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Deep brain stimulation of the subthalamic nucleus: histological verification and 9.4-T MRI correlation

  • Case Report - Functional
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Abstract

Background

Deep brain stimulation (DBS) of the subthalamic nucleus (STN) using an MRI-guided and MRI-verified technique without microelectrode recording is an effective and safe surgical treatment for patients with Parkinson’s disease (PD).

Objectives

To assess the anatomical accuracy of lead placement after MRI-guided, MRI-verified STN DBS using post-mortem histology and high-field MRI at 9.4 T.

Methods

We conducted post-mortem analysis of a patient’s brain who had had MRI-guided, MRI-verified STN DBS for PD, using 9.4-T MRI and histology. After death, the brain was retrieved and a block including the electrode tracks down to the mesencephalon was examined with high-field MRI at 9.4 T and histological analysis.

Results

High-field MRI images and corresponding histological examination showed that each electrode track ended within the intended target area, and that DBS did not cause significant neuroparenchymal tissue damage.

Conclusions

This study supports the anatomical accuracy of the MRI-guided and MRI-verified method of STN DBS.

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Abbreviations

STN:

Subthalamic nucleus

DBS:

Deep brain stimulation

T:

Tesla

PM:

Post-mortem

PD:

Parkinson’s disease

AC:

Anterior commissure

PC:

Posterior commissure

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Acknowledgments

The authors are indebted to the patient and family for kindly donating his brain to the Queen Square Brain Bank for Neurological Disorders. OA-H, LAM, and TY have all been supported by grants from the PSP Association (Europe). The MBI Al Jaber Foundation (a UK-based charity whose patron is Sheikh Mohamed Bin Isa Al Jaber) has also sponsored OA-H. TY has also been sponsored by grants from the National Institute for Health Research, the Medical Research Council, the MS Society, the British Heart Foundation, the Wellcome Trust, GSK, Biogen Indec, and Novartis. The Unit of Functional Neurosurgery, Queen Square, London is supported by the Parkinson’s Appeal and the Sainsbury Monument Trust. JH is supported by the Reta Lila Weston Institute for Neurological Studies, the Multiple System Atrophy Trust and the Alzheimer’s Research Trust. This work was undertaken at UCLH/UCL who received a proportion of funding from the UK Department of Health’s National Institute for Health Research Biomedical Research Funding Scheme (UCLH/UCL Comprehensive Biomedical Research Trust).

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Authors and Affiliations

  1. Neuroradiology Academic Unit, Department of Brain Repair and Rehabilitation, UCL Institute of Neurology, 8-11 Queen Square, London, WC1n 3BG, UK

    Othman Al-Helli, David L. Thomas & Tarek A. Yousry

  2. Reta Lila Weston Institute of Neurological Studies, UCL Institute of Neurology, London, UK

    Luke Massey

  3. Sara Koe PSP Research Centre, UCL Institute of Neurology, London, UK

    Luke Massey

  4. Unit of Functional Neurosurgery, UCL Institute of Neurology, London, UK

    Thomas Foltynie, Patricia Limousin & Ludvic Zrinzo

  5. Queen Square Brain Bank for Neurological Disorders, UCL Institute of Neurology, London, UK

    Janice L. Holton

  6. Lysholm Department of Neuroradiology, National Hospital for Neurology and Neurosurgery, London, UK

    Tarek A. Yousry

Authors
  1. Othman Al-Helli
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  2. David L. Thomas
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  3. Luke Massey
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  4. Thomas Foltynie
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  5. Patricia Limousin
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  6. Janice L. Holton
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  7. Tarek A. Yousry
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  8. Ludvic Zrinzo
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Corresponding author

Correspondence to Othman Al-Helli.

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Al-Helli, O., Thomas, D.L., Massey, L. et al. Deep brain stimulation of the subthalamic nucleus: histological verification and 9.4-T MRI correlation. Acta Neurochir 157, 2143–2147 (2015). https://doi.org/10.1007/s00701-015-2599-x

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  • DOI: https://doi.org/10.1007/s00701-015-2599-x

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