Three-dimensional SPACE fluid-attenuated inversion recovery at 3 T to improve subthalamic nucleus lead placement for deep brain stimulation in Parkinson's disease: from preclinical to clinical studies.
Identifieur interne : 001914 ( Ncbi/Merge ); précédent : 001913; suivant : 001915Three-dimensional SPACE fluid-attenuated inversion recovery at 3 T to improve subthalamic nucleus lead placement for deep brain stimulation in Parkinson's disease: from preclinical to clinical studies.
Auteurs : Suhan Senova ; Koichi Hosomi ; Jean-Marc Gurruchaga ; Gaëtane Gouello ; Naoufel Ouerchefani ; Yara Beaugendre ; Hélène Lepetit ; Jean-Pascal Lefaucheur ; Romina Aron Badin ; Julien Dauguet ; Caroline Jan ; Philippe Hantraye ; Pierre Brugières ; Stéphane PalfiSource :
- Journal of neurosurgery [ 1933-0693 ] ; 2016.
Abstract
OBJECTIVE Deep brain stimulation (DBS) of the subthalamic nucleus (STN) is a well-established therapy for motor symptoms in patients with pharmacoresistant Parkinson's disease (PD). However, the procedure, which requires multimodal perioperative exploration such as imaging, electrophysiology, or clinical examination during macrostimulation to secure lead positioning, remains challenging because the STN cannot be reliably visualized using the gold standard, T2-weighted imaging (T2WI) at 1.5 T. Thus, there is a need to improve imaging tools to better visualize the STN, optimize DBS lead implantation, and enlarge DBS diffusion. METHODS Gradient-echo sequences such as those used in T2WI suffer from higher distortions at higher magnetic fields than spin-echo sequences. First, a spin-echo 3D SPACE (sampling perfection with application-optimized contrasts using different flip angle evolutions) FLAIR sequence at 3 T was designed, validated histologically in 2 nonhuman primates, and applied to 10 patients with PD; their data were clinically compared in a double-blind manner with those of a control group of 10 other patients with PD in whom STN targeting was performed using T2WI. RESULTS Overlap between the nonhuman primate STNs segmented on 3D-histological and on 3D-SPACE-FLAIR volumes was high for the 3 most anterior quarters (mean [± SD] Dice scores 0.73 ± 0.11, 0.74 ± 0.06, and 0.60 ± 0.09). STN limits determined by the 3D-SPACE-FLAIR sequence were more consistent with electrophysiological edges than those determined by T2WI (0.9 vs 1.4 mm, respectively). The imaging contrast of the STN on the 3D-SPACE-FLAIR sequence was 4 times higher (p < 0.05). Improvement in the Unified Parkinson's Disease Rating Scale Part III score (off medication, on stimulation) 12 months after the operation was higher for patients who underwent 3D-SPACE-FLAIR-guided implantation than for those in whom T2WI was used (62.2% vs 43.6%, respectively; p < 0.05). The total electrical energy delivered decreased by 36.3% with the 3D-SPACE-FLAIR sequence (p < 0.05). CONCLUSIONS 3D-SPACE-FLAIR sequences at 3 T improved STN lead placement under stereotactic conditions, improved the clinical outcome of patients with PD, and increased the benefit/risk ratio of STN-DBS surgery.
