November 21, 2017 |
MRI Technology Reveals Deep Brain Pathways in Detail
July 2, 2015  | 

Durham, NC – Scientists at Duke Medicine have produced a 3-D map of the human brain stem at an unprecedented level of detail using MRI technology.

In a study published in Human Brain Mapping, the researchers unveil an ultra high-resolution brain stem model that could better guide brain surgeons treating conditions such as tremors and Parkinson’s disease with deep brain stimulation (DBS).

The new 3-D model could eliminate risky trial-and-error as surgeons implant electrodes — a change akin to trading an outdated paper road atlas for a real-time GPS.

“On the conventional MRI that we take before surgery, the thalamus looks like a gray mass where you can see only the borders,” said neurosurgeon Nandan Lad, M.D., Ph.D., director of the Duke NeuroOutcomes Center and an author of the paper. “Now we will have actual detail. With this map, for the first time we’re able to see the thalamus and that underlying circuitry that we are modulating.”

Many neurosurgeons currently rely on lower resolution CT and MRI scans and geographic coordinates relative to the planes of the brain to guide them when placing electrodes into the thalamus. They are targeting a circuit called the dentatorubrothalamic tract or DRT (depicted as an X-shaped pathway in the accompanying image), Lad said.

Surgeons must often remove and reinsert electrodes and test frequencies to find the spots inside the thalamus where, for instance, the electric current subdues the hands of a patient with debilitating tremors. This indirect targeting is the standard of care for DBS, but comes with risk. Moving an electrode requires another pass through delicate tissue, and complications from DBS can include hemorrhage, seizure, or memory problems.  Continue>

Page | 1 2 3
Suggested Articles