Abstract
Deep brain stimulation (DBS) of the subthalamic nucleus is a neurosurgical intervention for Parkinson's disease patients who no longer appropriately respond to drug treatments. A small fraction of patients will fail to respond to DBS, develop psychiatric and cognitive side-effects, or incur surgery-related complications such as infections and hemorrhagic events. In these cases, DBS may require recalibration, reimplantation, or removal. These negative responses to treatment can partly be attributed to suboptimal pre-operative planning procedures via direct targeting through low-field and low-resolution magnetic resonance imaging (MRI). One solution for increasing the success and efficacy of DBS is to optimize preoperative planning procedures via sophisticated neuroimaging techniques such as high-resolution MRI and higher field strengths to improve visualization of DBS targets and vasculature. We discuss targeting approaches, MRI acquisition, parameters, and post-acquisition analyses. Additionally, we highlight a number of approaches including the use of ultra-high field (UHF) MRI to overcome limitations of standard settings. There is a trade-off between spatial resolution, motion artifacts, and acquisition time, which could potentially be dissolved through the use of UHF-MRI. Image registration, correction, and post-processing techniques may require combined expertise of traditional radiologists, clinicians, and fundamental researchers. The optimization of pre-operative planning with MRI can therefore be best achieved through direct collaboration between researchers and clinicians.
Original language | English |
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Article number | 3124 |
Number of pages | 28 |
Journal | Journal of Clinical Medicine |
Volume | 9 |
Issue number | 10 |
DOIs | |
Publication status | Published - Oct 2020 |
Keywords
- Parkinson’
- s disease
- magnetic resonance imaging
- deep brain stimulation
- ultra-high field
- SUSCEPTIBILITY MAPPING QSM
- HIGH-FIELD MRI
- HIGH-RESOLUTION T-1
- BASAL GANGLIA
- 7 T
- IMAGE REGISTRATION
- GLOBUS-PALLIDUS
- IN-VIVO
- AUTOMATIC SEGMENTATION
- MOVEMENT-DISORDERS