DOI: 10.3171/2015.7.JNS15379
PubMed: 26745490
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<series><title level="j">Journal of neurosurgery</title>
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<front><div type="abstract" xml:lang="en">OBJECTIVE Deep brain stimulation (DBS) of the subthalamic nucleus (STN) is a well-established therapy for motor symptoms in patients with pharmacoresistant Parkinson's disease (PD). However, the procedure, which requires multimodal perioperative exploration such as imaging, electrophysiology, or clinical examination during macrostimulation to secure lead positioning, remains challenging because the STN cannot be reliably visualized using the gold standard, T2-weighted imaging (T2WI) at 1.5 T. Thus, there is a need to improve imaging tools to better visualize the STN, optimize DBS lead implantation, and enlarge DBS diffusion. METHODS Gradient-echo sequences such as those used in T2WI suffer from higher distortions at higher magnetic fields than spin-echo sequences. First, a spin-echo 3D SPACE (sampling perfection with application-optimized contrasts using different flip angle evolutions) FLAIR sequence at 3 T was designed, validated histologically in 2 nonhuman primates, and applied to 10 patients with PD; their data were clinically compared in a double-blind manner with those of a control group of 10 other patients with PD in whom STN targeting was performed using T2WI. RESULTS Overlap between the nonhuman primate STNs segmented on 3D-histological and on 3D-SPACE-FLAIR volumes was high for the 3 most anterior quarters (mean [± SD] Dice scores 0.73 ± 0.11, 0.74 ± 0.06, and 0.60 ± 0.09). STN limits determined by the 3D-SPACE-FLAIR sequence were more consistent with electrophysiological edges than those determined by T2WI (0.9 vs 1.4 mm, respectively). The imaging contrast of the STN on the 3D-SPACE-FLAIR sequence was 4 times higher (p < 0.05). Improvement in the Unified Parkinson's Disease Rating Scale Part III score (off medication, on stimulation) 12 months after the operation was higher for patients who underwent 3D-SPACE-FLAIR-guided implantation than for those in whom T2WI was used (62.2% vs 43.6%, respectively; p < 0.05). The total electrical energy delivered decreased by 36.3% with the 3D-SPACE-FLAIR sequence (p < 0.05). CONCLUSIONS 3D-SPACE-FLAIR sequences at 3 T improved STN lead placement under stereotactic conditions, improved the clinical outcome of patients with PD, and increased the benefit/risk ratio of STN-DBS surgery.</div>
</front>
</TEI>
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<DateCreated><Year>2016</Year>
<Month>08</Month>
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<DateRevised><Year>2016</Year>
<Month>08</Month>
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<Title>Journal of neurosurgery</Title>
<ISOAbbreviation>J. Neurosurg.</ISOAbbreviation>
</Journal>
<ArticleTitle>Three-dimensional SPACE fluid-attenuated inversion recovery at 3 T to improve subthalamic nucleus lead placement for deep brain stimulation in Parkinson's disease: from preclinical to clinical studies.</ArticleTitle>
<Pagination><MedlinePgn>472-80</MedlinePgn>
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<Abstract><AbstractText>OBJECTIVE Deep brain stimulation (DBS) of the subthalamic nucleus (STN) is a well-established therapy for motor symptoms in patients with pharmacoresistant Parkinson's disease (PD). However, the procedure, which requires multimodal perioperative exploration such as imaging, electrophysiology, or clinical examination during macrostimulation to secure lead positioning, remains challenging because the STN cannot be reliably visualized using the gold standard, T2-weighted imaging (T2WI) at 1.5 T. Thus, there is a need to improve imaging