A diffusion-based connectivity map of the GPi for optimised stereotactic targeting in DBS

dc.contributor.author Nádia Moreira Silva en
dc.contributor.author Ahmadi,SA en
dc.contributor.author Tafula,SN en
dc.contributor.author João Paulo Cunha en
dc.contributor.author Botzel,K en
dc.contributor.author Vollmar,C en
dc.contributor.author Rozanski,VE en
dc.date.accessioned 2018-01-16T12:40:58Z
dc.date.available 2018-01-16T12:40:58Z
dc.date.issued 2017 en
dc.description.abstract Background: The GPi (globus pallidus internus) is an important target nucleus for Deep Brain Stimulation (DBS) in medically refractory movement disorders, in particular dystonia and Parkinson's disease. Beneficial clinical outcome critically depends on precise electrode localization. Recent evidence indicates that not only neurons, but also axonal fibre tracts contribute to promoting the clinical effect. Thus, stereotactic planning should, in the future, also take the individual course of fibre tracts into account. Objective: The aim of this project is to explore the GPi connectivity profile and provide a connectivity based parcellation of the GPi. Methods: Diffusion MRI sequences were performed in sixteen healthy, right-handed subjects. Connectivity-based parcellation of the GPi was performed applying two independent methods: 1) a hypothesis-driven, seed-to-target approach based on anatomic priors set as connectivity targets and 2) a purely data-driven approach based on k-means clustering of the GPi. Results: Applying the hypothesis-driven approach, we obtained five major parcellation clusters, displaying connectivity to the prefrontal cortex, the brainstem, the GPe (globus pallidus externus), the putamen and the thalamus. Parcellation clusters obtained by both methods were similar in their connectivity profile. With the data-driven approach, we obtained three major parcellation clusters. Inter individual variability was comparable with results obtained in thalamic parcellation. Conclusion: The three parcellation clusters obtained by the purely data-driven method might reflect GPi subdivision into a sensorimotor, associative and limbic portion. Clinical and physiological studies indicate greatest clinical DBS benefit for electrodes placed in the postero-ventro-lateral GPi, the region displaying connectivity to the thalamus in our study and generally attributed to the sensorimotor system. Clinical studies relating DBS electrode positions to our GPi connectivity map would be needed to complement our findings. en
dc.identifier.uri http://repositorio.inesctec.pt/handle/123456789/6354
dc.identifier.uri http://dx.doi.org/10.1016/j.neuroimage.2016.06.018 en
dc.language eng en
dc.relation 5875 en
dc.relation 5864 en
dc.rights info:eu-repo/semantics/embargoedAccess en
dc.title A diffusion-based connectivity map of the GPi for optimised stereotactic targeting in DBS en
dc.type article en
dc.type Publication en
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