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首页> 外文期刊>Journal of Neuroscience Methods >Anatomo-clinical atlases correlate clinical data and electrode contact coordinates: Application to subthalamic deep brain stimulation
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Anatomo-clinical atlases correlate clinical data and electrode contact coordinates: Application to subthalamic deep brain stimulation

机译：解剖临床图谱将临床数据与电极接触坐标相关联：在丘脑深部脑刺激中的应用

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For patients suffering from Parkinson's disease with severe movement disorders, functional surgery may be required when medical therapy is not effective. In Deep Brain Stimulation (DBS), electrodes are implanted within the brain to stimulate deep structures such as SubThalamic Nucleus (STN). The quality of patient surgical outcome is generally related to the accuracy of nucleus targeting during surgery. In this paper, we focused on identifying optimum sites for STN DBS by studying symptomatic motor improvement along with neuropsychological side effects. We described successive steps for constructing digital atlases gathering patient's location of electrode contacts automatically segmented from postoperative images, and clinical scores. Three motor and five neuropsychological scores were included in the study. Correlations with active contact locations were carried out using an adapted hierarchical ascendant classification. Such analysis enabled the extraction of representative clusters to determine the optimum site for therapeutic STN DBS. For each clinical score, we built an anatomo-clinical atlas representing its improvement or deterioration in relation with the anatomical location of electrodes and from a population of implanted patients. To the best of our knowledge, we reported for the first time a discrepancy between a very good motor improvement by targeting the postero-superior region of the STN and an inevitable deterioration of the categorical and phonemic fluency in the same region. Such atlases and associated analysis may help better understanding of functional mapping in deep structures and may help pre-operative decision-making process and especially targeting. ? 2012 Elsevier B.V.
机译：对于患有严重运动障碍的帕金森氏病的患者，如果药物治疗无效，则可能需要进行功能性手术。在深部脑刺激（DBS）中，将电极植入大脑内以刺激深丘脑膜，例如丘脑膜下核（STN）。患者手术结局的质量通常与手术期间核靶向的准确性有关。在本文中，我们通过研究症状性运动改善以及神经心理副作用，致力于确定STN DBS的最佳部位。我们描述了构建数字地图集的连续步骤，这些数字地图集收集了患者的电极触点位置，这些位置会从术后图像和临床评分中自动分割出来。该研究包括三个运动评分和五个神经心理学评分。与活动接触位置的相关性使用适应性的分层上升分类进行。这种分析使得能够提取代表性簇来确定治疗性STN DBS的最佳部位。对于每个临床评分，我们建立了一个解剖-临床图集，表示其相对于电极的解剖位置以及来自植入患者群体的改善或恶化。据我们所知，我们首次报告了以STN的后上方区域为目标的非常好的运动改善与同一区域的分类和语音流利度的必然下降之间的差异。这样的地图集和相关分析可能有助于更好地理解深层结构中的功能映射，并可能有助于术前决策过程，尤其是目标确定。 ？ 2012年Elsevier B.V.

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