tools to better visualize the STN, optimize DBS lead implantation, and enlarge DBS diffusion. METHODS Gradient-echo sequences such as those used in T2WI suffer from higher distortions at higher magnetic fields than spin-echo sequences. First, a spin-echo 3D SPACE (sampling perfection with application-optimized contrasts using different flip angle evolutions) FLAIR sequence at 3 T was designed, validated histologically in 2 nonhuman primates, and applied to 10 patients with PD; their data were clinically compared in a double-blind manner with those of a control group of 10 other patients with PD in whom STN targeting was performed using T2WI. RESULTS Overlap between the nonhuman primate STNs segmented on 3D-histological and on 3D-SPACE-FLAIR volumes was high for the 3 most anterior quarters (mean [± SD] Dice scores 0.73 ± 0.11, 0.74 ± 0.06, and 0.60 ± 0.09). STN limits determined by the 3D-SPACE-FLAIR sequence were more consistent with electrophysiological edges than those determined by T2WI (0.9 vs 1.4 mm, respectively). The imaging contrast of the STN on the 3D-SPACE-FLAIR sequence was 4 times higher (p < 0.05). Improvement in the Unified Parkinson's Disease Rating Scale Part III score (off medication, on stimulation) 12 months after the operation was higher for patients who underwent 3D-SPACE-FLAIR-guided implantation than for those in whom T2WI was used (62.2% vs 43.6%, respectively; p < 0.05). The total electrical energy delivered decreased by 36.3% with the 3D-SPACE-FLAIR sequence (p < 0.05). CONCLUSIONS 3D-SPACE-FLAIR sequences at 3 T improved STN lead placement under stereotactic conditions, improved the clinical outcome of patients with PD, and increased the benefit/risk ratio of STN-DBS surgery.</AbstractText>
</Abstract>
<AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Senova</LastName>
<ForeName>Suhan</ForeName>
<Initials>S</Initials>
<AffiliationInfo><Affiliation>Service de Neurochirurgie.</Affiliation>
</AffiliationInfo>
<AffiliationInfo><Affiliation>Inserm U955 Team 14;</Affiliation>
</AffiliationInfo>
<AffiliationInfo><Affiliation>Faculté de Médecine, Université Paris Est, Créteil;</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Hosomi</LastName>
<ForeName>Koichi</ForeName>
<Initials>K</Initials>
<AffiliationInfo><Affiliation>Service de Neurochirurgie.</Affiliation>
</AffiliationInfo>
<AffiliationInfo><Affiliation>Faculté de Médecine, Université Paris Est, Créteil;</Affiliation>
</AffiliationInfo>
<AffiliationInfo><Affiliation>DSV/I2BM/MIRCen/Laboratory of Neurodegenerative Diseases, CNRS, Commissariat à l'Energie Atomique, Fontenay-aux-Roses; and.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Gurruchaga</LastName>
<ForeName>Jean-Marc</ForeName>
<Initials>JM</Initials>
<AffiliationInfo><Affiliation>Service de Neurochirurgie.</Affiliation>
</AffiliationInfo>
<AffiliationInfo><Affiliation>Inserm U955 Team 14;</Affiliation>
</AffiliationInfo>
<AffiliationInfo><Affiliation>Faculté de Médecine, Université Paris Est, Créteil;</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Gouello</LastName>
<ForeName>Gaëtane</ForeName>
<Initials>G</Initials>
<AffiliationInfo><Affiliation>Service de Neurochirurgie.</Affiliation>
</AffiliationInfo>
<AffiliationInfo><Affiliation>Inserm U955 Team 14;</Affiliation>
</AffiliationInfo>
<AffiliationInfo><Affiliation>Faculté de Médecine, Université Paris Est, Créteil;</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Ouerchefani</LastName>
<ForeName>Naoufel</ForeName>
<Initials>N</Initials>
<AffiliationInfo><Affiliation>Service de Neurochirurgie.</Affiliation>
</AffiliationInfo>
<AffiliationInfo><Affiliation>Inserm U955 Team 14;</Affiliation>
</AffiliationInfo>
<AffiliationInfo><Affiliation>Faculté de Médecine, Université Paris Est, Créteil;</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Beaugendre</LastName>
