P.124 Subnuclear contact localization within the subthalamic nucleus in deep brain stimulation for Parkinson Disease

Abstract

Background: Therapeutic response from subthalamic nucleus (STN) deep brain stimulation (DBS) for Parkinson disease (PD) has been associated with proximity to an ideal target, commonly in the dorsal sensorimotor STN. Automated registration and atlas-based segmentation has allowed for contact localization within STN subnuclei. We sought to apply these methods to characterize the spatial distribution of our active contact placements. Methods: We conducted a retrospective analysis of 55 patients who underwent bilateral STN DBS for PD. Post-operative CT/MRI scans were non-linearly registered into a standard space, and DBS-electrodes were localized using Lead-DBS. 3-dimensional meshes from a segmented atlas (Ewert 2017) were utilized. Analysis was performed in MATLAB R2019b. Results: Mean active contacts were within sensorimotor STN bilaterally, located posteroinferiorly compared to reported ideal targets. Centroids fell within (left/right): sensorimotor (46%/40%), associative (22%/22%), limbic (0%/2%) and outside STN (32%/36%). Principal components analysis demonstrated most spatial variance is explained by the first component (left 65.8%, right 61.9%). Conclusions: We obtained contact locations in relation to STN subnuclei, allowing for an anatomically guided approach to our analysis. 66% of the active contacts were located within the STN, and most of the spatial variation occurred along a single dimension. Future directions include utilizing subnuclei localizations to investigate clinical outcomes.