A role of diffusion tensor imaging fiber tracking in deep brain stimulation surgery: DBS of the dentato-rubro-thalamic tract (drt) for the treatment of therapy-refractory tremor

2011 ◽  
Vol 153 (8) ◽  
pp. 1579-1585 ◽  
Author(s):  
Volker A. Coenen ◽  
Niels Allert ◽  
Burkhard Mädler
Keyword(s):  
Diffusion Tensor Imaging ◽  
Deep Brain Stimulation ◽  
Brain Stimulation ◽  
Diffusion Tensor ◽  
Fiber Tracking ◽  
Deep Brain Stimulation Surgery ◽  
Deep Brain

Individual Fiber Anatomy of the Subthalamic Region Revealed With Diffusion Tensor Imaging: A Concept to Identify the Deep Brain Stimulation Target for Tremor Suppression

Neurosurgery ◽  
2011 ◽  
Vol 68 (4) ◽  
pp. 1069-1076 ◽  
Author(s):  
Volker A. Coenen ◽  
Burkhard Mädler ◽  
Hagen Schiffbauer ◽  
Horst Urbach ◽  
Niels Allert
Keyword(s):  
Diffusion Tensor Imaging ◽  
Deep Brain Stimulation ◽  
Brain Stimulation ◽  
Diffusion Tensor ◽  
Fiber Tracking ◽  
Helical Computed Tomography ◽  
Individual Fiber ◽  
Electrode Contact ◽  
Dti Fiber Tracking ◽  
Deep Brain

Abstract BACKGROUND: Deep brain stimulation (DBS) has been proven to alleviate tremor of various origins. Distinct regions have been targeted. One explanation for good clinical tremor control might be the involvement of the dentatorubrothalamic tract (DRT) as has been suggested in superficial (thalamic) and inferior (posterior subthalamic) target regions. Beyond a correlation with atlas data and the postmortem evaluation of patients treated with lesion surgery, proof for the involvement of DRT in tremor reduction in the living, the scope of this work, is elusive. OBJECTIVE: To report a case of unilateral refractory tremor in tremor-dominant Parkinson disease treated with thalamic DBS. METHODS: Preoperative diffusion tensor imaging (DTI) was performed. Correlation with individual DBS electrode contact locations was obtained through postoperative fusion of helical computed tomography (CT) data with DTI fiber tracking. RESULTS: Tremor was alleviated effectively. An evaluation of the active electrode contact position revealed clear involvement of the DRT in tremor control. A closer evaluation of clinical effects and side effects revealed a highly detailed individual fiber map of the subthalamic region with DTI fiber tracking. CONCLUSION: This is the first time the involvement of the DRT in tremor reduction through DBS has been shown in the living. The combination of DTI with postoperative CT and the evaluation of the electrophysiological environment of distinct electrode contacts led to an individual detailed fiber map and might be extrapolated to refined DTI-based targeting strategies in the future. Data acquisition for a larger study group is the topic of our ongoing research.

Symptomatic Cystic Lesion Following Deep Brain Stimulation Surgery

2020 ◽  
pp. 37-40
Author(s):  
Vibhash D. Sharma ◽  
Shilpa Chitnis
Keyword(s):  
Deep Brain Stimulation ◽  
Brain Stimulation ◽  
Rare Complication ◽  
Cyst Formation ◽  
Management Options ◽  
Unexplained Symptoms ◽  
The Common ◽  
Deep Brain Stimulation Surgery ◽  
Deep Brain

Deep brain stimulation therapy is an effective therapy for selected patients with movement disorders. The procedure is relatively safe, but complications related to the surgical procedure or implanted hardware can occur. The common complications include hemorrhage, infarct, infection, and confusion. Noninfectious cyst formation around the DBS lead is a rare but potential complication of this procedure, which can occur several weeks to months after DBS lead implantation. This chapter describes a case of noninfectious cyst formation at the tip of DBS lead in a patient with essential tremor. Clinical presentation, role of imaging, and the management options for this rare complication are discussed. This case also illustrates the importance of post-DBS imaging in suspected cases with new or unexplained symptoms.

Using imaging to identify psychogenic parkinsonism before deep brain stimulation surgery

2012 ◽  
Vol 116 (1) ◽  
pp. 114-118 ◽  
Author(s):  
Michael H. Pourfar ◽  
Chris C. Tang ◽  
Alon Y. Mogilner ◽  
Vijay Dhawan ◽  
David Eidelberg
Keyword(s):  
Deep Brain Stimulation ◽  
Brain Stimulation ◽  
Metabolic Networks ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Number Of Patients ◽  
Normal Expression ◽  
Deep Brain Stimulation Surgery ◽  
Deep Brain

The frequency with which patients with atypical parkinsonism and advanced motor symptoms undergo deep brain stimulation (DBS) procedures is unknown. However, the potential exposure of these patients to unnecessary surgical risks makes their identification critical. As many as 15% of patients enrolled in recent early Parkinson disease (PD) trials have been found to lack evidence of a dopaminergic deficit following PET or SPECT imaging. This suggests that a number of patients with parkinsonism who are referred for DBS may not have idiopathic PD. The authors report on 2 patients with probable psychogenic parkinsonism who presented for DBS surgery. They found that both patients had normal caudate and putamen [18F]-fluorodopa uptake on PET imaging, along with normal expression of specific disease-related metabolic networks for PD and multiple system atrophy, a common form of atypical neurodegenerative parkinsonism. The clinical and PET findings in these patients highlight the role of functional imaging in assisting clinical decision making when the diagnosis is uncertain.

Post-Traumatic Tremor and Thalamic Deep Brain Stimulation: Evidence for Use of Diffusion Tensor Imaging

2016 ◽  
Vol 96 ◽  
pp. 607.e7-607.e11 ◽  
Author(s):  
Sandra G.J. Boccard ◽  
Pedro Rebelo ◽  
Binith Cheeran ◽  
Alexander Green ◽  
James J. FitzGerald ◽  
...  
Keyword(s):  
Diffusion Tensor Imaging ◽  
Deep Brain Stimulation ◽  
Brain Stimulation ◽  
Diffusion Tensor ◽  
Post Traumatic ◽  
Deep Brain
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