<ForeName>Yara</ForeName>
<Initials>Y</Initials>
<AffiliationInfo><Affiliation>Service de Neurochirurgie.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Lepetit</LastName>
<ForeName>Hélène</ForeName>
<Initials>H</Initials>
<AffiliationInfo><Affiliation>Service de Neurochirurgie.</Affiliation>
</AffiliationInfo>
<AffiliationInfo><Affiliation>Inserm U955 Team 14;</Affiliation>
</AffiliationInfo>
<AffiliationInfo><Affiliation>Faculté de Médecine, Université Paris Est, Créteil;</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Lefaucheur</LastName>
<ForeName>Jean-Pascal</ForeName>
<Initials>JP</Initials>
<AffiliationInfo><Affiliation>Service des Explorations Fonctionnelles, Assistance Publique des Hopitaux de Paris, Hôpital H. Mondor, DHU PePsy;</Affiliation>
</AffiliationInfo>
<AffiliationInfo><Affiliation>Faculté de Médecine, Université Paris Est, Créteil;</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Badin</LastName>
<ForeName>Romina Aron</ForeName>
<Initials>RA</Initials>
<AffiliationInfo><Affiliation>DSV/I2BM/MIRCen/Laboratory of Neurodegenerative Diseases, CNRS, Commissariat à l'Energie Atomique, Fontenay-aux-Roses; and.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Dauguet</LastName>
<ForeName>Julien</ForeName>
<Initials>J</Initials>
<AffiliationInfo><Affiliation>DSV/I2BM/MIRCen/Laboratory of Neurodegenerative Diseases, CNRS, Commissariat à l'Energie Atomique, Fontenay-aux-Roses; and.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Jan</LastName>
<ForeName>Caroline</ForeName>
<Initials>C</Initials>
<AffiliationInfo><Affiliation>DSV/I2BM/MIRCen/Laboratory of Neurodegenerative Diseases, CNRS, Commissariat à l'Energie Atomique, Fontenay-aux-Roses; and.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Hantraye</LastName>
<ForeName>Philippe</ForeName>
<Initials>P</Initials>
<AffiliationInfo><Affiliation>DSV/I2BM/MIRCen/Laboratory of Neurodegenerative Diseases, CNRS, Commissariat à l'Energie Atomique, Fontenay-aux-Roses; and.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Brugières</LastName>
<ForeName>Pierre</ForeName>
<Initials>P</Initials>
<AffiliationInfo><Affiliation>Service de Neuroradiologie, and.</Affiliation>
</AffiliationInfo>
<AffiliationInfo><Affiliation>Inserm U955 Team 14;</Affiliation>
</AffiliationInfo>
<AffiliationInfo><Affiliation>Faculté de Médecine, Université Paris Est, Créteil;</Affiliation>
</AffiliationInfo>
<AffiliationInfo><Affiliation>DSV/I2BM/Neurospin/UNIACT, Commissariat à l'Energie Atomique, Saclay, France.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Palfi</LastName>
<ForeName>Stéphane</ForeName>
<Initials>S</Initials>
<AffiliationInfo><Affiliation>Service de Neurochirurgie.</Affiliation>
</AffiliationInfo>
<AffiliationInfo><Affiliation>Inserm U955 Team 14;</Affiliation>
</AffiliationInfo>
<AffiliationInfo><Affiliation>Faculté de Médecine, Université Paris Est, Créteil;</Affiliation>
</AffiliationInfo>
</Author>
</AuthorList>
<Language>eng</Language>
<PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType>
</PublicationTypeList>
<ArticleDate DateType="Electronic"><Year>2016</Year>
<Month>01</Month>
<Day>08</Day>
</ArticleDate>
</Article>
<MedlineJournalInfo><Country>United States</Country>
<MedlineTA>J Neurosurg</MedlineTA>
<NlmUniqueID>0253357</NlmUniqueID>
<ISSNLinking>0022-3085</ISSNLinking>
</MedlineJournalInfo>
<CitationSubset>AIM</CitationSubset>
<CitationSubset>IM</CitationSubset>
<KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">DBS = deep brain stimulation</Keyword>
<Keyword MajorTopicYN="N">H&Y = Hoehn and Yahr</Keyword>
<Keyword MajorTopicYN="N">LEDD = levodopa equivalent daily dose</Keyword>
<Keyword MajorTopicYN="N">M12 = month 12 after implantation</Keyword>
