Structural connectivity of the ANT region based on human ex-vivo and HCP data. Relevance for DBS in ANT for epilepsy
Objective: Deep Brain Stimulation (DBS) in the Anterior Nucleus of the Thalamus (ANT) has been shown to be a safe and efficacious treatment option for patients with Drug-Resitant focal Epilepsy (DRE). The ANT has been selected frequently in open and controlled studies for bilateral DBS. There is a s...
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2022-11-01
|
| Series: | NeuroImage |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1053811922006668 |
| _version_ | 1811188468610498560 |
|---|---|
| author | Milan Majtanik Frans Gielen Volker Arnd Coenen Kai Lehtimäki Jürgen Konrad Mai |
| author_facet | Milan Majtanik Frans Gielen Volker Arnd Coenen Kai Lehtimäki Jürgen Konrad Mai |
| author_sort | Milan Majtanik |
| collection | DOAJ |
| description | Objective: Deep Brain Stimulation (DBS) in the Anterior Nucleus of the Thalamus (ANT) has been shown to be a safe and efficacious treatment option for patients with Drug-Resitant focal Epilepsy (DRE). The ANT has been selected frequently in open and controlled studies for bilateral DBS. There is a substantial variability in ANT-DBS outcomes which is not fully understood. These outcomes might not be explained by the target location alone but potentially depend on the connectivity of the mere stimulation site with the epilepsy onset-associated brain regions. The likely sub-components of this anatomy are fiber pathways which penetrate or touch the ANT region and constitute a complex and dense fiber network which has not been described so far. A detailed characterization of this ANT associated fiber anatomy may therefore help to identify which areas are associated with positive or negative outcomes of ANT-DBS. Furthermore, prediction properties in individual ANT-DBS cases might be tested. In this work we aim to generate an anatomically detailed map of candidate fiber structures which might in the future lead to a holistic image of structural connectivity of the ANT region. Methods: To resolve the various components of the complex fiber network connected to the ANT we used a synthetic pathway reconstruction method that combines anatomical fiber tracking with dMRI-based tractography and iteratively created an anatomical high-resolution fiber map representing the most important bundles related to the ANT. Results: The anatomically detailed 3D representation of the fibers in the ANT region generated with the synthetic pathway reconstruction method incorporates multiple anatomically defined fiber bundles with their course, orientation, connectivity and relative strength. Distinctive positions within the ANT region have a different hierarchical profile with respect to the stimulation-activated fiber bundles. This detailed connectivity map, which is embedded into the topographic map of the MNI brain, provides novel opportunities to analyze the outcomes of the ANT-DBS studies. Conclusion: Our synthetic reconstruction method provides the first anatomically realistic fiber pathway map in the human ANT region incorporating histological and structural MRI data. We propose that this complex ANT fiber network can be used for detailed analysis of the outcomes of DBS studies and potentially for visualization during the stimulation planning procedures. The connectivity map might also facilitate surgical planning and will help to simulate the complex ANT connectivity. Possible activation patterns that may be elicited by electrodes in different positions in the ANT region will help to understand clinically diverse outcomes based on this new dense fiber network map. As a consequence this work might in the future help to improve individual outcomes in ANT-DBS. |
| first_indexed | 2024-04-11T14:19:17Z |
| format | Article |
| id | doaj.art-96a90fcba83b41278d652e7e912743f2 |
| institution | Directory Open Access Journal |
| issn | 1095-9572 |
| language | English |
| last_indexed | 2024-04-11T14:19:17Z |
| publishDate | 2022-11-01 |
| publisher | Elsevier |
| record_format | Article |
| series | NeuroImage |
| spelling | doaj.art-96a90fcba83b41278d652e7e912743f22022-12-22T04:19:07ZengElsevierNeuroImage1095-95722022-11-01262119551Structural connectivity of the ANT region based on human ex-vivo and HCP data. Relevance for DBS in ANT for epilepsyMilan Majtanik0Frans Gielen1Volker Arnd Coenen2Kai Lehtimäki3Jürgen Konrad Mai4MRX-Brain GmbH, Moritz-Sommer-Str. 4., 40225 Duesseldorf, Germany; Department of Informatics, Heinrich Heine University of Düsseldorf, Universitätsstraße 1, 40225 Düsseldorf, GermanyMedtronic Bakken Research Center, Endepolsdomein 5, 6229 GW Maastricht, the NetherlandsDepartment of Stereotactic and Functional Neurosurgery, Medical Center of University of Freiburg,Breisacher Straße 64, 79106 Freiburg im Breisgau, Germany; Medical Faculty of the University of Freiburg, Breisacher Str. 153, 79110 Freiburg im Breisgau, GermanyDepartment of Neurosciences and Rehabilitation