical School, Boston, USA; Computer Science and Artificial Intelligence Laboratory, Massachusetts Institute of Technology, Boston, USA
| |
Collapse
|
7
|
Hirt L, Thies KA, Ojemann S, Abosch A, Darwin ML, Thompson JA, Kern DS. Case series investigating the differences between stimulation of rostral zona incerta region in isolation or in conjunction with the subthalamic nucleus on acute clinical effects for Parkinson’s disease. INTERDISCIPLINARY NEUROSURGERY 2022. [DOI: 10.1016/j.inat.2022.101553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
|
8
|
He C, Guan X, Zhang W, Li J, Liu C, Wei H, Xu X, Zhang Y. Quantitative susceptibility atlas construction in Montreal Neurological Institute space: towards histological-consistent iron-rich deep brain nucleus subregion identification. Brain Struct Funct 2022:10.1007/s00429-022-02547-1. [PMID: 36038737 DOI: 10.1007/s00429-022-02547-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Accepted: 07/27/2022] [Indexed: 01/25/2023]
Abstract
Iron-rich deep brain nuclei (DBN) of the human brain are involved in various motoric, emotional and cognitive brain functions. The abnormal iron alterations in the DBN are closely associated with multiple neurological and psychiatric diseases. Quantitative susceptibility mapping (QSM) provides the spatial distribution of the magnetic susceptibility of human brain tissues. Compared to traditional structural imaging, QSM provides superiority for imaging the iron-rich DBN owing to the susceptibility difference existing between brain tissues. In this study, we constructed a Montreal Neurological Institute (MNI) space unbiased QSM human brain atlas via group-wise registration from 100 healthy subjects aged 19-29 years. The atlas construction process was guided by hybrid images that were fused from multi-modal magnetic resonance images (MRI). We named it as Multi-modal-fused magnetic Susceptibility (MuSus-100) atlas. The high-quality susceptibility atlas provides extraordinary image contrast between iron-rich DBN with their surroundings. Parcellation maps of DBN and their subregions that are highly related to neurological and psychiatric pathology were then manually labeled based on the atlas set with the assistance of an image border-enhancement process. Especially, the bilateral thalamus was delineated into 64 detailed subregions referring to the Schaltenbrand-Wahren stereotactic atlas. To our best knowledge, the histological-consistent thalamic nucleus parcellation map is well defined for the first time in the MNI space. Compared with existing atlases that emphasizing DBN parcellation, the newly proposed atlas outperforms on the task of atlas-guided individual brain image DBN segmentation both in accuracy and robustness. Moreover, we applied the proposed DBN parcellation map to conduct detailed identification of the pathology-related iron content alterations in subcortical nuclei for Parkinson's Disease (PD) patients. We envision that the MuSus-100 atlas can play a crucial role in improving the accuracy of DBN segmentation for the research of neurological and psychiatric disease progress and also be helpful for target planning in deep brain stimulation surgery.
Collapse
Affiliation(s)
- Chenyu He
- School of Information Science and Technology, ShanghaiTech University, 393 Huaxia Road, Shanghai, 201210, China
| | - Xiaojun Guan
- Department of Radiology of The Second Affiliated Hospital, Zhejiang University School of Medicine, 88 Jiefang Road, Hangzhou, 310009, Zhejiang, China
| | - Weimin Zhang
- School of Information Science and Technology, ShanghaiTech University, 393 Huaxia Road, Shanghai, 201210, China
| | - Jun Li
- School of Information Science and Technology, ShanghaiTech University, 393 Huaxia Road, Shanghai, 201210, China
| | - Chunlei Liu
- Electrical Engineering and Computer Science, University of California at Berkeley, Berkeley, CA, 94720, United States
| | - Hongjiang Wei
- School of Biomedical Engineering, Shanghai Jiao Tong University, 800 Dongchuan Road, Shanghai, 200030, China
| | - Xiaojun Xu
- Department of Radiology of The Second Affiliated Hospital, Zhejiang University School of Medicine, 88 Jiefang Road, Hangzhou, 310009, Zhejiang, China
| | - Yuyao Zhang
- School of Information Science and Technology, ShanghaiTech University, 393 Huaxia Road, Shanghai, 201210, China. .,Shanghai Engineering Research Center of Intelligent Vision and Imaging, ShanghaiTech University, 393 Huaxia Road, Shanghai, 201210, China.
