BACKGROUND: The GPi (globus pallidus internus) is an important target nucleus for Deep Brain Stimulation (DBS) in medically refractory movement disorders, in particular dystonia and Parkinson's disease. Beneficial clinical outcome critically depends on precise electrode localization. Recent evidence indicates that not only neurons, but also axonal fibre tracts contribute to promoting the clinical effect. Thus, stereotactic planning should, in the future, also take the individual course of fibre tracts into account. OBJECTIVE: The aim of this project is to explore the GPi connectivity profile and provide a connectivity-based parcellation of the GPi. METHODS: Diffusion MRI sequences were performed in sixteen healthy, right-handed subjects. Connectivity-based parcellation of the GPi was performed applying two independent methods: 1) a hypothesis-driven, seed-to-target approach based on anatomic priors set as connectivity targets and 2) a purely data-driven approach based on k-means clustering of the GPi. RESULTS: Applying the hypothesis-driven approach, we obtained five major parcellation clusters, displaying connectivity to the prefrontal cortex, the brainstem, the GPe (globus pallidus externus), the putamen and the thalamus. Parcellation clusters obtained by both methods were similar in their connectivity profile. With the data-driven approach, we obtained three major parcellation clusters. Inter-individual variability was comparable with results obtained in thalamic parcellation. CONCLUSION: The three parcellation clusters obtained by the purely data-driven method might reflect GPi subdivision into a sensorimotor, associative and limbic portion. Clinical and physiological studies indicate greatest clinical DBS benefit for electrodes placed in the postero-ventro-lateral GPi, the region displaying connectivity to the thalamus in our study and generally attributed to the sensorimotor system. Clinical studies relating DBS electrode positions to our GPi connectivity map would be needed to complement our findings.
BACKGROUND: The GPi (globus pallidus internus) is an important target nucleus for Deep Brain Stimulation (DBS) in medically refractory movement disorders, in particular dystonia and Parkinson's disease. Beneficial clinical outcome critically depends on precise electrode localization. Recent evidence indicates that not only neurons, but also axonal fibre tracts contribute to promoting the clinical effect. Thus, stereotactic planning should, in the future, also take the individual course of fibre tracts into account. OBJECTIVE: The aim of this project is to explore the GPi connectivity profile and provide a connectivity-based parcellation of the GPi. METHODS: Diffusion MRI sequences were performed in sixteen healthy, right-handed subjects. Connectivity-based parcellation of the GPi was performed applying two independent methods: 1) a hypothesis-driven, seed-to-target approach based on anatomic priors set as connectivity targets and 2) a purely data-driven approach based on k-means clustering of the GPi. RESULTS: Applying the hypothesis-driven approach, we obtained five major parcellation clusters, displaying connectivity to the prefrontal cortex, the brainstem, the GPe (globus pallidus externus), the putamen and the thalamus. Parcellation clusters obtained by both methods were similar in their connectivity profile. With the data-driven approach, we obtained three major parcellation clusters. Inter-individual variability was comparable with results obtained in thalamic parcellation. CONCLUSION: The three parcellation clusters obtained by the purely data-driven method might reflect GPi subdivision into a sensorimotor, associative and limbic portion. Clinical and physiological studies indicate greatest clinical DBS benefit for electrodes placed in the postero-ventro-lateral GPi, the region displaying connectivity to the thalamus in our study and generally attributed to the sensorimotor system. Clinical studies relating DBS electrode positions to our GPi connectivity map would be needed to complement our findings.
Authors: Andreas Horn; Ningfei Li; Till A Dembek; Ari Kappel; Chadwick Boulay; Siobhan Ewert; Anna Tietze; Andreas Husch; Thushara Perera; Wolf-Julian Neumann; Marco Reisert; Hang Si; Robert Oostenveld; Christopher Rorden; Fang-Cheng Yeh; Qianqian Fang; Todd M Herrington; Johannes Vorwerk; Andrea A Kühn Journal: Neuroimage Date: 2018-09-01 Impact factor: 6.556
Authors: Joshua K Wong; Erik H Middlebrooks; Sanjeet S Grewal; Leonardo Almeida; Christopher W Hess; Michael S Okun Journal: Mov Disord Date: 2020-04-12 Impact factor: 10.338
Authors: Nádia Moreira da Silva; Rob Forsyth; Andrew McEvoy; Anna Miserocchi; Jane de Tisi; Sjoerd B Vos; Gavin P Winston; John Duncan; Yujiang Wang; Peter N Taylor Journal: Neuroimage Clin Date: 2020-06-26 Impact factor: 4.881
Authors: Domenico Servello; Tommaso Francesco Galbiati; Roberta Balestrino; Guglielmo Iess; Edvin Zekaj; Sara De Michele; Mauro Porta Journal: Brain Sci Date: 2020-05-15
Authors: Ka Loong Kelvin Au; Joshua K Wong; Takashi Tsuboi; Robert S Eisinger; Kathryn Moore; Janine Lemos Melo Lobo Jofili Lopes; Marshall T Holland; Vanessa M Holanda; Zhongxing Peng-Chen; Addie Patterson; Kelly D Foote; Adolfo Ramirez-Zamora; Michael S Okun; Leonardo Almeida Journal: Neurol Ther Date: 2020-11-02
Authors: Simone Zittel; Ute Hidding; Maria Trumpfheller; Vanessa Lupici Baltzer; Alessandro Gulberti; Miriam Schaper; Maxine Biermann; Carsten Buhmann; Andreas K Engel; Christian Gerloff; Manfred Westphal; Jana Stadler; Johannes A Köppen; Monika Pötter-Nerger; Christian K E Moll; Wolfgang Hamel Journal: J Neurol Date: 2020-02-17 Impact factor: 4.849