A three-dimensional histological atlas of the human basal ganglia. II. Atlas deformation strategy and evaluation in deep brain stimulation for Parkinson disease

• Published in: Journal of neurosurgery Vol. 110; no. 2; pp. 208 - 219
• Main Authors: Bardinet, Eric, Bhattacharjee, Manik, Dormont, Didier, Pidoux, Bernard, Malandain, Grégoire, Schüpbach, Michael, Ayache, Nicholas, Cornu, Philippe, Agid, Yves, Yelnik, Jérôme
• Format: Journal Article
• Language: English
• Published: United States American Association of Neurological Surgeons 01-02-2009
• Subjects: Basal Ganglia - pathology; Basal Ganglia - physiopathology; Bioengineering; Brain Mapping - methods; Computer Science; Deep Brain Stimulation - methods; Engineering Sciences; Humans; Image Interpretation, Computer-Assisted - methods; Imaging; Imaging, Three-Dimensional - methods; Life Sciences; Magnetic Resonance Imaging - methods; Medical Illustration; Medical Imaging; Microelectrodes; Microscopy; Modeling and Simulation; Parkinson Disease - pathology; Parkinson Disease - therapy; Red Nucleus - pathology; Red Nucleus - physiopathology; Sensitivity and Specificity; Signal and Image processing; Substantia Nigra - pathology; Substantia Nigra - physiopathology; Subthalamic Nucleus - pathology; Subthalamic Nucleus - physiopathology; Microelectrodes; pathology; Imaging Three-Dimensional; Subthalamic Nucleus; Substantia Nigra; methods; Humans; Image Interpretation Computer-Assisted; Red Nucleus; Parkinson Disease; Magnetic Resonance Imaging; Microscopy; Sensitivity and Specificity; Deep Brain Stimulation; Brain Mapping; Basal Ganglia; Medical Illustration
• ISSN: 0022-3085
• DOI: 10.3171/2008.3.17469

The localization of any given target in the brain has become a challenging issue because of the increased use of deep brain stimulation to treat Parkinson disease, dystonia, and nonmotor diseases (for example, Tourette syndrome, obsessive compulsive disorders, and depression). The aim of this study was to develop an automated method of adapting an atlas of the human basal ganglia to the brains of individual patients.
Magnetic resonance images of the brain specimen were obtained before extraction from the skull and histological processing. Adaptation of the atlas to individual patient anatomy was performed by reshaping the atlas MR images to the images obtained in the individual patient using a hierarchical registration applied to a region of interest centered on the basal ganglia, and then applying the reshaping matrix to the atlas surfaces.
Results were evaluated by direct visual inspection of the structures visible on MR images and atlas anatomy, by comparison with electrophysiological intraoperative data, and with previous atlas studies in patients with Parkinson disease. The method was both robust and accurate, never failing to provide an anatomically reliable atlas to patient registration. The registration obtained did not exceed a 1-mm mismatch with the electrophysiological signatures in the region of the subthalamic nucleus.
This registration method applied to the basal ganglia atlas forms a powerful and reliable method for determining deep brain stimulation targets within the basal ganglia of individual patients.