| |
Collapse
|
9
|
Kai J, Khan AR, Haast RA, Lau JC. Mapping the subcortical connectome using in vivo diffusion MRI: Feasibility and reliability. Neuroimage 2022; 262:119553. [PMID: 35961469 DOI: 10.1016/j.neuroimage.2022.119553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 07/15/2022] [Accepted: 08/08/2022] [Indexed: 10/31/2022] Open
Abstract
Tractography combined with regions of interest (ROIs) has been used to non-invasively study the structural connectivity of the cortex as well as to assess the reliability of these connections. However, the subcortical connectome (subcortex to subcortex) has not been comprehensively examined, in part due to the difficulty of performing tractography in this complex and compact region. In this study, we performed an in vivo investigation using tractography to assess the feasibility and reliability of mapping known connections between structures of the subcortex using the test-retest dataset from the Human Connectome Project (HCP). We further validated our observations using a separate unrelated subjects dataset from the HCP. Quantitative assessment was performed by computing tract densities and spatial overlap of identified connections between subcortical ROIs. Further, known connections between structures of the basal ganglia and thalamus were identified and visually inspected, comparing tractography reconstructed trajectories with descriptions from tract-tracing studies. Our observations demonstrate both the feasibility and reliability of using a data-driven tractography-based approach to map the subcortical connectome in vivo.
Collapse
Affiliation(s)
- Jason Kai
- Department of Medical Biophysics, Schulich School of Medicine & Dentistry, The University of Western Ontario, London, Ontario, Canada; Centre for Functional and Metabolic Mapping, Robarts Research Institute, The University of Western Ontario, London, Ontario, Canada
| | - Ali R Khan
- Department of Medical Biophysics, Schulich School of Medicine & Dentistry, The University of Western Ontario, London, Ontario, Canada; Centre for Functional and Metabolic Mapping, Robarts Research Institute, The University of Western Ontario, London, Ontario, Canada
| | - Roy Am Haast
- Centre for Functional and Metabolic Mapping, Robarts Research Institute, The University of Western Ontario, London, Ontario, Canada; Aix-Marseille University, CNRS, CRMBM, UMR 7339, Marseille, France
| | - Jonathan C Lau
- Centre for Functional and Metabolic Mapping, Robarts Research Institute, The University of Western Ontario, London, Ontario, Canada; Department of Clinical Neurological Sciences, Division of Neurosurgery, Schulich School of Medicine & Dentistry, The University of Western Ontario, London, Ontario, Canada.
| |
Collapse
|
10
|
Neudorfer C, Kroneberg D, Al-Fatly B, Goede L, Kübler D, Faust K, van Rienen U, Tietze A, Picht T, Herrington TM, Middlebrooks EH, Kühn A, Schneider GH, Horn A. Personalizing Deep Brain Stimulation Using Advanced Imaging Sequences. Ann Neurol 2022; 91:613-628. [PMID: 35165921 DOI: 10.1002/ana.26326] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 02/09/2022] [Accepted: 02/11/2022] [Indexed: 11/05/2022]
Abstract
OBJECTIVE With a growing appreciation for interindividual anatomical variability and patient-specific brain connectivity, advanced imaging sequences offer the opportunity to directly visualize anatomical targets for deep brain stimulation (DBS). The lack of quantitative evidence demonstrating their clinical utility, however, has hindered their broad implementation in clinical practice. METHODS Using fast gray matter acquisition T1 inversion recovery (FGATIR) sequences, the present study identified a thalamic hypointensity that holds promise as a visual marker in DBS. To validate the clinical utility of the identified hypointensity, we retrospectively analyzed 65 patients (26 female, mean age = 69.1 ± 12.7 years) who underwent DBS in the treatment of essential tremor. We characterized its neuroanatomical substrates and evaluated the hypointensity's ability to predict clinical outcome using stimulation volume modeling and voxelwise mapping. Finally, we determined whether the hypointensity marker could predict symptom improvement on a patient-specific level. RESULTS Anatomical characterization suggested that the identified hypointensity constituted the terminal part of the dentatorubrothalamic tract. Overlap between DBS stimulation volumes and the hypointensity in standard space significantly correlated with tremor improvement (R2 = 0.16, p = 0.017) and distance to hotspots previously reported in the literature (R2 = 0.49, p = 7.9e-4). In contrast, the amount of variance explained by other anatomical atlas structures was reduced. When accounting for interindividual neuroanatomical variability, the predictive power of the hypointensity increased further (R2 = 0.37, p = 0.002). INTERPRETATION Our findings introduce and validate a novel imaging-based marker attainable from FGATIR sequences that has the potential to personalize and inform targeting and programming in DBS for essential tremor. ANN NEUROL 2022;91:613-628.
