Evidence map›Paper›PMID 38422832›Full record

ArticleNeuroImage. Clinical2024

Connectivity-based segmentation of the thalamic motor region for deep brain stimulation in essential tremor: A comparison of deterministic and probabilistic tractography.

Evangelia Tsolaki, Alon Kashanian, Kevin Chiu, Ausaf Bari, Nader Pouratian

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Article in NeuroImage. Clinical, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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1citing papers in PubMed
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1 citing paper in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

5 authors.

Evangelia TsolakiDepartment of Neurosurgery, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA. Electronic address: etsolaki@mednet.ucla.edu.
Alon KashanianDepartment of Neurosurgery, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA.
Kevin ChiuBrainlab, Inc., 5 Westbrook Corporate Center, Suite 1000, Westchester, IL 60154, USA.
Ausaf BariDepartment of Neurosurgery, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.
Nader PouratianDepartment of Neurological Surgery, UT Southwestern Medical Center, Dallas, TX, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveDeep brain stimulation (DBS) studies have shown that stimulation of the motor segment of the thalamus based on probabilistic tractography is predictive of improvement in essential tremor (ET). However, probabilistic methods are computationally demanding, requiring the need for alternative tractography methods for use in the clinical setting. The purpose of this study was to compare probabilistic vs deterministic tractography methods for connectivity-based targeting in patients with ET.

methodsProbabilistic and deterministic tractography methods were retrospectively applied to diffusion-weighted data sets in 36 patients with refractory ET. The thalamus and precentral gyrus were selected as regions of interest and fiber tracking was performed between these regions to produce connectivity-based thalamic segmentations, per prior methods. The resultant deterministic target maps were compared with those of thresholded probabilistic maps. The center of gravity (CG) of each connectivity map was determined and the differences in spatial distribution between the tractography methods were characterized. Furthermore, the intersection between the connectivity maps and CGs with the therapeutic volume of tissue activated (VTA) was calculated. A mixed linear model was then used to assess clinical improvement in tremor with volume of overlap.

resultsBoth tractography methods delineated the region of the thalamus with connectivity to the precentral gyrus to be within the posterolateral aspect of the thalamus. The average CG of deterministic maps was more medial-posterior in both the left (3.7 ± 1.3 mm

conclusionsDeterministic tractography can reconstruct DBS thalamic target maps in approximately 5 min comparable to those produced by probabilistic methods that require > 12 h to generate. Despite differences in CG between the methods, both deterministic-based and probabilistic targeting were predictive of clinical improvement in ET.

Indexed as

Deep Brain StimulationEssential TremorHumansRetrospective StudiesThalamusTremorDeep brain stimulationDeterministicDiffusion tractographyEssential tremorProbabilisticThalamus

Identifiers

PMID38422832
PMCPMC10944185

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