TY - JOUR
T1 - Dentate nucleus deep brain stimulation
T2 - Technical note of a novel methodology assisted by tractography
AU - Diniz, Juliete Melo
AU - Cury, Rubens Gisbert
AU - Iglesio, Ricardo Ferrareto
AU - Lepski, Guilherme Alves
AU - França, Carina Cura
AU - Barbosa, Egberto Reis
AU - de Andrade, Daniel Ciampi
AU - Teixeira, Manoel Jacobsen
AU - Duarte, Kleber Paiva
N1 - Copyright: © 2021 Surgical Neurology International.
PY - 2021
Y1 - 2021
N2 - Background: The cerebellum has emerged as an attractive and promising target for neuromodulation in movement disorders due to its vast connection with important cortical and subcortical areas. Here, we describe a novel technique of deep brain stimulation (DBS) of the dentate nucleus (DN) aided by tractography.Methods: Since 2015, patients with movement disorders including dystonia, ataxia, and tremor have been treated with DN DBS. The cerebellar target was initially localized using coordinates measured from the fastigial point. The target was adjusted with direct visualization of the DN in the susceptibility-weighted imaging and T2 sequences of the MRI and finally refined based on the reconstruction of the dentatorubrothalamic tract (DRTT).Results: Three patients were treated with this technique. The final target was located in the anterior portion of DN in close proximity to the DRTT, with the tip of the lead on the white matter and the remaining contacts on the DN. Clinical outcomes were variable and overall positive, with no major side effect.Conclusion: Targeting the DN based on tractography of the DRTT seems to be feasible and safe. Larger studies will be necessary to support our preliminary findings.
AB - Background: The cerebellum has emerged as an attractive and promising target for neuromodulation in movement disorders due to its vast connection with important cortical and subcortical areas. Here, we describe a novel technique of deep brain stimulation (DBS) of the dentate nucleus (DN) aided by tractography.Methods: Since 2015, patients with movement disorders including dystonia, ataxia, and tremor have been treated with DN DBS. The cerebellar target was initially localized using coordinates measured from the fastigial point. The target was adjusted with direct visualization of the DN in the susceptibility-weighted imaging and T2 sequences of the MRI and finally refined based on the reconstruction of the dentatorubrothalamic tract (DRTT).Results: Three patients were treated with this technique. The final target was located in the anterior portion of DN in close proximity to the DRTT, with the tip of the lead on the white matter and the remaining contacts on the DN. Clinical outcomes were variable and overall positive, with no major side effect.Conclusion: Targeting the DN based on tractography of the DRTT seems to be feasible and safe. Larger studies will be necessary to support our preliminary findings.
U2 - 10.25259/SNI_338_2021
DO - 10.25259/SNI_338_2021
M3 - Journal article
C2 - 34513166
SN - 2229-5097
VL - 12
JO - Surgical Neurology International
JF - Surgical Neurology International
M1 - 400
ER -