Collapse
Affiliation(s)
- Clemens Neudorfer
- Movement Disorder and Neuromodulation Unit, Department of Neurology, Charité-Universitätsmedizin Berlin, corporate member of Free University of Berlin and Humboldt University of Berlin, Berlin, Germany.,MGH Neurosurgery & Center for Neurotechnology and Neurorecovery (CNTR), MGH Neurology Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.,Center for Brain Circuit Therapeutics Department of Neurology Brigham & Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Daniel Kroneberg
- Movement Disorder and Neuromodulation Unit, Department of Neurology, Charité-Universitätsmedizin Berlin, corporate member of Free University of Berlin and Humboldt University of Berlin, Berlin, Germany
| | - Bassam Al-Fatly
- Movement Disorder and Neuromodulation Unit, Department of Neurology, Charité-Universitätsmedizin Berlin, corporate member of Free University of Berlin and Humboldt University of Berlin, Berlin, Germany
| | - Lukas Goede
- Movement Disorder and Neuromodulation Unit, Department of Neurology, Charité-Universitätsmedizin Berlin, corporate member of Free University of Berlin and Humboldt University of Berlin, Berlin, Germany
| | - Dorothee Kübler
- Movement Disorder and Neuromodulation Unit, Department of Neurology, Charité-Universitätsmedizin Berlin, corporate member of Free University of Berlin and Humboldt University of Berlin, Berlin, Germany
| | - Katharina Faust
- Department of Neurosurgery, Charité-Universitätsmedizin Berlin, corporate member of Free University of Berlin and Humboldt University of Berlin, Berlin, Germany
| | - Ursula van Rienen
- Institute of General Electrical Engineering, University of Rostock, Rostock, Germany.,Department Life, Light, and Matter, University of Rostock, Rostock, Germany.,Department of Ageing of Individuals and Society, University of Rostock, Rostock, Germany
| | - Anna Tietze
- Institute of Neuroradiology, Charité-Universitätsmedizin Berlin, corporate member of Free University of Berlin and Humboldt University of Berlin, Berlin, Germany
| | - Thomas Picht
- Department of Neurosurgery, Charité-Universitätsmedizin Berlin, corporate member of Free University of Berlin and Humboldt University of Berlin, Berlin, Germany
| | - Todd M Herrington
- Department of Neurology, Massachusetts General Hospital, Boston, MA.,Department of Neurology, Harvard Medical School, Boston, MA
| | - Erik H Middlebrooks
- Department of Radiology, Mayo Clinic, Jacksonville, FL.,Department of Neurosurgery, Mayo Clinic, Jacksonville, FL
| | - Andrea Kühn
- Movement Disorder and Neuromodulation Unit, Department of Neurology, Charité-Universitätsmedizin Berlin, corporate member of Free University of Berlin and Humboldt University of Berlin, Berlin, Germany
| | - Gerd-Helge Schneider
- Department of Neurosurgery, Charité-Universitätsmedizin Berlin, corporate member of Free University of Berlin and Humboldt University of Berlin, Berlin, Germany
| | - Andreas Horn
- Movement Disorder and Neuromodulation Unit, Department of Neurology, Charité-Universitätsmedizin Berlin, corporate member of Free University of Berlin and Humboldt University of Berlin, Berlin, Germany.,MGH Neurosurgery & Center for Neurotechnology and Neurorecovery (CNTR), MGH Neurology Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.,Center for Brain Circuit Therapeutics Department of Neurology Brigham & Women's Hospital, Harvard Medical School, Boston, MA, USA
| |
Collapse
|
11
|
Páez-Nova M, Spiegelmann R, Korn-Israeli S, Zibly Z, Illera-Rivera D, Daza-Cordoba C, Alcazar-Daza JC, Garcia-Ballestas E. Targeting the vim by direct visualization of the cerebello-thalamo-cortical pathway in 3 T proton density MRI: correlation with focused ultrasound lesioning. Neurosurg Rev 2022; 45:2323-2332. [PMID: 35147798 DOI: 10.1007/s10143-022-01752-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Revised: 01/13/2022] [Accepted: 02/04/2022] [Indexed: 10/19/2022]
Abstract
Surgical targeting of the ventral intermediate nucleus of the thalamus (VIM) has been historically done using indirect strategies. Here we depict the cerebello-thalamo-cortical tract (CTCT) through 3 T proton density (PD) in a cohort of patients who underwent high-intensity focus ultrasound (HIFUS) thalamotomy. Forty-seven patients treated in our institution with MR-guided HIFUS VIM thalamotomy were included in this study. PD weighted 3 T MRI used for presurgical planning was compared with postoperative MRI obtained 1 month after surgery. Images were processed with ISTX software (Brain lab, Munich, Germany). The coordinates of the VIM lesion concerning the inter-commissural line (ICL) were annotated. Deterministic tractographies using three ROIs were used to verify the different tracts. The triangle seen in the 3 T PD sequence at the level of the mesencephalic-diencephalic junction was systematically recognized. The posterior angle of this triangle at the junction of the CTCT and the ZI was denominated as "point P." The area of this triangle corresponds to the posterior subthalamic area (PSA) harboring the Raprl fibers. The CTCT was visible from 1 to 2.5 mm below the ICL. The average center of the final HIFUS lesion (point F) was 11 mm from the medial thalamic border of the thalamus (14.9 mm from the midline), 6.4 mm anterior to PC, and 0.6 mm above the ICL. The FUS point was consistently 1-2 mm directly above point P. The anterior border of the external angle of this triangle (point P) can be used as an intraparenchymal point for targeting the ventral border of the VIM. Three ROIs placed in a single slice around this triangle are a fast way to originate tractography of the CTCT, lemniscus medialis, and pyramidal tract.
