Target identification for stereotactic thalamotomy using diffusion tractography

Zsigmond Tamás Kincses, Nikoletta Szabó, István Valálik, Zsolt Kopniczky, Lívia Dézsi, P. Klivényi, Mark Jenkinson, András Király, Magor Babos, E. Vörös, P. Barzó, L. Vécsei

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

Background: Stereotactic targets for thalamotomy are usually derived from population-based coordinates. Individual anatomy is used only to scale the coordinates based on the location of some internal guide points. While on conventional MR imaging the thalamic nuclei are indistinguishable, recently it has become possible to identify individual thalamic nuclei using different connectivity profiles, as defined by MR diffusion tractography. Methodology and Principal Findings: Here we investigated the inter-individual variation of the location of target nuclei for thalamotomy: the putative ventralis oralis posterior (Vop) and the ventral intermedius (Vim) nucleus as defined by probabilistic tractography. We showed that the mean inter-individual distance of the peak Vop location is 7.33 mm and 7.42 mm for Vim. The mean overlap between individual Vop nuclei was 40.2% and it was 31.8% for Vim nuclei. As a proof of concept, we also present a patient who underwent Vop thalamotomy for untreatable tremor caused by traumatic brain injury and another patient who underwent Vim thalamotomy for essential tremor. The probabilistic tractography indicated that the successful tremor control was achieved with lesions in the Vop and Vim respectively. Conclusions: Our data call attention to the need for a better appreciation of the individual anatomy when planning stereotactic functional neurosurgery.

Original languageEnglish
Article numbere29969
JournalPLoS One
Volume7
Issue number1
DOIs
Publication statusPublished - Jan 4 2012

Fingerprint

Ventral Thalamic Nuclei
Thalamic Nuclei
Diffusion Tensor Imaging
Tremor
Anatomy
Essential Tremor
Neurosurgery
lesions (animal)
planning
image analysis
brain
Brain
Population
Imaging techniques
Planning
methodology
Traumatic Brain Injury

ASJC Scopus subject areas

  • Agricultural and Biological Sciences(all)
  • Biochemistry, Genetics and Molecular Biology(all)
  • Medicine(all)

Cite this

Target identification for stereotactic thalamotomy using diffusion tractography. / Kincses, Zsigmond Tamás; Szabó, Nikoletta; Valálik, István; Kopniczky, Zsolt; Dézsi, Lívia; Klivényi, P.; Jenkinson, Mark; Király, András; Babos, Magor; Vörös, E.; Barzó, P.; Vécsei, L.

In: PLoS One, Vol. 7, No. 1, e29969, 04.01.2012.

Research output: Contribution to journalArticle

Kincses, ZT, Szabó, N, Valálik, I, Kopniczky, Z, Dézsi, L, Klivényi, P, Jenkinson, M, Király, A, Babos, M, Vörös, E, Barzó, P & Vécsei, L 2012, 'Target identification for stereotactic thalamotomy using diffusion tractography', PLoS One, vol. 7, no. 1, e29969. https://doi.org/10.1371/journal.pone.0029969
Kincses, Zsigmond Tamás ; Szabó, Nikoletta ; Valálik, István ; Kopniczky, Zsolt ; Dézsi, Lívia ; Klivényi, P. ; Jenkinson, Mark ; Király, András ; Babos, Magor ; Vörös, E. ; Barzó, P. ; Vécsei, L. / Target identification for stereotactic thalamotomy using diffusion tractography. In: PLoS One. 2012 ; Vol. 7, No. 1.
@article{ddc5969c224f4bf6b505375035bd938d,
title = "Target identification for stereotactic thalamotomy using diffusion tractography",
abstract = "Background: Stereotactic targets for thalamotomy are usually derived from population-based coordinates. Individual anatomy is used only to scale the coordinates based on the location of some internal guide points. While on conventional MR imaging the thalamic nuclei are indistinguishable, recently it has become possible to identify individual thalamic nuclei using different connectivity profiles, as defined by MR diffusion tractography. Methodology and Principal Findings: Here we investigated the inter-individual variation of the location of target nuclei for thalamotomy: the putative ventralis oralis posterior (Vop) and the ventral intermedius (Vim) nucleus as defined by probabilistic tractography. We showed that the mean inter-individual distance of the peak Vop location is 7.33 mm and 7.42 mm for Vim. The mean overlap between individual Vop nuclei was 40.2{\%} and it was 31.8{\%} for Vim nuclei. As a proof of concept, we also present a patient who underwent Vop thalamotomy for untreatable tremor caused by traumatic brain injury and another patient who underwent Vim thalamotomy for essential tremor. The probabilistic tractography indicated that the successful tremor control was achieved with lesions in the Vop and Vim respectively. Conclusions: Our data call attention to the need for a better appreciation of the individual anatomy when planning stereotactic functional neurosurgery.",
author = "Kincses, {Zsigmond Tam{\'a}s} and Nikoletta Szab{\'o} and Istv{\'a}n Val{\'a}lik and Zsolt Kopniczky and L{\'i}via D{\'e}zsi and P. Kliv{\'e}nyi and Mark Jenkinson and Andr{\'a}s Kir{\'a}ly and Magor Babos and E. V{\"o}r{\"o}s and P. Barz{\'o} and L. V{\'e}csei",
year = "2012",
month = "1",
day = "4",
doi = "10.1371/journal.pone.0029969",
language = "English",
volume = "7",
journal = "PLoS One",
issn = "1932-6203",
publisher = "Public Library of Science",
number = "1",