<Keyword MajorTopicYN="N">NHP = nonhuman primate</Keyword>
<Keyword MajorTopicYN="N">PD = Parkinson's disease</Keyword>
<Keyword MajorTopicYN="N">Parkinson's disease</Keyword>
<Keyword MajorTopicYN="N">SPACE = sampling perfection with application-optimized contrasts using different flip angle evolutions</Keyword>
<Keyword MajorTopicYN="N">STN = subthalamic nucleus</Keyword>
<Keyword MajorTopicYN="N">T1WI = T1-weighted imaging</Keyword>
<Keyword MajorTopicYN="N">T2WI = T2-weighted imaging</Keyword>
<Keyword MajorTopicYN="N">TEED = total electrical energy delivered</Keyword>
<Keyword MajorTopicYN="N">UPDRS = Unified Parkinson's Disease Rating Scale</Keyword>
<Keyword MajorTopicYN="N">anatomical MRI</Keyword>
<Keyword MajorTopicYN="N">deep brain stimulation</Keyword>
<Keyword MajorTopicYN="N">eSTN = electrophysiologically identified subthalamic nucleus</Keyword>
<Keyword MajorTopicYN="N">functional neurosurgery</Keyword>
<Keyword MajorTopicYN="N">nonhuman primate</Keyword>
<Keyword MajorTopicYN="N">subthalamic nucleus</Keyword>
<Keyword MajorTopicYN="N">translational study</Keyword>
</KeywordList>
</MedlineCitation>
<PubmedData><History><PubMedPubDate PubStatus="entrez"><Year>2016</Year>
<Month>1</Month>
<Day>9</Day>
<Hour>6</Hour>
<Minute>0</Minute>
</PubMedPubDate>
<PubMedPubDate PubStatus="pubmed"><Year>2016</Year>
<Month>1</Month>
<Day>9</Day>
<Hour>6</Hour>
<Minute>0</Minute>
</PubMedPubDate>
<PubMedPubDate PubStatus="medline"><Year>2016</Year>
<Month>1</Month>
<Day>9</Day>
<Hour>6</Hour>
<Minute>0</Minute>
</PubMedPubDate>
</History>
<PublicationStatus>ppublish</PublicationStatus>
<ArticleIdList><ArticleId IdType="pubmed">26745490</ArticleId>
<ArticleId IdType="doi">10.3171/2015.7.JNS15379</ArticleId>
</ArticleIdList>
</PubmedData>
</pubmed>
<affiliations><list></list>
<tree><noCountry><name sortKey="Badin, Romina Aron" sort="Badin, Romina Aron" uniqKey="Badin R" first="Romina Aron" last="Badin">Romina Aron Badin</name>
<name sortKey="Beaugendre, Yara" sort="Beaugendre, Yara" uniqKey="Beaugendre Y" first="Yara" last="Beaugendre">Yara Beaugendre</name>
<name sortKey="Brugieres, Pierre" sort="Brugieres, Pierre" uniqKey="Brugieres P" first="Pierre" last="Brugières">Pierre Brugières</name>
<name sortKey="Dauguet, Julien" sort="Dauguet, Julien" uniqKey="Dauguet J" first="Julien" last="Dauguet">Julien Dauguet</name>
<name sortKey="Gouello, Gaetane" sort="Gouello, Gaetane" uniqKey="Gouello G" first="Gaëtane" last="Gouello">Gaëtane Gouello</name>
<name sortKey="Gurruchaga, Jean Marc" sort="Gurruchaga, Jean Marc" uniqKey="Gurruchaga J" first="Jean-Marc" last="Gurruchaga">Jean-Marc Gurruchaga</name>
<name sortKey="Hantraye, Philippe" sort="Hantraye, Philippe" uniqKey="Hantraye P" first="Philippe" last="Hantraye">Philippe Hantraye</name>
<name sortKey="Hosomi, Koichi" sort="Hosomi, Koichi" uniqKey="Hosomi K" first="Koichi" last="Hosomi">Koichi Hosomi</name>
<name sortKey="Jan, Caroline" sort="Jan, Caroline" uniqKey="Jan C" first="Caroline" last="Jan">Caroline Jan</name>
<name sortKey="Lefaucheur, Jean Pascal" sort="Lefaucheur, Jean Pascal" uniqKey="Lefaucheur J" first="Jean-Pascal" last="Lefaucheur">Jean-Pascal Lefaucheur</name>
<name sortKey="Lepetit, Helene" sort="Lepetit, Helene" uniqKey="Lepetit H" first="Hélène" last="Lepetit">Hélène Lepetit</name>
<name sortKey="Ouerchefani, Naoufel" sort="Ouerchefani, Naoufel" uniqKey="Ouerchefani N" first="Naoufel" last="Ouerchefani">Naoufel Ouerchefani</name>
<name sortKey="Palfi, Stephane" sort="Palfi, Stephane" uniqKey="Palfi S" first="Stéphane" last="Palfi">Stéphane Palfi</name>
<name sortKey="Senova, Suhan" sort="Senova, Suhan" uniqKey="Senova S" first="Suhan" last="Senova">Suhan Senova</name>
</noCountry>
</tree>
</affiliations>
</record>
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