Collapse
Affiliation(s)
- Maximiliano Páez-Nova
- Functional Neurosurgery Unit, DepartmentofNeurosurgery, The Chaim Sheba Medical Center, Tel Hashomer, Israel.
| | - Roberto Spiegelmann
- Functional Neurosurgery Unit, DepartmentofNeurosurgery, The Chaim Sheba Medical Center, Tel Hashomer, Israel. .,The Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
| | - Simon Korn-Israeli
- The Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.,Abnormal Movements Unit, Department of Neurology, The Chaim Sheba Medical Center, Tel Hashomer, Israel
| | - Zion Zibly
- Functional Neurosurgery Unit, DepartmentofNeurosurgery, The Chaim Sheba Medical Center, Tel Hashomer, Israel
| | - Diego Illera-Rivera
- Social Medicine and Family Health Department, University of Cauca, Popayan, Colombia
| | - Carmen Daza-Cordoba
- Abnormal Movements Unit, Department of Neurology, The Chaim Sheba Medical Center, Tel Hashomer, Israel
| | | | | |
Collapse
|
12
|
Miletić S, Bazin PL, Isherwood SJS, Keuken MC, Alkemade A, Forstmann BU. Charting human subcortical maturation across the adult lifespan with in vivo 7 T MRI. Neuroimage 2022; 249:118872. [PMID: 34999202 DOI: 10.1016/j.neuroimage.2022.118872] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 12/20/2021] [Accepted: 01/03/2022] [Indexed: 12/26/2022] Open
Abstract
The human subcortex comprises hundreds of unique structures. Subcortical functioning is crucial for behavior, and disrupted function is observed in common neurodegenerative diseases. Despite their importance, human subcortical structures continue to be difficult to study in vivo. Here we provide a detailed account of 17 prominent subcortical structures and ventricles, describing their approximate iron and myelin contents, morphometry, and their age-related changes across the normal adult lifespan. The results provide compelling insights into the heterogeneity and intricate age-related alterations of these structures. They also show that the locations of many structures shift across the lifespan, which is of direct relevance for the use of standard magnetic resonance imaging atlases. The results further our understanding of subcortical morphometry and neuroimaging properties, and of normal aging processes which ultimately can improve our understanding of neurodegeneration.
Collapse
Affiliation(s)
- Steven Miletić
- University of Amsterdam, Department of Psychology, Integrative Model-based Cognitive Neuroscience research unit (IMCN), Nieuwe Achtergracht 129B, Amsterdam 1001 NK, the Netherlands.
| | - Pierre-Louis Bazin
- University of Amsterdam, Department of Psychology, Integrative Model-based Cognitive Neuroscience research unit (IMCN), Nieuwe Achtergracht 129B, Amsterdam 1001 NK, the Netherlands; Max Planck Institute for Human Cognitive and Brain Sciences, Departments of Neurophysics and Neurology, Stephanstraße 1A, Leipzig, Germany
| | - Scott J S Isherwood
- University of Amsterdam, Department of Psychology, Integrative Model-based Cognitive Neuroscience research unit (IMCN), Nieuwe Achtergracht 129B, Amsterdam 1001 NK, the Netherlands
| | - Max C Keuken
- University of Amsterdam, Department of Psychology, Integrative Model-based Cognitive Neuroscience research unit (IMCN), Nieuwe Achtergracht 129B, Amsterdam 1001 NK, the Netherlands
| | - Anneke Alkemade
- University of Amsterdam, Department of Psychology, Integrative Model-based Cognitive Neuroscience research unit (IMCN), Nieuwe Achtergracht 129B, Amsterdam 1001 NK, the Netherlands
| | - Birte U Forstmann
- University of Amsterdam, Department of Psychology, Integrative Model-based Cognitive Neuroscience research unit (IMCN), Nieuwe Achtergracht 129B, Amsterdam 1001 NK, the Netherlands.
