Subthalamic deep brain stimulation
Essential tremor
Parkinson's disease
Obsessive compulsive disorder
Traumatic Brain Injury
Technique
The susceptibility weighted imaging with 3 Tesla MRI-based subthalamic nucleus localization shows the best accuracy compared with T2-weighted and fluid-attenuated inversion recovery 3-T MRI. Therefore, the susceptibility-weighted 3-T MRI should be preferred for surgical planning when the operation procedure is performed under general anesthesia without microelectrode recordings 1).
To answer the question of whether the anatomical center of the subthalamic nucleus (STN), as calculated indirectly from stereotactic atlases or by direct visualization on magnetic resonance imaging (MRI), corresponds to the best functional target.
The functional STN target is located in direct proximity to its anatomical center. During preoperative targeting, Rabie et al., recommend using the “direct” method, and taking into consideration the relationships of the final target to the mid-commissural point (MCP) and the different red nucleus (RN) borders 2).