Kinesthetic Cells within the Subthalamic Nucleus and Deep Brain Stimulation for Parkinson Disease

Erik Bolier; Maarten Bot; Pepijn van den Munckhof; Gian Pal; Sepehr Sani; Glenn T. Stebbins; Leo Verhagen Metman

doi:10.1016/j.wneu.2020.04.160

Kinesthetic Cells within the Subthalamic Nucleus and Deep Brain Stimulation for Parkinson Disease

Erik Bolier^*, Maarten Bot, Pepijn van den Munckhof, Gian Pal, Sepehr Sani, Glenn T. Stebbins, Leo Verhagen Metman

^*Corresponding author for this work

Neurology

Research output: Contribution to journal › Article › peer-review

2 Scopus citations

Abstract

Objective: We sought to determine the location of kinesthetic cell clusters within the subthalamic nucleus (STN) on magnetic resonance imaging, adjusted for interindividual anatomic variability by employing the medial STN border as a reference point. Methods: We retrospectively localized microelectrode recording−defined kinesthetic cells on 3-Tesla T2-weighted and susceptibility-weighted images in patients who underwent STN deep brain stimulation for Parkinson disease and averaged the stereotactic coordinates. These locations were calculated relative to the nonindividualized midcommissural point (MCP) and, in order to account for interindividual anatomic variability, also calculated relative to the patient-specific intersection of Bejjani line with the medial STN border. Two example patients were selected in order to visualize the discrepancies between the adjusted and nonadjusted theoretic kinesthetic cell clusters on magnetic resonance imaging. Results: Relative to the MCP, average kinesthetic cell coordinates were 12.3 ± 1.2 mm lateral, 1.7 ± 1.4 mm posterior, and 2.3 ± 1.5 mm inferior. Relative to the medial STN border, mean coordinates were 3.4 ± 1.0 mm lateral, 1.0 ± 1.4 mm anterior, and 1.7 ± 1.5 mm superior on T2-sequences, and on susceptibility-weighted images mean coordinates were 3.2 ± 1.1 mm lateral, 0.8 ± 1.5 mm anterior, and 2.1 ± 1.5 mm superior. The theoretic kinesthetic cell clusters may appear outside the sensorimotor STN when using the MCP, whereas these clusters fall well within the sensorimotor STN when employing the medial STN border as a reference point. Conclusions: By using the medial STN border as a patient-specific anatomic reference point in STN deep brain stimulation for Parkinson disease, we accounted for interindividual anatomic variability and provided accurate insight in the clustering of kinesthetic cells within the dorsolateral STN.

Original language	English (US)
Pages (from-to)	e784-e791
Journal	World neurosurgery
Volume	139
DOIs	https://doi.org/10.1016/j.wneu.2020.04.160
State	Published - Jul 2020

Funding

EB received financial support from The Vreedefonds Foundation, Parkinson's Foundation the Netherlands, and Amsterdam Foundation for Promoting Neurosurgical Development. Conflict of interest statement: LVM has received fees for consulting activities from Abbott, AbbVie Inc., and Boston Scientific Corporation; is on the advisory boards of Abbott Neuromodulation, AbbVie Inc., and Biogen Inc.; serves on the editorial board of Neurology and Therapy, Brain Sciences; received commercial research support (Clinical Trial Agreement/Role: Site PI) from Medtronic Inc., Boston Scientific Corporation, Abbott Neuromodulation, AbbVie Inc., Neuroderm Ltd, Biogen Inc., and Prilenia Therapeutics; and received government research support NIH Research Grant R01 NS40902. Consortium grant. P.I. DM Corcos. Role: Site P.I.GTS has received funding for travel and speaker honoraria from the International Parkinson and Movement Disorder Society, Dystonia Coalition, American Academy of Neurology, Michael J. Fox Foundation for Parkinson's Research, Food and Drug Administration, National Institutes of Health, TOXINS, and American Society for Experimental Neurotherapeutics; has received fees for consulting activities and advisory boards from Acadia Pharmaceuticals, Adamas Pharmaceuticals Inc., Ceregene Inc., CHDI Management Inc., Ingenix Pharmaceutical Services (i3 Research), Neurocrine Biosciences Inc., Pfizer Inc., Tool-4-Patient, Ultragenyx Pharmaceutical, Medgenesis, and Cleveland Clinic Foundation; and has received research support from Michael J. Fox Foundation for Parkinson's Research, CHDI, Dystonia Coalition, International Parkinson and Movement Disorder Society, CBD Solution, and US Army Medical Research and Materiel Command (PR161108, Co-I, 2017-2022).SS has received fellowship training grant support from Medtronic Inc., Abbott, and Boston Scientific.The DBS team of the Academic Medical Center (MB and PVDM) received unrestricted research grants from Medtronic and financial compensation for teaching courses for the European Continued Medical Training Program. SS has received fellowship training grant support from Medtronic Inc., Abbott , and Boston Scientific . The DBS team of the Academic Medical Center (MB and PVDM) received unrestricted research grants from Medtronic and financial compensation for teaching courses for the European Continued Medical Training Program.

