Three-dimensional Structural Visualization of Subthalamic Nucleus for Deep Brain Stimulation_Journal of Biomedical Engineering

Authors：

ZHANGZhiqi ¹ , GENGXinyi ¹ , XUXin ² , LINGZhipei ² , TANGYuguo ¹ ,  WANGShouyan ¹

1. Key Laboratory of Neural Engineering Technology, Suzhou Institute of Biomedical Engineering and Technology, Chinese Academy of Sciences, Suzhou 215163, China;
2. Chinese PLA General Hospital, Beijing 100853, China;

Corresponding author：

WANGShouyan, Email: swang@sibet.ac.cn

Keywords：

magnetic resonance imaging; deep brain stimulation; intra-operative localization of electrodes; three-dimensional visualization

DOI：

10.7507/1001-5515.20160069

Video：

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The effect of deep brain stimulation (DBS) surgery treatment for Parkinson's disease is determined by the accuracy of the electrodes placement and localization. The subthalamic nuclei (STN) as the implant target is small and has no clear boundary on the images. In addition, the intra-operative magnetic resonance images (MRI) have such a low resolution that the artifacts of the electrodes impact the observation. The three-dimensional (3D) visualization of STN and other nuclei nearby is able to provide the surgeons with direct and accurate localizing information. In this study, pre- and intra-operative MRIs of the Parkinson's disease patients were used to realize the 3D visualization. After making a co-registration between the high-resolution pre-operative MRIs and the low-resolution intra-operative MRIs, we normalized the MRIs into a standard atlas space. We used a special threshold mask to search the lead trajectories in each axial slice. After checking the location of the electrode contacts with the coronal MRIs of the patients, we reconstructed the whole lead trajectories. Then the STN and other nuclei nearby in the standard atlas space were visualized with the grey images of the standard atlas, accomplishing the lead reconstruction and nerve nuclei visualization near STN of all patients. This study provides intuitive and quantitative information to identify the accuracy of the DBS electrode implantation, which could help decide the post-operative programming setting.

Citation： ZHANGZhiqi, GENGXinyi, XUXin, LINGZhipei, TANGYuguo, WANGShouyan. Three-dimensional Structural Visualization of Subthalamic Nucleus for Deep Brain Stimulation. Journal of Biomedical Engineering, 2016, 33(3): 405-412. doi: 10.7507/1001-5515.20160069 Copy

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5.	TODA H, SAWAMOTO N, HANAKAWA T, et al. A novel composite targeting method using high-field magnetic resonance imaging for subthalamic nucleus deep brain stimulation[J]. J Neurosurg, 2009, 111(4) :737-745.
6.	FONOV V, EVANS A C, BOTTERON K, et al. Unbiased average age-appropriate atlases for pediatric studies[J]. Neuroimage, 2011, 54(1) :313-327.
7.	HORN A, KVHN A A. Lead-DBS:a toolbox for deep brain stimulation electrode localizations and visualizations[J]. Neuroimage, 2015, 107:127-135.
8.	DALE A M, LIU A K, FISCHL B R, et al. Dynamic statistical parametric mapping[J]. Neuron, 26(1) :55-67.
9.	SCHÖNECKER T, KUPSCH A, KVHN A A, et al. Automated optimization of subcortical cerebral Mr imaging-atlas coregistration for improved postoperative electrode localization in deep brain stimulation[J]. AJNR Am J Neuroradiol, 2009, 30(10) :1914-1921.
10.	GRACHEV I D, BERDICHEVSKY D, RAUCH S L, et al. A method for assessing the accuracy of intersubject registration of the human brain using anatomic landmarks[J]. Neuroimage, 1999, 9(2) :250-268.
11.	VIDEEN T O, CAMPBELL M C, TABBAL S D, et al. Validation of a fiducial-based Atlas localization method for deep brain stimulation contacts in the area of the subthalamic nucleus[J]. J Neurosci Methods, 2008, 168(2) :275-281.
12.	ANDRADE-SOUZA Y M, SCHWALB J M, HAMANI C, et al. Comparison of three methods of targeting the subthalamic nucleus for chronic stimulation in Parkinson's disease[J]. Neurosurgery, 2005, 56(2 Suppl):360-368.
13.	KRAUTH A, BLANC R, POVEDA A, et al. A mean three-dimensional Atlas of the human thalamus:Generation from multiple histological data[J]. Neuroimage, 2010, 49(3) :2053-2062.
14.	KLEIN A, ANDERSSON J, ARDEKANI B A, et al. Evaluation of 14 nonlinear deformation algorithms applied to human brain MRI registration[J]. Neuroimage, 2009, 46(3) :786-802.
15.	VAN DEN MUNCKHOF P, CONTARINO M F, BOUR L J, et al. Postoperative curving and upward displacement of deep brain stimulation electrodes caused by brain shift[J]. Neurosurgery, 2010, 67(1) :49-53.

