Medical Journal of The Islamic Republic of Iran (MJIRI)

  Abstract

  Introduction: It is demonstrated that the degree of clinical improvement in

  Parkinson's disease (PD) achieved by deep brain stimulation (DBS) is largely dependent

  on the accuracy of lead placement. In addition, individual variability in the

  situation of subthalamic nucleus (STN) is responsible for spatial inter-individual

  fluctuations of the real patient's target.

  Objective: Our study was aimed to identify the anatomic location of STN from

  midcommissural point (MCP) in Iranian Parkinson's disease patients who underwent

  DBS by means of a 3-dimentional magnetic resonance imaging (MRI).

  Methods: Forty-six patients with the PD were recruied as candidates for bilateral

  implantation of STN-DBS (92 subthalamic nucleuses) were recruited. All these patients

  had bilateral implantation at the same operation. DBS and MRI parameters including

  the target coordinates (X, Y, Z) and the distances from MCP to the center of

  STN in all three axes on both sides were reported and calculated for each patient.

  Results: The location of STN was approximated by a site with 11 mm lateral, 3 mm

  inferior and 3 mm posterior to the midcommissural point. This distance was significantly

  lower in PD patients who aged >50 years in both right and left sides in the Y-axis

  direction.

  Conclusion: Our findings led to a considerable set of information which could

  help neurosurgeons during DBS procedure in Iranian PD patients. Despite the differences observed between various population of PD patients in the anatomical location of STN, our results further depicted the clustration of active contact points in same region.