Keywords

Deep brain stimulation
Kinesthetic cells
Parkinson disease
Subthalamic nucleus

ASJC Scopus subject areas

Surgery
Clinical Neurology

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10.1016/j.wneu.2020.04.160

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title = "Kinesthetic Cells within the Subthalamic Nucleus and Deep Brain Stimulation for Parkinson Disease",

abstract = "Objective: We sought to determine the location of kinesthetic cell clusters within the subthalamic nucleus (STN) on magnetic resonance imaging, adjusted for interindividual anatomic variability by employing the medial STN border as a reference point. Methods: We retrospectively localized microelectrode recording−defined kinesthetic cells on 3-Tesla T2-weighted and susceptibility-weighted images in patients who underwent STN deep brain stimulation for Parkinson disease and averaged the stereotactic coordinates. These locations were calculated relative to the nonindividualized midcommissural point (MCP) and, in order to account for interindividual anatomic variability, also calculated relative to the patient-specific intersection of Bejjani line with the medial STN border. Two example patients were selected in order to visualize the discrepancies between the adjusted and nonadjusted theoretic kinesthetic cell clusters on magnetic resonance imaging. Results: Relative to the MCP, average kinesthetic cell coordinates were 12.3 ± 1.2 mm lateral, 1.7 ± 1.4 mm posterior, and 2.3 ± 1.5 mm inferior. Relative to the medial STN border, mean coordinates were 3.4 ± 1.0 mm lateral, 1.0 ± 1.4 mm anterior, and 1.7 ± 1.5 mm superior on T2-sequences, and on susceptibility-weighted images mean coordinates were 3.2 ± 1.1 mm lateral, 0.8 ± 1.5 mm anterior, and 2.1 ± 1.5 mm superior. The theoretic kinesthetic cell clusters may appear outside the sensorimotor STN when using the MCP, whereas these clusters fall well within the sensorimotor STN when employing the medial STN border as a reference point. Conclusions: By using the medial STN border as a patient-specific anatomic reference point in STN deep brain stimulation for Parkinson disease, we accounted for interindividual anatomic variability and provided accurate insight in the clustering of kinesthetic cells within the dorsolateral STN.",

keywords = "Deep brain stimulation, Kinesthetic cells, Parkinson disease, Subthalamic nucleus",

author = "Erik Bolier and Maarten Bot and {van den Munckhof}, Pepijn and Gian Pal and Sepehr Sani and Stebbins, {Glenn T.} and {Verhagen Metman}, Leo",

note = "Publisher Copyright: {\textcopyright} 2020 Elsevier Inc.",

year = "2020",

month = jul,

doi = "10.1016/j.wneu.2020.04.160",

language = "English (US)",

volume = "139",

pages = "e784--e791",

journal = "World neurosurgery",

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T1 - Kinesthetic Cells within the Subthalamic Nucleus and Deep Brain Stimulation for Parkinson Disease

AU - Bolier, Erik

AU - Bot, Maarten

AU - van den Munckhof, Pepijn

AU - Pal, Gian

AU - Sani, Sepehr

AU - Stebbins, Glenn T.

