Dentate nucleus deep brain stimulation: Technical note of a novel methodology assisted by tractography.

Autor:	Diniz JM; Department of Neurology, Functional Neurosurgery Division, School of Medicine, University of São Paulo, São Paulo, Brazil., Cury RG; Department of Neurology, Movement Disorders Center, School of Medicine, University of São Paulo, São Paulo, Brazil., Iglesio RF; Department of Neurology, Functional Neurosurgery Division, School of Medicine, University of São Paulo, São Paulo, Brazil., Lepski GA; Department of Neurology, Functional Neurosurgery Division, School of Medicine, University of São Paulo, São Paulo, Brazil., França CC; Department of Neurology, Movement Disorders Center, School of Medicine, University of São Paulo, São Paulo, Brazil., Barbosa ER; Department of Neurology, Movement Disorders Center, School of Medicine, University of São Paulo, São Paulo, Brazil., de Andrade DC; Department of Neurology, Pain Center, Hospital das Clínicas FMUSP, São Paulo, Brazil., Teixeira MJ; Department of Neurology, Functional Neurosurgery Division, School of Medicine, University of São Paulo, São Paulo, Brazil., Duarte KP; Department of Neurology, Functional Neurosurgery Division, School of Medicine, University of São Paulo, São Paulo, Brazil.
Jazyk:	angličtina
Zdroj:	Surgical neurology international [Surg Neurol Int] 2021 Aug 09; Vol. 12, pp. 400. Date of Electronic Publication: 2021 Aug 09 (Print Publication: 2021).
DOI:	10.25259/SNI_338_2021
Abstrakt:	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. Competing Interests: There are no conflicts of interest. (Copyright: © 2021 Surgical Neurology International.)
Databáze:	MEDLINE
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