Thalamic stimulation for tremor: Can target determination be improved?
Identifieur interne : 000147 ( France/Analysis ); précédent : 000146; suivant : 000148Thalamic stimulation for tremor: Can target determination be improved?
Auteurs : Eric Bardinet [France] ; Hayat Belaid [France] ; David Grabli [France] ; Marie-Laure Welter [France] ; Sara Fernandez Vidal [France] ; Damien Galanaud [France] ; Stéphane Derrey [France] ; Didier Dormont [France] ; Philippe Cornu [France] ; Jérôme Yelnik [France] ; Carine Karachi [France]Source :
- Movement Disorders [ 0885-3185 ] ; 2011-02-01.
Descripteurs français
- Pascal (Inist)
English descriptors
- KwdEn :
- Adult, Aged, Brain Mapping, Deep Brain Stimulation, Deep brain stimulation, Double-Blind Method, Electrodes, Implanted, Essential Tremor (therapy), Humans, Middle Aged, Nervous system diseases, Parkinson Disease (therapy), Thalamus, Thalamus (surgery), Treatment Outcome, Tremor, Tremor (therapy), deep brain stimulation, thalamus, tremor.
- MESH :
- surgery : Thalamus.
- therapy : Essential Tremor, Parkinson Disease, Tremor.
- mix :
Abstract
High frequency stimulation of the ventral intermedius nucleus (Vim) of the thalamus is successfully used for the treatment of postural tremor. Target coordinates are most commonly calculated using a statistical method. Here, we compare a statistical and an individual targeting method, using an histology‐based three‐dimensional deformable brain atlas which allows localization of the Vim on individual patient's MR images by adaptation of the atlas onto the patient's brain. Twenty‐nine consecutive patients had electrodes implanted in the Vim uni‐or bilaterally for severe essential tremor. Thirty‐five targets were determined by calculating the statistical target and then using the deformable atlas to compute the individual target. Pythagorean distance between these targets was calculated. Statistical and individual targets were compared by double blind evaluation of perioperative stimulation effects. For most cases (n = 24), the Pythagorean distance was higher than 1.5 mm. In 79% of these cases, the definitive electrode was implanted using the position of the individual target. For the remaining cases (n = 11, distance < 1.5 mm), the definitive electrode was implanted according to the statistical target location in 73% of the cases. As a whole, when individual target was used, it was located at least 2 mm more medial than the statistical one in 86% cases. These results suggest that Vim target determination based on a statistical method might be inaccurate. In particular, laterality might be overestimated, leading to nonoptimal clinical results. In clinical practice, this means that microelectrode exploration during Vim surgery should include at least one trajectory more medial than the statistical target. © 2010 Movement Disorder Society
Url:
- https://api.istex.fr/document/839238EE19EF60308E3DFECE59B654DF6010F341/fulltext/pdf
- https://hal.inria.fr/hal-00795734
DOI: 10.1002/mds.23448
Affiliations:
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ISTEX:839238EE19EF60308E3DFECE59B654DF6010F341Le document en format XML
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Disord.</title><idno type="ISSN">0885-3185</idno><idno type="eISSN">1531-8257</idno><imprint><publisher>Wiley Subscription Services, Inc., A Wiley Company</publisher><pubPlace>Hoboken</pubPlace><date type="published" when="2011-02-01">2011-02-01</date><biblScope unit="vol">26</biblScope><biblScope unit="issue">2</biblScope><biblScope unit="page" from="307">307</biblScope><biblScope unit="page" to="312">312</biblScope></imprint><idno type="ISSN">0885-3185</idno></series><idno type="istex">839238EE19EF60308E3DFECE59B654DF6010F341</idno><idno type="DOI">10.1002/mds.23448</idno><idno type="ArticleID">MDS23448</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0885-3185</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adult</term><term>Aged</term><term>Brain Mapping</term><term>Deep Brain Stimulation</term><term>Deep brain stimulation</term><term>Double-Blind Method</term><term>Electrodes, Implanted</term><term>Essential Tremor (therapy)</term><term>Humans</term><term>Middle Aged</term><term>Nervous system diseases</term><term>Parkinson Disease (therapy)</term><term>Thalamus</term><term>Thalamus (surgery)</term><term>Treatment Outcome</term><term>Tremor</term><term>Tremor (therapy)</term><term>deep brain stimulation</term><term>thalamus</term><term>tremor</term></keywords><keywords scheme="MESH" qualifier="surgery" xml:lang="en"><term>Thalamus</term></keywords><keywords scheme="MESH" qualifier="therapy" xml:lang="en"><term>Essential Tremor</term><term>Parkinson Disease</term><term>Tremor</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Pathologie du système nerveux</term><term>Stimulation cérébrale profonde</term><term>Thalamus</term><term>Tremblement</term></keywords><keywords scheme="mix" xml:lang="en"><term>Adult</term><term>Aged</term><term>Brain Mapping</term><term>Deep