AU - Verhagen Metman, Leo

PY - 2020/7

Y1 - 2020/7

N2 - Objective: We sought to determine the location of kinesthetic cell clusters within the subthalamic nucleus (STN) on magnetic resonance imaging, adjusted for interindividual anatomic variability by employing the medial STN border as a reference point. Methods: We retrospectively localized microelectrode recording−defined kinesthetic cells on 3-Tesla T2-weighted and susceptibility-weighted images in patients who underwent STN deep brain stimulation for Parkinson disease and averaged the stereotactic coordinates. These locations were calculated relative to the nonindividualized midcommissural point (MCP) and, in order to account for interindividual anatomic variability, also calculated relative to the patient-specific intersection of Bejjani line with the medial STN border. Two example patients were selected in order to visualize the discrepancies between the adjusted and nonadjusted theoretic kinesthetic cell clusters on magnetic resonance imaging. Results: Relative to the MCP, average kinesthetic cell coordinates were 12.3 ± 1.2 mm lateral, 1.7 ± 1.4 mm posterior, and 2.3 ± 1.5 mm inferior. Relative to the medial STN border, mean coordinates were 3.4 ± 1.0 mm lateral, 1.0 ± 1.4 mm anterior, and 1.7 ± 1.5 mm superior on T2-sequences, and on susceptibility-weighted images mean coordinates were 3.2 ± 1.1 mm lateral, 0.8 ± 1.5 mm anterior, and 2.1 ± 1.5 mm superior. The theoretic kinesthetic cell clusters may appear outside the sensorimotor STN when using the MCP, whereas these clusters fall well within the sensorimotor STN when employing the medial STN border as a reference point. Conclusions: By using the medial STN border as a patient-specific anatomic reference point in STN deep brain stimulation for Parkinson disease, we accounted for interindividual anatomic variability and provided accurate insight in the clustering of kinesthetic cells within the dorsolateral STN.

AB - Objective: We sought to determine the location of kinesthetic cell clusters within the subthalamic nucleus (STN) on magnetic resonance imaging, adjusted for interindividual anatomic variability by employing the medial STN border as a reference point. Methods: We retrospectively localized microelectrode recording−defined kinesthetic cells on 3-Tesla T2-weighted and susceptibility-weighted images in patients who underwent STN deep brain stimulation for Parkinson disease and averaged the stereotactic coordinates. These locations were calculated relative to the nonindividualized midcommissural point (MCP) and, in order to account for interindividual anatomic variability, also calculated relative to the patient-specific intersection of Bejjani line with the medial STN border. Two example patients were selected in order to visualize the discrepancies between the adjusted and nonadjusted theoretic kinesthetic cell clusters on magnetic resonance imaging. Results: Relative to the MCP, average kinesthetic cell coordinates were 12.3 ± 1.2 mm lateral, 1.7 ± 1.4 mm posterior, and 2.3 ± 1.5 mm inferior. Relative to the medial STN border, mean coordinates were 3.4 ± 1.0 mm lateral, 1.0 ± 1.4 mm anterior, and 1.7 ± 1.5 mm superior on T2-sequences, and on susceptibility-weighted images mean coordinates were 3.2 ± 1.1 mm lateral, 0.8 ± 1.5 mm anterior, and 2.1 ± 1.5 mm superior. The theoretic kinesthetic cell clusters may appear outside the sensorimotor STN when using the MCP, whereas these clusters fall well within the sensorimotor STN when employing the medial STN border as a reference point. Conclusions: By using the medial STN border as a patient-specific anatomic reference point in STN deep brain stimulation for Parkinson disease, we accounted for interindividual anatomic variability and provided accurate insight in the clustering of kinesthetic cells within the dorsolateral STN.

KW - Deep brain stimulation

KW - Kinesthetic cells

KW - Parkinson disease

KW - Subthalamic nucleus

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Kinesthetic Cells within the Subthalamic Nucleus and Deep Brain Stimulation for Parkinson Disease

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