TY  - JOUR
PB  - ELSEVIER SCIENCE INC
A1  - Hamel, W
A1  - Koeppen, JA
A1  - Alesch, F
A1  - Antonini, A
A1  - Barcia, JA
A1  - Bergman, H
A1  - Chabardes, S
A1  - Contarino, MF
A1  - Cornu, P
A1  - Demmel, W
A1  - Deuschl, G
A1  - Fasano, A
A1  - Kuehn, AA
A1  - Limousin, P
A1  - McIntyre, CC
A1  - Mehdorn, HM
A1  - Pilleri, M
A1  - Pollak, P
A1  - Rodriguez-Oroz, MC
A1  - Rumia, J
A1  - Samuel, M
A1  - Timmermann, L
A1  - Valldeoriola, F
A1  - Vesper, J
A1  - Visser-Vandewalle, V
A1  - Volkmann, J
A1  - Lozano, AM
Y1  - 2017/03//
VL  - 99
N2  - BACKGROUND:  Deep brain stimulation within or adjacent to the subthalamic nucleus (STN) represents the most common stereotactic procedure performed for Parkinson disease. Better STN imaging is often regarded as a requirement for improving stereotactic targeting. However, it is unclear whether there is consensus about the optimal target. METHODS: To obtain an expert opinion on the site regarded optimal for ?STN stimulation,? movement disorder specialists were asked to indicate their preferred position for an active contact on hard copies of the Schaltenbrand and Wahren atlas depicting the STN in all 3 planes. This represented an idealized setting, and it mimicked optimal imaging for direct target definition in a perfectly delineated STN. RESULTS: The suggested targets were heterogeneous, although some clustering was observed in the dorsolateral STN and subthalamic area. In particular, in the anteroposterior direction, the intended targets differed to a great extent. Most of the indicated targets are thought to also result in concomitant stimulation of structures adjacent to the STN, including the zona incerta, fields of Forel, and internal capsule. CONCLUSIONS: This survey illustrates that most sites regarded as optimal for STN stimulation are close to each other, but there appears to be no uniform perception of the optimal anatomic target, possibly influencing surgical results. The anatomic sweet zone for STN stimulation needs further specification, as this information is likely to make magnetic resonance imaging?based target definition less variable when applied to individual patients.
JF  - World Neurosurgery
EP  - 46
AV  - public
ID  - discovery10094446
SN  - 1878-8750
N1  - This version is the author accepted manuscript. For information on re-use, please refer to the publisher's terms and conditions.
KW  - Deep brain stimulation
KW  -  Parkinson disease
KW  -  Subthalamic nucleus
KW  -  Targeting
TI  - Targeting of the Subthalamic Nucleus for Deep Brain Stimulation: A Survey Among Parkinson Disease Specialists
SP  - 41
UR  - https://doi.org/10.1016/j.wneu.2016.11.012
ER  -