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首页> 美国卫生研究院文献>ISRN Neurology >Computed Three-Dimensional Atlas of Subthalamic Nucleus and Its Adjacent Structures for Deep Brain Stimulation in Parkinsons Disease
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Computed Three-Dimensional Atlas of Subthalamic Nucleus and Its Adjacent Structures for Deep Brain Stimulation in Parkinsons Disease

机译：丘脑下核的三维三维图谱及其邻近结构用于帕金森氏病的深部脑刺激

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Background. Deep brain stimulation (DBS) of the subthalamic nucleus (STN) is one of the standard surgical treatments for advanced Parkinson's disease. However, it has been difficult to accurately localize the stimulated contact area of the electrode in the subthalamic nucleus and its adjacent structures using a two-dimensional atlas. The goal of this study is to verify the real and detailed localization of stimulated contact of the DBS electrode therapeutically inserted into the STN and its adjacent structures using a novel computed three-dimensional atlas built by a personal computer. Method. A three-dimensional atlas of the STN and its adjacent structures (3D-Subthalamus atlas) was elaborated on the basis of sagittal slices from the Schaltenbrand and Wahren stereotactic atlas on a personal computer utilizing a commercial software. The electrode inserted into the STN and its adjacent structures was superimposed on our 3D-Subthalamus atlas based on intraoperative third ventriculography in 11 cases. Findings. Accurate localization of the DBS electrode was identified using the 3D-Subthalamus atlas, and its clinical efficacy of the electrode stimulation was investigated in all 11 cases. Conclusion. This study demonstrates that the 3D-Subthalamus atlas is a useful tool for understanding the morphology of deep brain structures and for the precise anatomical position findings of the stimulated contact of a DBS electrode. The clinical analysis using the 3D atlas supports the contention that the stimulation of structures adjacent to the STN, particularly the zona incerta or the field of Forel H, is as effective as the stimulation of the STN itself for the treatment of advanced Parkinson's disease.
机译：背景。丘脑底核（STN）的深部脑刺激（DBS）是晚期帕金森氏病的标准外科治疗方法之一。然而，使用二维图谱难以精确地将电极的受激接触区域定位在丘脑下核及其邻近结构中。这项研究的目的是使用由个人计算机建立的新型计算三维地图集，来验证治疗性插入STN及其邻近结构的DBS电极的受激接触的真实而详细的定位。方法。在使用商用软件的个人计算机上，根据Schaltenbrand和Wahren立体定位图集的矢状切面，制作了STN及其相邻结构的三维图集（3D-丘脑下部图集）。根据术中第三心室描记法，将插入STN及其相邻结构的电极叠加在我们的3D-丘脑下地图集上，共有11例。发现。使用3D-丘脑下部地图集确定了DBS电极的准确定位，并在所有11例病例中研究了其电极刺激的临床效果。结论。这项研究表明，3D-丘脑下部图谱是了解深部大脑结构的形态以及DBS电极受激接触的精确解剖位置发现的有用工具。使用3D地图集的临床分析支持以下论点：刺激STN邻近的结构（特别是不透明带或Forel H视野）与刺激STN本身在治疗晚期帕金森氏病方面一样有效。

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