Tays, PO Box 2000, FI-33521 Tampere University and Tampere University Hospital, Tampere, FinlandMRX-Brain GmbH, Moritz-Sommer-Str. 4., 40225 Duesseldorf, Germany; Department of Neuroanatomy, Heinrich Heine University of Düsseldorf, Universitätsstraße 1, 40225 Düsseldorf, Germany; Corresponding author at: Moritz-Sommer-Str. 4, D-40225 Duesseldorf, Germany.Objective: Deep Brain Stimulation (DBS) in the Anterior Nucleus of the Thalamus (ANT) has been shown to be a safe and efficacious treatment option for patients with Drug-Resitant focal Epilepsy (DRE). The ANT has been selected frequently in open and controlled studies for bilateral DBS. There is a substantial variability in ANT-DBS outcomes which is not fully understood. These outcomes might not be explained by the target location alone but potentially depend on the connectivity of the mere stimulation site with the epilepsy onset-associated brain regions. The likely sub-components of this anatomy are fiber pathways which penetrate or touch the ANT region and constitute a complex and dense fiber network which has not been described so far. A detailed characterization of this ANT associated fiber anatomy may therefore help to identify which areas are associated with positive or negative outcomes of ANT-DBS. Furthermore, prediction properties in individual ANT-DBS cases might be tested. In this work we aim to generate an anatomically detailed map of candidate fiber structures which might in the future lead to a holistic image of structural connectivity of the ANT region. Methods: To resolve the various components of the complex fiber network connected to the ANT we used a synthetic pathway reconstruction method that combines anatomical fiber tracking with dMRI-based tractography and iteratively created an anatomical high-resolution fiber map representing the most important bundles related to the ANT. Results: The anatomically detailed 3D representation of the fibers in the ANT region generated with the synthetic pathway reconstruction method incorporates multiple anatomically defined fiber bundles with their course, orientation, connectivity and relative strength. Distinctive positions within the ANT region have a different hierarchical profile with respect to the stimulation-activated fiber bundles. This detailed connectivity map, which is embedded into the topographic map of the MNI brain, provides novel opportunities to analyze the outcomes of the ANT-DBS studies. Conclusion: Our synthetic reconstruction method provides the first anatomically realistic fiber pathway map in the human ANT region incorporating histological and structural MRI data. We propose that this complex ANT fiber network can be used for detailed analysis of the outcomes of DBS studies and potentially for visualization during the stimulation planning procedures. The connectivity map might also facilitate surgical planning and will help to simulate the complex ANT connectivity. Possible activation patterns that may be elicited by electrodes in different positions in the ANT region will help to understand clinically diverse outcomes based on this new dense fiber network map. As a consequence this work might in the future help to improve individual outcomes in ANT-DBS.http://www.sciencedirect.com/science/article/pii/S1053811922006668 |
| spellingShingle | Milan Majtanik Frans Gielen Volker Arnd Coenen Kai Lehtimäki Jürgen Konrad Mai Structural connectivity of the ANT region based on human ex-vivo and HCP data. Relevance for DBS in ANT for epilepsy NeuroImage |
| title | Structural connectivity of the ANT region based on human ex-vivo and HCP data. Relevance for DBS in ANT for epilepsy |
| title_full | Structural connectivity of the ANT region based on human ex-vivo and HCP data. Relevance for DBS in ANT for epilepsy |
| title_fullStr | Structural connectivity of the ANT region based on human ex-vivo and HCP data. Relevance for DBS in ANT for epilepsy |
| title_full_unstemmed | Structural connectivity of the ANT region based on human ex-vivo and HCP data. Relevance for DBS in ANT for epilepsy |
| title_short | Structural connectivity of the ANT region based on human ex-vivo and HCP data. Relevance for DBS in ANT for epilepsy |
| title_sort | structural connectivity of the ant region based on human ex vivo and hcp data relevance for dbs in ant for epilepsy |
| url | http://www.sciencedirect.com/science/article/pii/S1053811922006668 |
| work_keys_str_mv | AT milanmajtanik structuralconnectivityoftheantregionbasedonhumanexvivoandhcpdatarelevancefordbsinantforepilepsy AT fransgielen structuralconnectivityoftheantregionbasedonhumanexvivoandhcpdatarelevancefordbsinantforepilepsy AT volkerarndcoenen structuralconnectivityoftheantregionbasedonhumanexvivoandhcpdatarelevancefordbsinantforepilepsy AT kailehtimaki structuralconnectivityoftheantregionbasedonhumanexvivoandhcpdatarelevancefordbsinantforepilepsy AT jurgenkonradmai structuralconnectivityoftheantregionbasedonhumanexvivoandhcpdatarelevancefordbsinantforepilepsy |