de Laurentis Camilla, Thobois Stéphane, Danaila Teodor, Laurencin Chloe, Polo Gustavo, Prange Stéphane, Simon Emile
Functional Neurosurgery Unit, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Bron, France.
Movement Disorders unit, Parkinson Expert Center, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Bron, France.
Acta Neurochir (Wien). 2025 Jul 22;167(1):199. doi: 10.1007/s00701-025-06619-z.
Accurate placement of electrodes within the subthalamic nucleus is critical for deep brain stimulation (STN-DBS) in Parkinson's disease (PD). Our objective was to compare microelectrode recording (MER) and an automatic MR-based segmentation tool (BrainLab Elements) for STN targeting and the determination of STN boundaries.
Seventy-eight PD patients were included. Electrode placement within the STN and STN entry and exit points were determined by both methods and compared for concordance.
Of 344 trajectories, 269 were inside the STN, with good concordance of both techniques (Fleiss' kappa 0.721, [95%CI 0.623, 0.819]). Concordance of MER and MR-based for the selection of the optimal trajectory was good (Fleiss' kappa 0.693, [95%CI 0.578, 0.808]), with less than 2.75mm difference between MER and MR-based for the STN entry (upper limit of agreement 2.752 [95%CI 2.365 to 3.138] mm; lower limit of agreement -2.406 [95%CI -2.793 to -2.020] mm) and exit points (upper limit of agreement 2.750 [95%CI 2.351 to 3.149] mm; lower limit of agreement -2.577mm [95%CI -2.976 to -2.178]).
We demonstrated that MER and MR-based segmentation have a good concordance to determine STN boundaries during DBS surgery.
在帕金森病（PD）的脑深部电刺激（STN-DBS）中，将电极精确放置在丘脑底核内至关重要。我们的目的是比较微电极记录（MER）和基于磁共振成像的自动分割工具（BrainLab Elements）在丘脑底核靶向定位及确定丘脑底核边界方面的效果。
纳入78例帕金森病患者。通过两种方法确定电极在丘脑底核内的放置位置以及丘脑底核的出入点，并比较两者的一致性。
在344条轨迹中，269条位于丘脑底核内，两种技术的一致性良好（Fleiss' kappa系数为0.721，[95%置信区间0.623, 0.819]）。MER和基于磁共振成像的方法在选择最佳轨迹方面的一致性良好（Fleiss' kappa系数为0.693，[95%置信区间0.578, 0.808]），丘脑底核入口处MER与基于磁共振成像的方法之间的差异小于2.75mm（一致性上限为2.752 [95%置信区间2.365至3.138] mm；一致性下限为-2.406 [95%置信区间-2.793至-2.020] mm），出口处差异情况为（一致性上限为2.750 [95%置信区间2.351至3.149] mm；一致性下限为-2.577mm [95%置信区间-2.976至-2.178]）。
我们证明了在脑深部电刺激手术中，MER和基于磁共振成像的分割方法在确定丘脑底核边界方面具有良好的一致性。
