Iron concentration linked to structural connectivity in the subthalamic nucleus: implications for deep brain stimulation

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  • 1 Weill Medical College of Cornell University, New York;
  • 2 Meinig School of Biomedical Engineering, Cornell University, Ithaca;
  • 3 Department of Radiology, Icahn School of Medicine at Mount Sinai, New York;
  • 4 The City College of the City University of New York, New York;
  • 5 Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China;
  • 6 Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York; and
  • 7 Departments of Neurosurgery, Neurology, Psychiatry, and Neuroscience, Icahn School of Medicine at Mount Sinai, New York, New York
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OBJECTIVE

The objective of this study was to investigate the relationship between iron and white matter connectivity in the subthalamic nucleus (STN) in patients undergoing deep brain stimulation (DBS) of the STN for treatment of Parkinson’s disease.

METHODS

Nine Parkinson’s disease patients underwent preoperative 3T MRI imaging which included acquisition of T1-weighted anatomical images along with diffusion tensor imaging (DTI) and quantitative susceptibility mapping (QSM). MR tractography was performed for the seed voxels located within the STN, and the correlations between normalized QSM values and the STN’s connectivity to a set of a priori chosen regions of interest were assessed.

RESULTS

A strong negative correlation was found between STN connectivity and QSM intensity for the thalamus, premotor, motor, and sensory regions, while a strong positive correlation was found for frontal, putamen, and brain stem areas.

CONCLUSIONS

Quantitative susceptibility mapping not only accurately delineates the STN borders but is also able to provide functional information about the STN functional subdivisions. The observed iron-to-connectivity correlation patterns may aid in planning DBS surgery to avoid unwanted side effects associated with DBS.

ABBREVIATIONS DBS = deep brain stimulation; DTI = diffusion tensor imaging; PD = Parkinson’s disease; QSM = quantitative susceptibility mapping; ROI = region of interest; STN = subthalamic nucleus.

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Contributor Notes

Correspondence Brian H. Kopell: Icahn School of Medicine at Mount Sinai, New York, NY. brian.kopell@mountsinai.org.

INCLUDE WHEN CITING Published online January 18, 2019; DOI: 10.3171/2018.8.JNS18531.

Disclosures Dr. Wang reports ownership of Medimagemetric, LLC. Dr. Kopell reports consultant relationships with Medtronic and Abbott Neuromodulation.

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