| |
Collapse
|
13
|
Brun G, Testud B, Girard OM, Lehmann P, de Rochefort L, Besson P, Massire A, Ridley B, Girard N, Guye M, Ranjeva JP, Le Troter A. Automatic segmentation of Deep Grey Nuclei using a high-resolution 7T MRI Atlas - quantification of T1 values in healthy volunteers. Eur J Neurosci 2021; 55:438-460. [PMID: 34939245 DOI: 10.1111/ejn.15575] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 12/17/2021] [Accepted: 12/18/2021] [Indexed: 11/30/2022]
Abstract
We present a new consensus atlas of deep grey nuclei obtained by shape-based averaging of manual segmentation of two experienced neuroradiologists and optimized from 7T MP2RAGE images acquired at (0.6mm)3 in 60 healthy subjects. A group-wise normalization method was used to build a high-contrast and high-resolution T1 -weighted brain template (0.5mm)3 using data from 30 out of the 60 controls. Delineation of 24 deep grey nuclei per hemisphere, including the claustrum and twelve thalamic nuclei, was then performed by two expert neuroradiologists and reviewed by a third neuroradiologist according to tissue contrast and external references based on the Morel atlas. Corresponding deep grey matter structures were also extracted from the Morel and CIT168 atlases. The data-derived, Morel and CIT168 atlases were all applied at the individual level using non-linear registration to fit the subject reference and to extract absolute mean quantitative T1 values derived from the 3D-MP2RAGE volumes, after correction for residual B1 + biases. Three metrics (The Dice and the volumetric similarity coefficients, and a novel Hausdorff distance) were used to estimate the inter-rater agreement of manual MRI segmentation and inter-atlas variability, and these metrics were measured to quantify biases due to image registration and their impact on the measurements of the quantitative T1 values was highlighted. This represents a fully-automated segmentation process permitting the extraction of unbiased normative T1 values in a population of young healthy controls as a reference for characterizing subtle structural alterations of deep grey nuclei relevant to a range of neurological diseases.
Collapse
Affiliation(s)
- Gilles Brun
- Aix Marseille Univ, CNRS, CRMBM, Marseille, France.,AP-HM, CHU Timone, Pôle d'Imagerie Médicale, CEMEREM, Marseille, France.,AP-HM, CHU Timone, Pôle d'Imagerie Médicale, Service de Neuroradiologie, Marseille, France
| | - Benoit Testud
- Aix Marseille Univ, CNRS, CRMBM, Marseille, France.,AP-HM, CHU Timone, Pôle d'Imagerie Médicale, CEMEREM, Marseille, France.,AP-HM, CHU Timone, Pôle d'Imagerie Médicale, Service de Neuroradiologie, Marseille, France
| | - Olivier M Girard
- Aix Marseille Univ, CNRS, CRMBM, Marseille, France.,AP-HM, CHU Timone, Pôle d'Imagerie Médicale, CEMEREM, Marseille, France
| | - Pierre Lehmann
- Aix Marseille Univ, CNRS, CRMBM, Marseille, France.,AP-HM, CHU Timone, Pôle d'Imagerie Médicale, CEMEREM, Marseille, France.,AP-HM, CHU Timone, Pôle d'Imagerie Médicale, Service de Neuroradiologie, Marseille, France
| | - Ludovic de Rochefort
- Aix Marseille Univ, CNRS, CRMBM, Marseille, France.,AP-HM, CHU Timone, Pôle d'Imagerie Médicale, CEMEREM, Marseille, France
| | - Pierre Besson
- Aix Marseille Univ, CNRS, CRMBM, Marseille, France.,AP-HM, CHU Timone, Pôle d'Imagerie Médicale, CEMEREM, Marseille, France
| | - Aurélien Massire
- Aix Marseille Univ, CNRS, CRMBM, Marseille, France.,AP-HM, CHU Timone, Pôle d'Imagerie Médicale, CEMEREM, Marseille, France
| | - Ben Ridley
- Aix Marseille Univ, CNRS, CRMBM, Marseille, France.,AP-HM, CHU Timone, Pôle d'Imagerie Médicale, CEMEREM, Marseille, France.,IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italia
| | - Nadine Girard
- Aix Marseille Univ, CNRS, CRMBM, Marseille, France.,AP-HM, CHU Timone, Pôle d'Imagerie Médicale, CEMEREM, Marseille, France.,AP-HM, CHU Timone, Pôle d'Imagerie Médicale, Service de Neuroradiologie, Marseille, France
| | - Maxime Guye
- Aix Marseille Univ, CNRS, CRMBM, Marseille, France.,AP-HM, CHU Timone, Pôle d'Imagerie Médicale, CEMEREM, Marseille, France
| | - Jean-Philippe Ranjeva
- Aix Marseille Univ, CNRS, CRMBM, Marseille, France.,AP-HM, CHU Timone, Pôle d'Imagerie Médicale, CEMEREM, Marseille, France
| | - Arnaud Le Troter
- Aix Marseille Univ, CNRS, CRMBM, Marseille, France.,AP-HM, CHU Timone, Pôle d'Imagerie Médicale, CEMEREM, Marseille, France
| |
Collapse
|
14
|
