丘脑前区白质束的高角度分辨率弥散加权成像和高阶束成像:对深部脑刺激目标定位的启示

Q4 Neuroscience
Ruhunur Özdemir , Kai Lehtimäki , Eetu Siitama , Timo Möttönen , Joonas Haapasalo , Soila Järvenpää , Hannu Eskola , Jukka Peltola
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引用次数: 0

摘要

背景丘脑前核(ANT)深部脑刺激疗法是欧盟/美国批准的治疗耐药性局灶性癫痫的新兴疗法。其作用机制尚不完全清楚,与运动障碍等疾病相比,癫痫患者的疗效似乎不太一致。此外,目前指导 DBS 治疗的基于解剖学的信息(如相关纤维系统的牵引图)非常少。目的 在健康志愿者中使用基于确定性和概率性牵引图的多壳/多组织约束球形解卷积(MSMT-CSD),利用 3T 高角度分辨率扩散加权成像(HARDI)数据的复杂扫描方案,在体内展示基于组织学的 ANT 相关纤维系统。方法在西门子 MAGNETOM Skyra 3T 磁共振成像(MRI)机上使用多个 b 值(1000、2000 和 3000)和 64 个方向采集了五名健康志愿者的 HARDI 数据,并对其进行了进一步的预处理,以进行牵引成像。根据现有文献,对选定的纤维系统进行了基于 MSMT-CSD 的确定性和概率性束成像:结果发现了多个纤维系统:丘脑前辐射(ANT)、丘脑-扣带回束、丘脑下蒂(在杏仁核、腹侧被盖区和枕叶皮层有远端终止区)和乳突丘脑束。此外,我们还观察到与海马的三条平行连接(通过钟摆束、穹窿和颞下-丘脑通路)。有趣的是,模拟 DBS 接触位置的 ANT 复合体中的不同种子区域导致了不同纤维系统的可视化。讨论 ANT 的连接非常复杂,不同的刺激位置可能会影响不同的网络,这取决于导联位置和主动接触的选择。本文提出了受不同 DBS 导联接触位置影响的神经元网络的假设模型。更深入地了解神经解剖学特征可指导立体定向植入和后续编程,从而优化疗效。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
High angular resolution diffusion-weighted imaging and higher order tractography of the white matter tracts in the anterior thalamic area: Insights into deep brain stimulation targeting

Background

Deep brain stimulation of the anterior nucleus of the thalamus (ANT) is emerging EU/US-approved form of therapy for drug-resistant focal epilepsy. Its mechanism of action is not yet fully understood, and the patient outcomes in epilepsy appear less consistent compared to for instance movement disorders. Furthermore, very little anatomy-based information, such as tractography of relevant fiber systems, exists guiding DBS therapy at present.

Objective

To demonstrate ANT-related fiber systems based on histology in vivo employing multi-shell/multi-tissue constrained spherical deconvolution (MSMT-CSD) based deterministic and probabilistic tractography using a sophisticated scanning protocol of 3T high angular resolution diffusion-weighted imaging (HARDI) data in healthy volunteers.

Method

HARDI data was acquired from five healthy volunteers in a 3T Siemens MAGNETOM Skyra Magnetic resonance imaging (MRI) machine using multiple b-values (1000, 2000, and 3000), 64 directions, and further preprocessed for tractography. MSMT-CSD-based deterministic and probabilistic tractography was performed from selected fiber systems based on existing literature.

Results

Multiple fiber systems were identified: The anterior thalamic radiation (ANT), the thalamo-cingulate tract, the inferior thalamic peduncle (with remote termination areas in the amygdala, the ventral tegmental area, and the occipital cortex), and the mammillothalamic tract. In addition, we observed three parallel connections to the hippocampus (via the cingulum bundle, the fornix, and the temporo-pulvinar pathway). Interestingly, different seed areas in ANT complex mimicking DBS contact locations resulted in visualization of different fiber systems.

Discussion

The connections of the ANT are complex and different stimulation sites are likely to affect different networks depending on lead locations and the selection of the active contact.

Conclusions

In-depth understanding of the network of anatomical structures related to the ANT is likely to influence therapy outcomes. A hypothetical model of neuronal networks affected by different DBS lead contact locations is proposed. A more profound understanding of neuroanatomic characteristics may guide stereotactic implantation and subsequent programming to optimize outcomes.

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来源期刊
Neuroimage. Reports
Neuroimage. Reports Neuroscience (General)
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