}

TY - JOUR

T1 - Target identification for stereotactic thalamotomy using diffusion tractography

AU - Kincses, Zsigmond Tamás

AU - Szabó, Nikoletta

AU - Valálik, István

AU - Kopniczky, Zsolt

AU - Dézsi, Lívia

AU - Klivényi, P.

AU - Jenkinson, Mark

AU - Király, András

AU - Babos, Magor

AU - Vörös, E.

AU - Barzó, P.

AU - Vécsei, L.

PY - 2012/1/4

Y1 - 2012/1/4

N2 - Background: Stereotactic targets for thalamotomy are usually derived from population-based coordinates. Individual anatomy is used only to scale the coordinates based on the location of some internal guide points. While on conventional MR imaging the thalamic nuclei are indistinguishable, recently it has become possible to identify individual thalamic nuclei using different connectivity profiles, as defined by MR diffusion tractography. Methodology and Principal Findings: Here we investigated the inter-individual variation of the location of target nuclei for thalamotomy: the putative ventralis oralis posterior (Vop) and the ventral intermedius (Vim) nucleus as defined by probabilistic tractography. We showed that the mean inter-individual distance of the peak Vop location is 7.33 mm and 7.42 mm for Vim. The mean overlap between individual Vop nuclei was 40.2% and it was 31.8% for Vim nuclei. As a proof of concept, we also present a patient who underwent Vop thalamotomy for untreatable tremor caused by traumatic brain injury and another patient who underwent Vim thalamotomy for essential tremor. The probabilistic tractography indicated that the successful tremor control was achieved with lesions in the Vop and Vim respectively. Conclusions: Our data call attention to the need for a better appreciation of the individual anatomy when planning stereotactic functional neurosurgery.

AB - Background: Stereotactic targets for thalamotomy are usually derived from population-based coordinates. Individual anatomy is used only to scale the coordinates based on the location of some internal guide points. While on conventional MR imaging the thalamic nuclei are indistinguishable, recently it has become possible to identify individual thalamic nuclei using different connectivity profiles, as defined by MR diffusion tractography. Methodology and Principal Findings: Here we investigated the inter-individual variation of the location of target nuclei for thalamotomy: the putative ventralis oralis posterior (Vop) and the ventral intermedius (Vim) nucleus as defined by probabilistic tractography. We showed that the mean inter-individual distance of the peak Vop location is 7.33 mm and 7.42 mm for Vim. The mean overlap between individual Vop nuclei was 40.2% and it was 31.8% for Vim nuclei. As a proof of concept, we also present a patient who underwent Vop thalamotomy for untreatable tremor caused by traumatic brain injury and another patient who underwent Vim thalamotomy for essential tremor. The probabilistic tractography indicated that the successful tremor control was achieved with lesions in the Vop and Vim respectively. Conclusions: Our data call attention to the need for a better appreciation of the individual anatomy when planning stereotactic functional neurosurgery.

UR - http://www.scopus.com/inward/record.url?scp=84855405454&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84855405454&partnerID=8YFLogxK

U2 - 10.1371/journal.pone.0029969

DO - 10.1371/journal.pone.0029969

M3 - Article

C2 - 22238685

AN - SCOPUS:84855405454

VL - 7

JO - PLoS One

JF - PLoS One

SN - 1932-6203

IS - 1

M1 - e29969

ER -