Yu B, Li L, Guan X, Xu X, Liu X, Yang Q, Wei H, Zuo C, Zhang Y. HybraPD atlas: Towards precise subcortical nuclei segmentation using multimodality medical images in patients with Parkinson disease. Hum Brain Mapp 2021; 42:4399-4421. [PMID: 34101297 PMCID: PMC8357000 DOI: 10.1002/hbm.25556] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Revised: 05/27/2021] [Accepted: 05/30/2021] [Indexed: 12/29/2022] Open
Abstract
Human brain atlases are essential for research and surgical treatment of Parkinson's disease (PD). For example, deep brain stimulation for PD often requires human brain atlases for brain structure identification. However, few atlases can provide disease-specific subcortical structures for PD, and most of them are based on T1w and T2w images. In this work, we construct a HybraPD atlas using fused quantitative susceptibility mapping (QSM) and T1w images from 87 patients with PD. The constructed HybraPD atlas provides a series of templates, that is, T1w, GRE magnitude, QSM, R2*, and brain tissue probabilistic maps. Then, we manually delineate a parcellation map with 12 bilateral subcortical nuclei, which are highly related to PD pathology, such as sub-regions in globus pallidus and substantia nigra. Furthermore, we build a whole-brain parcellation map by combining existing cortical parcellation and white-matter segmentation with the proposed subcortical nuclei map. Considering the multimodality of the HybraPD atlas, the segmentation accuracy of each nucleus is evaluated using T1w and QSM templates, respectively. The results show that the HybraPD atlas provides more accurate segmentation than existing atlases. Moreover, we analyze the metabolic difference in subcortical nuclei between PD patients and healthy control subjects by applying the HybraPD atlas to calculate uptake values of contrast agents on positron emission tomography (PET) images. The atlas-based analysis generates accurate disease-related brain nuclei segmentation on PET images. The newly developed HybraPD atlas could serve as an efficient template to study brain pathological alterations in subcortical regions for PD research.
Collapse
Affiliation(s)
- Boliang Yu
- School of Information Science and TechnologyShanghaiTech UniversityShanghaiChina
| | - Ling Li
- PET Center, Huashan HospitalFudan UniversityShanghaiChina
| | - Xiaojun Guan
- Department of Radiology, The Second Affiliated HospitalZhejiang University School of MedicineHangzhouChina
| | - Xiaojun Xu
- Department of Radiology, The Second Affiliated HospitalZhejiang University School of MedicineHangzhouChina
| | - Xueling Liu
- Department of Radiology, Huashan HospitalFudan UniversityShanghaiChina
| | - Qing Yang
- Institute of Brain‐Intelligence Technology, Zhangjiang LaboratoryShanghaiChina
| | - Hongjiang Wei
- Institute for Medicine Imaging Technology, School of Biomedical EngineeringShanghai Jiao Tong UniversityShanghaiChina
| | - Chuantao Zuo
- PET Center, Huashan HospitalFudan UniversityShanghaiChina
| | - Yuyao Zhang
- School of Information Science and TechnologyShanghaiTech UniversityShanghaiChina
- Shanghai Engineering Research Center of Intelligent Vision and ImagingShanghaiTech UniversityShanghaiChina
| |
Collapse
|
15
|
Lu CW, Harper DE, Askari A, Willsey MS, Vu PP, Schrepf AD, Harte SE, Patil PG. Stimulation of zona incerta selectively modulates pain in humans. Sci Rep 2021; 11:8924. [PMID: 33903611 PMCID: PMC8076305 DOI: 10.1038/s41598-021-87873-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2020] [Accepted: 04/06/2021] [Indexed: 12/02/2022] Open
Abstract
Stimulation of zona incerta in rodent models has been shown to modulate behavioral reactions to noxious stimuli. Sensory changes observed in Parkinsonian patients with subthalamic deep brain stimulation suggest that this effect is translatable to humans. Here, we utilized the serendipitous placement of subthalamic deep brain stimulation leads in 6 + 5 Parkinsonian patients to directly investigate the effects of zona incerta stimulation on human pain perception. We found that stimulation at 20 Hz, the physiological firing frequency of zona incerta, reduces experimental heat pain by a modest but significant amount, achieving a 30% reduction in one fifth of implants. Stimulation at higher frequencies did not modulate heat pain. Modulation was selective for heat pain and was not observed for warmth perception or pressure pain. These findings provide a mechanistic explanation of sensory changes seen in subthalamic deep brain stimulation patients and identify zona incerta as a potential target for neuromodulation of pain.
