Application of Diffusion Tensor Imaging (DTI) Tractography as a Targeting Modality for Deep Brain Stimulation (DBS) of the Subthalamic Nucleus (STN)
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- Watanabe Mitsuru
- Divisions of Neurosurgery Department of Neurological Surgery, Nihon University School of Medicine
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- Sumi Koichiro
- Divisions of Neurosurgery Department of Neurological Surgery, Nihon University School of Medicine
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- Obuchi Toshiki
- Divisions of Neurosurgery Department of Neurological Surgery, Nihon University School of Medicine
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- Shijo Katsunori
- Divisions of Neurosurgery Department of Neurological Surgery, Nihon University School of Medicine
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- Kano Toshikazu
- Divisions of Neurosurgery Department of Neurological Surgery, Nihon University School of Medicine
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- Kobayashi Kazutaka
- Divisions of Neurosurgery Department of Neurological Surgery, Nihon University School of Medicine
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- Oshima Hideki
- Divisions of Neurosurgery Department of Neurological Surgery, Nihon University School of Medicine
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- Fukaya Chikashi
- Divisions of Neurosurgery Applied System Neuroscience, Department of Neurological Surgery, Nihon University School of Medicine
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- Yoshino Atsuo
- Divisions of Neurosurgery Department of Neurological Surgery, Nihon University School of Medicine
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- Yamamoto Takamitsu
- Divisions of Neurosurgery Applied System Neuroscience, Department of Neurological Surgery, Nihon University School of Medicine
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- Katayama Yoichi
- Divisions of Neurosurgery Department of Neurological Surgery, Nihon University School of Medicine
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Introduction: We carried out diffusion tensor imaging (DTI) to detect the corticospinal tract (CST) during deep brain stimulation (DBS) of the subthalamic nucleus (STN), and we examined whether CST-based targeting could provide reliable internal fiducial markers for STN-DBS. Materials and Methods: Twenty-eight patients underwent bilateral simultaneous implantation of DBS electrodes for STN-DBS. We calculated the absolute values of the differences in the coordinates between the implanted DBS electrodes and the CST demonstrated by tractography in each patient at the level 3 mm inferior to the superior border of the red nucleus (RN). We also compared the distance between the implanted DBS electrodes and the estimated target points planned by RN-based and CST-based targeting. Results: The average distance from the center of the CST to the center of the implanted DBS electrode was 7.0 ± 2.3 mm in the x-direction, 2.1 ± 1.3 mm in the y-direction, and -4.3 ± 1.4 mm from the level of the AC-PC line as the z-coordinate. The average distance between the DBS electrode and planned targets estimated by RNbased targeting was 2.5 ± 1.1 mm, and that estimated by CST-based targeting was 3.9 ± 1.6 mm. The variances of these planned targets were not significantly different (p = 0.06, Mann-Whitney U-test). Conclusions: The stereotactic coordinates between the target points of STN and CST were confirmed by CSTbased targeting in this study. The results were not significantly different between RN-based targeting and DTIbased targeting for STN-DBS. The DTI-based targeting method using an internal fiducial marker has a possibility to become a powerful tool in stereotactic surgery.
収録刊行物
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- 日大医学雑誌
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日大医学雑誌 74 (2), 63-68, 2015
日本大学医学会
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詳細情報 詳細情報について
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- CRID
- 1390282681409068160
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- NII論文ID
- 130005120285
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- NII書誌ID
- AN0018408X
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- ISSN
- 18840779
- 00290424
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- NDL書誌ID
- 026411106
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- 本文言語コード
- ja
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- データソース種別
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- JaLC
- NDL
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