自动瞄准背外侧丘脑下核进行功能连接引导的经颅磁刺激疗法

Ageing and neurodegenerative diseases Pub Date : 2024-05-13 DOI:10.20517/and.2023.31

N. Zhao, Yang Qiao, J. Yue, Ying Jing, Qiu Ge, Meng Zhang, Jianguo Zhang, Yuan Zhen, Yu-Tao Xiang, Jue Wang, Yuding Zang

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引用次数: 0

摘要

目的：许多静息态功能磁共振成像（rs-fMRI）研究证明，重复经颅磁刺激（rTMS）是通过从浅层刺激靶点到深层有效区域的功能连接（FC）发挥治疗效果的。在帕金森病（PD）的深部脑刺激手术中，背外侧丘脑下核（DL-STN）是一个有效靶点，但其靶点选择高度依赖于训练有素的神经外科医生，且不易用于 FC 引导的经颅磁刺激。我们的目的是设计一种自动定位 DL-STN 的方法，并进一步开发一种一站式 rs-fMRI FC 分析插件，以协助未来的个体化 FC 引导经颅磁刺激。研究方法根据78名参与者的结构和铁敏感核磁共振成像，由两名评分员确定DL-STN坐标，其可靠性非常高。标准蒙特利尔神经研究所（MNI）空间中的平均坐标为：左侧 DL-STN，x：-11.89 ± 0.82，y：-14.51 ± 1.00：-14.51±1.00，z：-6.40±1.01；右侧 DL-STN，x：12.53±0.77，y：-13.97±0.86：-13.97±0.86，z：-6.57±0.99。由于所有 78 名参与者与平均坐标的单个距离均小于 3 毫米（对于大多数 rs-fMRI 研究而言，均小于一个体素），因此我们将平均坐标定义为 AutoSTN。然后，我们开发了一个名为 "连接性和坐标转换助手工具箱（CC-CAT）"的一站式插件，并进行了 AutoSTN FC 分析。结果显示在所有参与者中，AutoSTN 种子与运动皮层均显示出明显的 FC。结论基于AutoSTN的rs-fMRI FC可以指导未来对帕金森病的经颅磁刺激。一站式插件 CC-CAT 可用于任何 FC 指导的经颅磁刺激治疗。

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Automatically targeting the dorsolateral subthalamic nucleus for functional connectivity-guided rTMS therapy

Aim: Many resting-state functional magnetic resonance imaging (rs-fMRI) studies have provided evidence that repetitive transcranial magnetic stimulation (rTMS) exerts treatment effects via functional connectivity (FC) from a superficial stimulation target to a deep effective region. The dorsolateral subthalamic nucleus (DL-STN) is an effective target in deep brain stimulation surgery for Parkinson’s disease (PD), but its targeting highly depends on well-trained neurosurgeons and is not easily used for FC-guided rTMS. We aimed to devise a method for automatically localizing the DL-STN, and further develop a one-stop plug-in of rs-fMRI FC analysis to assist future individualized FC-guided rTMS. Methods: Based on structural and iron-sensitive MRI of 78 participants, two raters defined the DL-STN coordinates with very high reliability. The averaged coordinates in the standard Montreal Neurological Institute (MNI) space were: left DL-STN, x: -11.89 ± 0.82, y: -14.51 ± 1.00, and z: -6.40 ± 1.01 and the right DL-STN, x: 12.53 ± 0.77, y: -13.97 ± 0.86, and z: -6.57 ± 0.99. As the individual distances from the averaged coordinates were less than 3 mm (within one voxel for most rs-fMRI studies) for all 78 participants, we defined the average coordinates as AutoSTN. We then developed a one-stop plug-in named Connectivity and Coordinates Converting Assistant Toolbox (CC-CAT) and performed AutoSTN FC analysis. Results: The AutoSTN seed showed significant FC with the motor cortices in all participants. Conclusion: The AutoSTN-based rs-fMRI FC could guide future rTMS on PD. The one-stop plug-in CC-CAT can be used for any FC-guided rTMS treatment.

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Ageing and neurodegenerative diseases

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