Diffusion tensor imaging (DTI) and colored fractional anisotropy (FA) mapping of the subthalamic nucleus (STN) and the globus pallidus interna (GPi)

Mark Sedrak, Alessandra Gorgulho, Ausaf Bari, Eric Behnke, Andrew Frew, Inga Gevorkyan, Nader Pouratian, Antonio DeSalles

Research output: Contribution to journalArticlepeer-review

17 Scopus citations

Abstract

Introduction The subthalamic nucleus (STN) and the globus pallidus internus (GPi) are the most common surgical targets for the treatment of Parkinson's disease. We studied directionally colored fractional anisotropy (FA) and diffusion tensor imaging (DTI) sequences to better target these anatomical regions. Methods Four patients undergoing stereotactic surgery for movement disorders were studied. Stereotactic targets and fiber tractography were determined on MRIs using the Schaltenbrand-Wahren atlas for definition in the iPlan software. In addition, post-operative imaging was fused to preoperative FA sequences for end-result identification. Axial, sagittal, and coronal images of the FA sequence were studied. DTI parameters used ranged from 2 to 4 mm for voxel size in the x/y/z planes, fiber length was kept constant at 15 mm and FA threshold of 0.25. Results Colored FA maps resulted in a key signature in and around the STN and GPi. Regions identified include, but were not limited to: the internal capsule, nigral projections, the thalamic fasciculus, Forel's fields H1 and H2, zona incerta, suthalamic fasciculus, tegmental tracts, and\ cerebello-rubro-thalamic tract. Conclusions Colored FA maps allow a potential method to identify the STN and GPi accurately. DTI has proven to be a powerful tool that can be used to augment identification of the STN nucleus and GPi used for stereotactic surgery.

Original languageEnglish (US)
Pages (from-to)2079-2084
Number of pages6
JournalActa Neurochirurgica
Volume152
Issue number12
DOIs
StatePublished - Dec 2010
Externally publishedYes

Keywords

  • Deep brain stimulation
  • Diffusion tensor imaging
  • Fiber tractography
  • Globus pallidus
  • Pars interna
  • STN
  • Subthalamic nucleus

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

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