1. KRACK P, BATIR A, VAN BLERCOM N, et al. Five-year follow-up of bilateral stimulation of the subthalamic nucleus in advanced Parkinson's disease[J]. N Engl J Med, 2003, 349(20) :1925-1934.
2. SCHUURMAN P R, BOSCH D A, BOSSUYT P M, et al. A comparison of continuous thalamic stimulation and thalamotomy for suppression of severe tremor[J]. N Engl J Med, 2000, 342(7) :461-468.
3. FRANK M J, SAMANTA J, MOUSTAFA A A, et al. Hold your horses:impulsivity, deep brain stimulation, and medication in parkinsonism[J]. Science, 2007, 318(5854) :1309-1312.
4. STANCANELLO J, MUACEVIC A, SEBASTIANO F, et al. 3T MRI evaluation of the accuracy of atlas-based subthalamic nucleus identification[J]. Med Phys, 2008, 35(7) :3069-3077.
5. TODA H, SAWAMOTO N, HANAKAWA T, et al. A novel composite targeting method using high-field magnetic resonance imaging for subthalamic nucleus deep brain stimulation[J]. J Neurosurg, 2009, 111(4) :737-745.
6. FONOV V, EVANS A C, BOTTERON K, et al. Unbiased average age-appropriate atlases for pediatric studies[J]. Neuroimage, 2011, 54(1) :313-327.
7. HORN A, KVHN A A. Lead-DBS:a toolbox for deep brain stimulation electrode localizations and visualizations[J]. Neuroimage, 2015, 107:127-135.
8. DALE A M, LIU A K, FISCHL B R, et al. Dynamic statistical parametric mapping[J]. Neuron, 26(1) :55-67.
9. SCHÖNECKER T, KUPSCH A, KVHN A A, et al. Automated optimization of subcortical cerebral Mr imaging-atlas coregistration for improved postoperative electrode localization in deep brain stimulation[J]. AJNR Am J Neuroradiol, 2009, 30(10) :1914-1921.
10. GRACHEV I D, BERDICHEVSKY D, RAUCH S L, et al. A method for assessing the accuracy of intersubject registration of the human brain using anatomic landmarks[J]. Neuroimage, 1999, 9(2) :250-268.
11. VIDEEN T O, CAMPBELL M C, TABBAL S D, et al. Validation of a fiducial-based Atlas localization method for deep brain stimulation contacts in the area of the subthalamic nucleus[J]. J Neurosci Methods, 2008, 168(2) :275-281.
12. ANDRADE-SOUZA Y M, SCHWALB J M, HAMANI C, et al. Comparison of three methods of targeting the subthalamic nucleus for chronic stimulation in Parkinson's disease[J]. Neurosurgery, 2005, 56(2 Suppl):360-368.
13. KRAUTH A, BLANC R, POVEDA A, et al. A mean three-dimensional Atlas of the human thalamus:Generation from multiple histological data[J]. Neuroimage, 2010, 49(3) :2053-2062.
14. KLEIN A, ANDERSSON J, ARDEKANI B A, et al. Evaluation of 14 nonlinear deformation algorithms applied to human brain MRI registration[J]. Neuroimage, 2009, 46(3) :786-802.
15. VAN DEN MUNCKHOF P, CONTARINO M F, BOUR L J, et al. Postoperative curving and upward displacement of deep brain stimulation electrodes caused by brain shift[J]. Neurosurgery, 2010, 67(1) :49-53.

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