eprintid: 10094446 rev_number: 14 eprint_status: archive userid: 608 dir: disk0/10/09/44/46 datestamp: 2020-04-07 11:38:07 lastmod: 2021-10-18 00:31:45 status_changed: 2020-04-07 11:38:07 type: article metadata_visibility: show creators_name: Hamel, W creators_name: Koeppen, JA creators_name: Alesch, F creators_name: Antonini, A creators_name: Barcia, JA creators_name: Bergman, H creators_name: Chabardes, S creators_name: Contarino, MF creators_name: Cornu, P creators_name: Demmel, W creators_name: Deuschl, G creators_name: Fasano, A creators_name: Kuehn, AA creators_name: Limousin, P creators_name: McIntyre, CC creators_name: Mehdorn, HM creators_name: Pilleri, M creators_name: Pollak, P creators_name: Rodriguez-Oroz, MC creators_name: Rumia, J creators_name: Samuel, M creators_name: Timmermann, L creators_name: Valldeoriola, F creators_name: Vesper, J creators_name: Visser-Vandewalle, V creators_name: Volkmann, J creators_name: Lozano, AM title: Targeting of the Subthalamic Nucleus for Deep Brain Stimulation: A Survey Among Parkinson Disease Specialists ispublished: pub divisions: UCL divisions: B02 divisions: C07 divisions: D07 divisions: F84 keywords: Deep brain stimulation, Parkinson disease, Subthalamic nucleus, Targeting note: This version is the author accepted manuscript. For information on re-use, please refer to the publisher's terms and conditions. abstract: 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. date: 2017-03 date_type: published publisher: ELSEVIER SCIENCE INC official_url: https://doi.org/10.1016/j.wneu.2016.11.012 oa_status: green full_text_type: other language: eng primo: open primo_central: open_green verified: verified_manual elements_id: 1191798 doi: 10.1016/j.wneu.2016.11.012 lyricists_name: Limousin, Patricia lyricists_id: PDLIM44 actors_name: Limousin, Patricia actors_name: Taib, Linda actors_id: PDLIM44 actors_id: LTAIB41 actors_role: owner actors_role: impersonator full_text_status: public publication: World Neurosurgery volume: 99 pagerange: 41-46 pages: 6 issn: 1878-8750 citation: Hamel, W; Koeppen, JA; Alesch, F; Antonini, A; Barcia, JA; Bergman, H; Chabardes, S; ... Lozano, AM; + view all <#> Hamel, W; Koeppen, JA; Alesch, F; Antonini, A; Barcia, JA; Bergman, H; Chabardes, S; Contarino, MF; Cornu, P; Demmel, W; Deuschl, G; Fasano, A; Kuehn, AA; Limousin, P; McIntyre, CC; Mehdorn, HM; Pilleri, M; Pollak, P; Rodriguez-Oroz, MC; Rumia, J; Samuel, M; Timmermann, L; Valldeoriola, F; Vesper, J; Visser-Vandewalle, V; Volkmann, J; Lozano, AM; - view fewer <#> (2017) Targeting of the Subthalamic Nucleus for Deep Brain Stimulation: A Survey Among Parkinson Disease Specialists. World Neurosurgery , 99 pp. 41-46. 10.1016/j.wneu.2016.11.012 <https://doi.org/10.1016/j.wneu.2016.11.012>. Green open access document_url: https://discovery.ucl.ac.uk/id/eprint/10094446/1/WNS-16-1481R1_Survey_revision.pdf