Collapse
Affiliation(s)
- Charles W Lu
- Department of Neurosurgery, University of Michigan, 1500 E Medical Center Drive, SPC 5338, Ann Arbor, MI, 48109-5338, USA.,Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, USA
| | - Daniel E Harper
- Department of Anesthesiology, Emory University, Atlanta, GA, USA
| | - Asra Askari
- Department of Neurosurgery, University of Michigan, 1500 E Medical Center Drive, SPC 5338, Ann Arbor, MI, 48109-5338, USA
| | - Matthew S Willsey
- Department of Neurosurgery, University of Michigan, 1500 E Medical Center Drive, SPC 5338, Ann Arbor, MI, 48109-5338, USA.,Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, USA
| | - Philip P Vu
- Department of Neurosurgery, University of Michigan, 1500 E Medical Center Drive, SPC 5338, Ann Arbor, MI, 48109-5338, USA.,Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, USA
| | - Andrew D Schrepf
- Department of Anesthesiology, Chronic Pain and Fatigue Research Center, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Steven E Harte
- Department of Anesthesiology, Chronic Pain and Fatigue Research Center, University of Michigan Medical School, Ann Arbor, MI, USA.,Division of Rheumatology, Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Parag G Patil
- Department of Neurosurgery, University of Michigan, 1500 E Medical Center Drive, SPC 5338, Ann Arbor, MI, 48109-5338, USA. .,Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, USA.
| |
Collapse
|
16
|
Iorio-Morin C, Fomenko A, Kalia SK. Deep-Brain Stimulation for Essential Tremor and Other Tremor Syndromes: A Narrative Review of Current Targets and Clinical Outcomes. Brain Sci 2020; 10:E925. [PMID: 33271848 PMCID: PMC7761254 DOI: 10.3390/brainsci10120925] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 11/25/2020] [Accepted: 11/30/2020] [Indexed: 02/06/2023] Open
Abstract
Tremor is a prevalent symptom associated with multiple conditions, including essential tremor (ET), Parkinson's disease (PD), multiple sclerosis (MS), stroke and trauma. The surgical management of tremor evolved from stereotactic lesions to deep-brain stimulation (DBS), which allowed safe and reversible interference with specific neural networks. This paper reviews the current literature on DBS for tremor, starting with a detailed discussion of current tremor targets (ventral intermediate nucleus of the thalamus (Vim), prelemniscal radiations (Raprl), caudal zona incerta (Zi), thalamus (Vo) and subthalamic nucleus (STN)) and continuing with a discussion of results obtained when performing DBS in the various aforementioned tremor syndromes. Future directions for DBS research are then briefly discussed.
Collapse
Affiliation(s)
- Christian Iorio-Morin
- Christian Iorio-Morin, Division of Neurosurgery, Université de Sherbrooke, 3001, 12e Avenue Nord, Sherbrooke, QC J1H 5N4, Canada
- Division of Neurosurgery, Department of Surgery, University of Toronto, Toronto, ON M5T 2S8, Canada; (A.F.); (S.K.K.)
| | - Anton Fomenko
- Division of Neurosurgery, Department of Surgery, University of Toronto, Toronto, ON M5T 2S8, Canada; (A.F.); (S.K.K.)
| | - Suneil K. Kalia
- Division of Neurosurgery, Department of Surgery, University of Toronto, Toronto, ON M5T 2S8, Canada; (A.F.); (S.K.K.)
