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• W3047282487 abstract "Abstract The ventralis intermedius nucleus (Vim) is centrally placed in the dentato-thalamo-cortical pathway (DTCp) and is a key surgical target in the treatment of severe medically refractory tremor. It is not visible on conventional MRI sequences; consequently, stereotactic targeting currently relies on atlas-based coordinates. This fails to capture individual anatomical variability, which may lead to poor long-term clinical efficacy. Probabilistic tractography, combined with known anatomical connectivity, enables localisation of thalamic nuclei at an individual subject level. There are, however, a number of confounds associated with this technique that may influence results. Here we focused on an established method, using probabilistic tractography to reconstruct the DTCp, to identify the connectivity-defined Vim (cd-Vim) in vivo . Using 100 healthy individuals from the Human Connectome Project, our aim was to quantify cd-Vim variability across this population, measure the discrepancy with atlas-defined Vim (ad-Vim), and assess the influence of potential methodological confounds. We found no significant effect of any of the confounds. The mean cd-Vim coordinate was located within 1.9 mm (left) and 2.1 mm (right) of the average midpoint and 4.9 mm (left) and 5.4 mm (right) from the ad-Vim coordinates. cd-Vim location was more variable on the right, which reflects hemispheric asymmetries in the probabilistic DTCp reconstructed. The superior cerebellar peduncle was identified as a potential source of artificial variance. This work demonstrates significant individual anatomical variability of the cd-Vim that atlas-based approaches fail to capture. This variability was not related to any methodological confound tested. Lateralisation of cerebellar functions, such as speech, may contribute to the observed asymmetry. Tractography-based methods seem sensitive to individual anatomical variability that is missed by conventional neurosurgical targeting; These findings may form the basis for translational tools to improve efficacy and reduce side-effects of thalamic surgery for tremor. Highlights Connectivity-based Vim position varied markedly between subjects and from atlas-defined coordinates. This positional variability was not related to any methodological confound tested. Hemispheric asymmetry was observed in connectivity-based Vim position. We hypothesise lateralization of cerebellar functions, such as language, may contribute to asymmetry. Knowledge of Vim position variability could help inform neurosurgical planning in the management of tremor." @default.
• W3047282487 created "2020-08-10" @default.
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• W3047282487 date "2020-08-06" @default.
• W3047282487 modified "2023-09-27" @default.
• W3047282487 title "Ventralis intermedius nucleus anatomical variability assessment by MRI structural connectivity" @default.
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• W3047282487 doi "https://doi.org/10.1101/2020.08.05.236679" @default.
• W3047282487 hasPublicationYear "2020" @default.
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