Hamel, Wolfgang, Koeppen, Johannes A., Alesch, Francois, Antonini, Angelo ORCID: 0000-0003-1040-2807, Barcia, Juan A., Bergman, Hagai, Chabardes, Stephan, Contarino, Maria Fiorella ORCID: 0000-0002-0312-184X, Cornu, Philippe, Demmel, Walter, Deuschl, Guenther, Fasano, Alfonso ORCID: 0000-0001-5346-0180, Kuehn, Andrea A., Limousin, Patricia, McIntyre, Cameron C., Mehdorn, H. Maximilian, Pilleri, Manuela, Pollak, Pierre, Rodriguez-Oroz, Maria C., Rumia, Jordi, Samuel, Michael, Timmermann, Lars, Valldeoriola, Francesc, Vesper, Jan, Visser-Vandewalle, Veerle, Volkmann, Jens ORCID: 0000-0002-9570-593X and Lozano, Andres M. (2017). Targeting of the Subthalamic Nucleus for Deep Brain Stimulation: A Survey Among Parkinson Disease Specialists. World Neurosurg., 99. S. 41 - 47. NEW YORK: ELSEVIER SCIENCE INC. ISSN 1878-8769

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Abstract

BACKGROUND: Deep brain stimulation within or adjacent to the subthalamic nucleus (STN) represents the most common stereotactic procedure performed for Parkinson disease. Better STN imaging is often regarded as a requirement for improving stereotactic targeting. However, it is unclear whether there is consensus about the optimal target. METHODS: To obtain an expert opinion on the site regarded optimal for STN stimulation, movement disorder specialists were asked to indicate their preferred position for an active contact on hard copies of the Schaltenbrand and Wahren atlas depicting the STN in all 3 planes. This represented an idealized setting, and it mimicked optimal imaging for direct target definition in a perfectly delineated STN. RESULTS: The suggested targets were heterogeneous, although some clustering was observed in the dorsolateral STN and subthalamic area. In particular, in the anteroposterior direction, the intended targets differed to a great extent. Most of the indicated targets are thought to also result in concomitant stimulation of structures adjacent to the STN, including the zona incerta, fields of Forel, and internal capsule. CONCLUSIONS: This survey illustrates that most sites regarded as optimal for STN stimulation are close to each other, but there appears to be no uniform perception of the optimal anatomic target, possibly influencing surgical results. The anatomic sweet zone for STN stimulation needs further specification, as this information is likely to make magnetic resonance imaginge-based target definition less variable when applied to individual patients.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Hamel, WolfgangUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Koeppen, Johannes A.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Alesch, FrancoisUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Antonini, AngeloUNSPECIFIEDorcid.org/0000-0003-1040-2807UNSPECIFIED
Barcia, Juan A.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Bergman, HagaiUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Chabardes, StephanUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Contarino, Maria FiorellaUNSPECIFIEDorcid.org/0000-0002-0312-184XUNSPECIFIED
Cornu, PhilippeUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Demmel, WalterUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Deuschl, GuentherUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Fasano, AlfonsoUNSPECIFIEDorcid.org/0000-0001-5346-0180UNSPECIFIED
Kuehn, Andrea A.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Limousin, PatriciaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
McIntyre, Cameron C.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Mehdorn, H. MaximilianUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Pilleri, ManuelaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Pollak, PierreUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Rodriguez-Oroz, Maria C.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Rumia, JordiUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Samuel, MichaelUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Timmermann, LarsUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Valldeoriola, FrancescUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Vesper, JanUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Visser-Vandewalle, VeerleUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Volkmann, JensUNSPECIFIEDorcid.org/0000-0002-9570-593XUNSPECIFIED
Lozano, Andres M.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-239383
DOI: 10.1016/j.wneu.2016.11.012
Journal or Publication Title: World Neurosurg.
Volume: 99
Page Range: S. 41 - 47
Date: 2017
Publisher: ELSEVIER SCIENCE INC
Place of Publication: NEW YORK
ISSN: 1878-8769
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
ACTIVE CONTACTS; MEDICAL THERAPY; BASAL GANGLIA; OPEN-LABEL; LOCALIZATION; SITE; MRI; IMPROVEMENT; TRIAL; IDENTIFICATIONMultiple languages
Clinical Neurology; SurgeryMultiple languages
Refereed: Yes
URI: http://kups.ub.uni-koeln.de/id/eprint/23938

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