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Anatomo-clinical atlases correlate clinical data and electrode contact coordinates: application to subthalamic deep brain stimulation.
Lalys F., Haegelen C., Maroua M., Drapier S., Verin M., Jannin P.
Journal of Neuroscience Methods 212, 2 (2013) 297-307 - http://www.hal.inserm.fr/inserm-00750921
Anatomo-clinical atlases correlate clinical data and electrode contact coordinates: application to subthalamic deep brain stimulation.
Florent Lalys () 1, Claire Haegelen1, 2, Mehri Maroua1, Sophie Drapier3, Marc Verin3, Pierre Jannin1, 3
1 :  LTSI - Laboratoire Traitement du Signal et de l'Image
INSERM : U1099 – Université de Rennes 1
Campus Universitaire de Beaulieu - Bât 22 - 35042 Rennes
2 :  Service de neurochirurgie [Rennes]
Hôpital Pontchaillou – Université de Rennes 1 – CHU Rennes
2 rue Henri Le Guilloux 35033 RENNES cedex 9
3 :  Service de Neurologie [Rennes]
Hôpital Pontchaillou – CHU Rennes – Université de Rennes 1
2 Rue Henri Le Guilloux 35033 Rennes Cedex 9
For patients suffering from Parkinson's disease with severe movement disorders, functional surgery may be required when medical therapy is not effective. In Deep Brain Stimulation (DBS), electrodes are implanted within the brain to stimulate deep structures such as SubThalamic Nucleus (STN). The quality of patient surgical outcome is generally related to the accuracy of nucleus targeting during surgery. In this paper, we focused on identifying optimum sites for STN DBS by studying symptomatic motor improvement along with neuropsychological side effects. We described successive steps for constructing digital atlases gathering patient's location of electrode contacts automatically segmented from postoperative images, and clinical scores. Three motor and five neuropsychological scores were included in the study. Correlations with active contact locations were carried out using an adapted hierarchical ascendant classification. Such analysis enabled the extraction of representative clusters to determine the optimum site for therapeutic STN DBS. For each clinical score, we built an anatomo-clinical atlas representing its improvement or deterioration in relation with the anatomical location of electrodes and from a population of implanted patients. To the best of our knowledge, we reported for the first time a discrepancy between a very good motor improvement by targeting the postero-superior region of the STN and an inevitable deterioration of the categorical and phonemic fluency in the same region. Such atlases and associated analysis may help better understanding of functional mapping in deep structures and may help pre-operative decision-making process and especially targeting.
Sciences du Vivant/Neurosciences
Sciences du Vivant/Ingénierie biomédicale/Imagerie
Sciences de l'ingénieur/Traitement du signal et de l'image
Informatique/Traitement du signal et de l'image

Articles dans des revues avec comité de lecture
Journal of Neuroscience Methods (J Neurosci Methods)
Publisher Elsevier
ISSN 0165-0270 

Deep brain stimulation – Parkinson disease – anatomo-clinical atlas – medical imaging
Anatomy – Regional – Atlases as Topic – Deep Brain Stimulation – Electrodes – Implanted – Female – Humans – Male – Middle Aged – Parkinson Disease – Subthalamic Nucleus
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