ArticleActa neurochirurgica2025
How accurate is probabilistic tractography when used to predict the "sweet spot" in deep brain stimulation? Mind the gap!
Article in Acta neurochirurgica, 2025. 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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Who cites it
1 citing paper in PubMed.
- State-of-the-Art Imaging and Localization Assessment in Post-Operative Deep Brain Stimulation for Parkinson's Disease: A Review.Stereotactic and functional neurosurgery · 2026Review
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9 authors.
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Abstract
backgroundTractography has been used in various studies with respect to the improvement of patient-specific DBS targeting. Nevertheless, methodological influences of the chosen parameters and associated errors are often neglected. The aim of this study was to estimate concrete errors associated with specific image processing steps when using measurements of distances to specific subcortical fiber tracts to predict optimal stimulation sites for DBS targeting.
methodProbabilistic tractography of the crossing and non-decussating part of the dentato-rubro-thalamic-tract (c-/ nd-DRTT) was performed using FSL 6.0.3 in 40 PD- and ET-patients having received bilateral DBS surgery. DBS-electrodes were reconstructed using LeadDBS. The influence of (1) the choice of threshold for binarization of fiber tracts, (2) manual measurements compared to measurements using automized distance maps and (3) normalization into the MNI standard space on measured distances were investigated.
resultsDifferent thresholds for binarization resulted in non-linear and unpredictable variations of measured distances up to 1.72 ± 1.49 mm (mean value ± standard deviation). Manual measurements on the axial slice of the electrode contact showed a mean error of 0.91 ± 1.36 mm (maximum 14.9 mm) compared to automated measurements. Regarding normalization, a mean error of 0.82 ± 0.50 mm (maximum 2.34 mm) was found compared to measurements in native space.
conclusionMeasured maximum errors reach up to several millimeters, which might have significant impact on clinical targeting in DBS. Researchers should be aware of these errors and define individual standards for specific studies.
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