Brain Stimulation</term><term>Double-Blind Method</term><term>Electrodes, Implanted</term><term>Humans</term><term>Middle Aged</term><term>Treatment Outcome</term><term>deep brain stimulation</term><term>thalamus</term><term>tremor</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">High frequency stimulation of the ventral intermedius nucleus (Vim) of the thalamus is successfully used for the treatment of postural tremor. Target coordinates are most commonly calculated using a statistical method. Here, we compare a statistical and an individual targeting method, using an histology‐based three‐dimensional deformable brain atlas which allows localization of the Vim on individual patient's MR images by adaptation of the atlas onto the patient's brain. Twenty‐nine consecutive patients had electrodes implanted in the Vim uni‐or bilaterally for severe essential tremor. Thirty‐five targets were determined by calculating the statistical target and then using the deformable atlas to compute the individual target. Pythagorean distance between these targets was calculated. Statistical and individual targets were compared by double blind evaluation of perioperative stimulation effects. For most cases (n = 24), the Pythagorean distance was higher than 1.5 mm. In 79% of these cases, the definitive electrode was implanted using the position of the individual target. For the remaining cases (n = 11, distance < 1.5 mm), the definitive electrode was implanted according to the statistical target location in 73% of the cases. As a whole, when individual target was used, it was located at least 2 mm more medial than the statistical one in 86% cases. These results suggest that Vim target determination based on a statistical method might be inaccurate. In particular, laterality might be overestimated, leading to nonoptimal clinical results. In clinical practice, this means that microelectrode exploration during Vim surgery should include at least one trajectory more medial than the statistical target. © 2010 Movement Disorder Society</div></front></TEI><affiliations><list><country><li>France</li></country><settlement><li>Paris</li><li>Rouen</li></settlement></list><tree><country name="France"><noRegion><name sortKey="Bardinet, Eric" sort="Bardinet, Eric" uniqKey="Bardinet E" first="Eric" last="Bardinet">Eric Bardinet</name></noRegion><name sortKey="Bardinet, Eric" sort="Bardinet, Eric" uniqKey="Bardinet E" first="Eric" last="Bardinet">Eric Bardinet</name><name sortKey="Belaid, Hayat" sort="Belaid, Hayat" uniqKey="Belaid H" first="Hayat" last="Belaid">Hayat Belaid</name><name sortKey="Belaid, Hayat" sort="Belaid, Hayat" uniqKey="Belaid H" first="Hayat" last="Belaid">Hayat Belaid</name><name sortKey="Cornu, Philippe" sort="Cornu, Philippe" uniqKey="Cornu P" first="Philippe" last="Cornu">Philippe Cornu</name><name sortKey="Derrey, Stephane" sort="Derrey, Stephane" uniqKey="Derrey S" first="Stéphane" last="Derrey">Stéphane Derrey</name><name sortKey="Dormont, Didier" sort="Dormont, Didier" uniqKey="Dormont D" first="Didier" last="Dormont">Didier Dormont</name><name sortKey="Dormont, Didier" sort="Dormont, Didier" uniqKey="Dormont D" first="Didier" last="Dormont">Didier Dormont</name><name sortKey="Galanaud, Damien" sort="Galanaud, Damien" uniqKey="Galanaud D" first="Damien" last="Galanaud">Damien Galanaud</name><name sortKey="Galanaud, Damien" sort="Galanaud, Damien" uniqKey="Galanaud D" first="Damien" last="Galanaud">Damien Galanaud</name><name sortKey="Grabli, David" sort="Grabli, David" uniqKey="Grabli D" first="David" last="Grabli">David Grabli</name><name sortKey="Grabli, David" sort="Grabli, David" uniqKey="Grabli D" first="David" last="Grabli">David Grabli</name><name sortKey="Karachi, Carine" sort="Karachi, Carine" uniqKey="Karachi C" first="Carine" last="Karachi">Carine Karachi</name><name sortKey="Karachi, Carine" sort="Karachi, Carine" uniqKey="Karachi C" first="Carine" last="Karachi">Carine Karachi</name><name sortKey="Vidal, Sara Fernandez" sort="Vidal, Sara Fernandez" uniqKey="Vidal S" first="Sara Fernandez" last="Vidal">Sara Fernandez Vidal</name><name sortKey="Vidal, Sara Fernandez" sort="Vidal, Sara Fernandez" uniqKey="Vidal S" first="Sara Fernandez" last="Vidal">Sara Fernandez Vidal</name><name sortKey="Welter, Marie Aure" sort="Welter, Marie Aure" uniqKey="Welter M" first="Marie-Laure" last="Welter">Marie-Laure Welter</name><name sortKey="Welter, Marie Aure" sort="Welter, Marie Aure" uniqKey="Welter M" first="Marie-Laure" last="Welter">Marie-Laure Welter</name><name sortKey="Yelnik, Jerome" sort="Yelnik, Jerome" uniqKey="Yelnik J" first="Jérôme" last="Yelnik">Jérôme Yelnik</name><name sortKey="Yelnik, Jerome" sort="Yelnik, Jerome" uniqKey="Yelnik J" first="Jérôme" last="Yelnik">Jérôme Yelnik</name><name sortKey="Yelnik, Jerome" sort="Yelnik, Jerome" uniqKey="Yelnik J" first="Jérôme" last="Yelnik">Jérôme Yelnik</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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