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Discrepancies between the MRI- and the electrophysiologically defined subthalamic nucleus

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Abstract

Background

The aim of our study was to evaluate discrepancies between the electrophysiologically and MRI-defined subthalamic nucleus (STN) in order to contribute to the ongoing debate of whether or not microelectrode recording (MER) provides additional information to image-guided targeting in deep brain stimulation.

Methods

Forty-four STNs in 22 patients with Parkinson’s disease were investigated. The three-dimensional MRI-defined STN was derived from segmentations of axial and coronal T2-weighted images. The electrophysiological STNs were generated from intraoperative MERs in 1,487 locations. The stereotactical coordinates of positive and negative STN recordings were re-imported to the planning software, where a three-dimensional reconstruction of the electrophysiological STN was performed and fused to the MRI data set. The estimated borders of the MRI- and MER-STN were compared. For statistical analysis Student's t, Mann-Whitney rank sum and Fisher's exact tests were used.

Results

MER-STN volumes, which were found outside the MRI-STN, ranged from 0 mm3 to 87 mm3 (mean: 45 mm3). A mean of 44% of the MER-STN volumes exceeded the MRI-STN (maximum: 85.1%; minimum: 15.1 %); 53.4% (n = 793) of the microelectrode recordings were concordant and 46.6% (n = 694) discordant with the MRI-defined anatomical STN. Regarding the dorsal borders, we found discrepancies between the MER- and MRI-STN of 0.27 mm (= mean; SD: 0.51 mm) on the first operated side and 1.51 mm (SD: 1.5 mm) on the second (p = 0.010, t-test).

Conclusions

MER provides additional information to high-resolution anatomical MR images and may help to detect the amount and direction of brain shift.

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Authors and Affiliations

  1. Department of Neurosurgery, University Hospital Regensburg, Franz-Josef-Strauss-Allee 11, 93053, Regensburg, Germany

    Juergen Ralf Schlaier, Christine Habermeyer, Jan Warnat, Max Lange, Andreas Hochreiter, Martin Proescholdt & Alexander Brawanski

  2. Department of Neurology, University Hospital Regensburg, Franz-Josef-Strauss-Allee 11, 93053, Regensburg, Germany

    Annette Janzen

  3. Institute of Radiology, University Hospital Regensburg, Franz-Josef-Strauss-Allee 11, 93053, Regensburg, Germany

    Claudia Fellner

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  1. Juergen Ralf Schlaier
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  2. Christine Habermeyer
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  3. Jan Warnat
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  4. Max Lange
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Correspondence to Juergen Ralf Schlaier.

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Schlaier, J.R., Habermeyer, C., Warnat, J. et al. Discrepancies between the MRI- and the electrophysiologically defined subthalamic nucleus. Acta Neurochir 153, 2307–2318 (2011). https://doi.org/10.1007/s00701-011-1081-7

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  • DOI: https://doi.org/10.1007/s00701-011-1081-7

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