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J Neurol Surg A Cent Eur Neurosurg 2014; 75(04): 289-298
DOI: 10.1055/s-0034-1368093
Original Article
Georg Thieme Verlag KG Stuttgart · New York

Stereotactic Anatomy of the Human Subthalamic Nucleus: Providing Coordinates for Accurate Electrode Placement

Ioannis Mavridis
1   Department of Anatomy, University of Athens School of Medicine, Athens, Greece
,
Efstathios Boviatsis
2   2nd Department of Neurosurgery, University of Athens School of Medicine, Attikon Hospital, Athens, Greece
,
Sophia Anagnostopoulou
1   Department of Anatomy, University of Athens School of Medicine, Athens, Greece
› Author Affiliations
Further Information

Publication History

03 April 2013

02 October 2013

Publication Date:
25 February 2014 (online)

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Abstract

Background and Study Aims Stereotactic targeting of the subthalamic nucleus (STN) for insertion of deep brain stimulation (DBS) electrodes became popular in the last two decades. We present a study focused on the detailed stereotactic anatomy of the STN with respect to its targeting.

Material and Methods We used cerebral magnetic resonance (MR) images from 26 patients (50 STNs) for the imaging study. The material of the anatomical study consisted of 24 cerebral hemispheres (24 STNs) from 16 normal human brains. We measured and analyzed the X, X′, Y, Y′, and Z, Z′ stereotactic coordinates of the STN at specific clinically important transverse, coronal, and sagittal planes.

Results The STN extended almost 1.5 mm more lateral and almost 1 mm more posterior in patients  < 60 years of age. The Y coordinate was more posterior and the X coordinate more lateral on MRI than in anatomical specimens. The left STN was located more lateral than the right STN. Analyzing our data we found a standard coronal zone 1.1 mm wide (zone T), a standard coronal plane (thus providing the most accurate Y target coordinate, plane M), and a standard transverse area (area C) for accurate right STN targeting.

Conclusions Our study offers new insights into the stereotactic anatomy of the human STN. These data should be taken into account if performing STN DBS.

Keywords

deep brain stimulation - magnetic resonance imaging - stereotactic anatomy - stereotactic coordinates - subthalamic nucleus
 

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