| |
Collapse
|
17
|
Lau JC, Xiao Y, Haast RAM, Gilmore G, Uludağ K, MacDougall KW, Menon RS, Parrent AG, Peters TM, Khan AR. Direct visualization and characterization of the human zona incerta and surrounding structures. Hum Brain Mapp 2020; 41:4500-4517. [PMID: 32677751 PMCID: PMC7555067 DOI: 10.1002/hbm.25137] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2020] [Revised: 05/31/2020] [Accepted: 07/02/2020] [Indexed: 12/11/2022] Open
Abstract
The zona incerta (ZI) is a small gray matter region of the deep brain first identified in the 19th century, yet direct in vivo visualization and characterization has remained elusive. Noninvasive detection of the ZI and surrounding region could be critical to further our understanding of this widely connected but poorly understood deep brain region and could contribute to the development and optimization of neuromodulatory therapies. We demonstrate that high resolution (submillimetric) longitudinal (T1) relaxometry measurements at high magnetic field strength (7 T) can be used to delineate the ZI from surrounding white matter structures, specifically the fasciculus cerebellothalamicus, fields of Forel (fasciculus lenticularis, fasciculus thalamicus, and field H), and medial lemniscus. Using this approach, we successfully derived in vivo estimates of the size, shape, location, and tissue characteristics of substructures in the ZI region, confirming observations only previously possible through histological evaluation that this region is not just a space between structures but contains distinct morphological entities that should be considered separately. Our findings pave the way for increasingly detailed in vivo study and provide a structural foundation for precise functional and neuromodulatory investigation.
Collapse
Affiliation(s)
- Jonathan C Lau
- Department of Clinical Neurological Sciences, Division of Neurosurgery, Western University, London, Ontario, Canada.,Imaging Research Laboratories, Robarts Research Institute Canada, Western University, London, Ontario, Canada.,Centre for Functional and Metabolic Mapping, Robarts Research Institute, Western University, London, Ontario, Canada.,School of Biomedical Engineering, Western University, London, Ontario, Canada
| | - Yiming Xiao
- Imaging Research Laboratories, Robarts Research Institute Canada, Western University, London, Ontario, Canada.,Centre for Functional and Metabolic Mapping, Robarts Research Institute, Western University, London, Ontario, Canada
| | - Roy A M Haast
- Imaging Research Laboratories, Robarts Research Institute Canada, Western University, London, Ontario, Canada.,Centre for Functional and Metabolic Mapping, Robarts Research Institute, Western University, London, Ontario, Canada
| | - Greydon Gilmore
- Department of Clinical Neurological Sciences, Division of Neurosurgery, Western University, London, Ontario, Canada.,School of Biomedical Engineering, Western University, London, Ontario, Canada
| | - Kâmil Uludağ
- IBS Center for Neuroscience Imaging Research, Sungkyunkwan University, Suwon, South Korea.,Department of Biomedical Engineering, N Center, Sungkyunkwan University, Suwon, South Korea.,Techna Institute and Koerner Scientist in MR Imaging, University Health Network, Toronto, Ontario, Canada
| | - Keith W MacDougall
- Department of Clinical Neurological Sciences, Division of Neurosurgery, Western University, London, Ontario, Canada
| | - Ravi S Menon
- Imaging Research Laboratories, Robarts Research Institute Canada, Western University, London, Ontario, Canada.,Centre for Functional and Metabolic Mapping, Robarts Research Institute, Western University, London, Ontario, Canada.,Department of Medical Biophysics, Western University, London, Ontario, Canada
| | - Andrew G Parrent
- Department of Clinical Neurological Sciences, Division of Neurosurgery, Western University, London, Ontario, Canada
| | - Terry M Peters
- Department of Clinical Neurological Sciences, Division of Neurosurgery, Western University, London, Ontario, Canada.,Imaging Research Laboratories, Robarts Research Institute Canada, Western University, London, Ontario, Canada.,Centre for Functional and Metabolic Mapping, Robarts Research Institute, Western University, London, Ontario, Canada.,School of Biomedical Engineering, Western University, London, Ontario, Canada.,Department of Medical Biophysics, Western University, London, Ontario, Canada
| | - Ali R Khan
- Department of Clinical Neurological Sciences, Division of Neurosurgery, Western University, London, Ontario, Canada.,Imaging Research Laboratories, Robarts Research Institute Canada, Western University, London, Ontario, Canada.,Centre for Functional and Metabolic Mapping, Robarts Research Institute, Western University, London, Ontario, Canada.,School of Biomedical Engineering, Western University, London, Ontario, Canada.,Brain and Mind Institute, Western University, London, Ontario, Canada.,Department of Medical Biophysics, Western University, London, Ontario, Canada
| |
Collapse
|