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PubMed1993

Orienting head movements resulting from electrical microstimulation of the brainstem tegmentum in the barn owl.

The size and direction of orienting movements are represented systematically as a motor map in the optic tectum of the barn owl (du Lac and Knudsen, 1990). The optic tectum projects to several distinct regions in the medial brainstem tegmentum, which in turn project to the spinal cord (Masino and Knudsen, 1992). This study explores the hypothesis that a fundamental transformation in the neural representation of orienting movements takes place in the brainstem tegmentum. Head movements evoked by electrical microstimulation in the brainstem tegmentum of the alert barn owl were cataloged and the sites of stimulation were reconstructed histologically. Movements elicited from the brainstem tegmentum were categorized into one of six different classes: saccadic head rotations, head translations, facial movements, vocalizations, limb movements, and twitches. Saccadic head rotations could be further subdivided into two general categories: fixed-direction saccades and goal-directed saccades. Fixed-direction saccades, those whose direction was independent of initial head position, were elicited from the midbrain tegmentum. Goal-directed saccades, those whose direction changed with initial head position, were elicited from the central rhombencephalic reticular formation and from the efferent pathway of the cerebellum. Particular attention was paid to sites from which fixed-direction saccadic movements were elicited, as these movements appeared to represent components of orienting movements. Microstimulation in the medial midbrain tegmentum elicited fixed-direction saccades in one of six directions: rightward, leftward, upward, downward, clockwise roll, and counterclockwise roll. Stimulation in and around the interstitial nucleus of Cajal (InC; a complete list of anatomical abbreviations is given in the Appendix) produced ipsiversive horizontal saccades. Stimulation in the ventral InC and near the dorsal and medial edges of the red nucleus produced upward saccades. Stimulation in the reticular formation near the lateral edge of the red nucleus produced downward saccades. Stimulation in the ventromedial central gray produced ipsiversive roll saccades. The metrics and kinetics of fixed-direction saccades, but not their directions, could be influenced by stimulation parameters. As such, direction was an invariant property of the circuits being activated, whereas movement latency, duration, velocity, and size each demonstrated dependencies on stimulus amplitude, frequency, and duration. The data demonstrate directly that at the level of the midbrain tegmentum there exists a three-dimensional Cartesian representation of head-orienting movements such that horizontal, vertical, and roll components of movement are encoded by anatomically distinct neural circuits.(ABSTRACT TRUNCATED AT 400 WORDS)

Animals↗

PubMed1992

Spatial arrangement of the interpositorubral projection in the rabbit. A retrograde HRP study.

The objective of this investigation was to analyse the organization of rubral afferents from the cerebellar interpositus nuclear complex (NI) in the rabbit. Free HRP was employed as a retrograde tracer to identify the distribution patterns of labeled cells in the anterior and posterior interpositus nuclei. The interpositus projections distribute throughout nearly the entire contralateral red nucleus (RN) except for its rostralmost parvocellular region (RN-PA) which does not correspond to the usually distinguished parvocellular subdivision of the red nucleus (RN-P). The central and lateral regions of the posterior interpositus nucleus (NIP) project (nearly exclusively) to the medial region of the RN. The lateral region of the anterior interpositus nucleus (NIA) sends projections to both the lateral and medial regions of the caudal three-quarters of the RN. Thus, the lateral region of the RN appears to be under nearly exclusive control of NIA. The rostral one quarter of the RN receives cerebellar afferents from the NIP only and caudal pole of RN from the NIA exclusively. Comparison of labelling patterns indicates absence of topogrophic differentiation of projections from the NIP, whereas dorsoventral topography in the NIA can correlate to the rostrocaudal and mediolateral arrangement of the RN. Collectively, interpositorubral projections in the rabbit are similar to those in other species only in basic features.

Animals↗

PubMed1991

[Hyperkinésie volitionnelle following head injury].

A 13-year-old girl was struck by a car while riding her bicycle. She was comatose on her arrival at the hospital. Neurological examination revealed no focal sign except for right oculo-motor palsy. She became alert 15 days after the head injury when she first experienced a coarse tremor-like movement on the right arm. Neurological examination showed persistent oculo-motor palsy on the right side, decreased sensation of pain and touch on the left. There was no pyramidal deficit. Her gait and speech were normal and joint sensation was intact. A coarse tremor of the right arm was induced by volitional movements especially such as maintaining the arm in certain posture. It was not present at rest. Trajectory of finger-to-nose test was fairly well. However, the tremor became worse when the patient kept her finger near the target. Occasionally myoclonic-jerk and movement oppositionniste were mixed. Superficial EMG recordings of the tremor revealed 4 c/s rhythmic reciprocal grouping discharges, alternating flexor and extensor muscles. From these features, the abnormal movement should better be called tremor type of hyperkinésie volitionnelle (HV). The HV subsided spontaneously 4 months later. MRI of T2-weighted image showed high-intensity areas corresponding anatomically to the caudal part of right red nucleus and the right superior cerebellar peduncle just before its decussation. It is widely believed that lesions in cerebellar outflow pathway (i.e. dentate, red nucleus and thalamus) can cause HV.(ABSTRACT TRUNCATED AT 250 WORDS)

Action Potentials↗

PubMed1998

Regeneration of brainstem-spinal axons after lesion and immunological disruption of myelin in adult rat.

We previously observed that the transient developmental suppression of myelination or disruption of mature myelin, by local intraspinal infusion of serum complement proteins along with a complement-fixing, myelin-specific antibody (e.g., anti-Galactocerebroside), facilitated avian brainstem-spinal axonal regeneration after spinal transection. We now report the effects of similar immunological protocols on axonal regeneration in the injured adult rat spinal cord. After a lateral hemisection injury of the T10 spinal cord, infusion of the above reagents, over 14 days at T11, facilitated the regeneration of some brainstem-spinal axons. The hemisection lesion enabled comparisons between the retrograde labeling within an injured brainstem-spinal nucleus and the uninjured contralateral homologue. The brainstem-spinal nucleus examined in detail was the red nucleus (RN), chosen for its relatively compact descending pathway within the dorsolateral cord. Comparing the number of labeled neurons within each RN, of an experimentally myelin suppressed animal, indicated that approximately 32% of injured rubrospinal projections had regenerated into the caudal lumbar cord. In contrast, control-treated animals (e.g., PBS vehicle alone, GalC antibody alone, or serum complement alone) showed little or no axonal regeneration. We also examined the ultrastructural appearance of the treated cords. We noted demyelination over 1-2 segments surrounding the infusion site (T11) and a further two segments of myelin disruption (delamination) on either side of the demyelinated zone. The demyelination is an active process (< 3 days) with microglia and/or macrophages engulfing myelin. Thus, the facilitation of axonal regeneration through the transient suppression of CNS myelin may be fundamental to all higher vertebrates.

Animals↗

PubMed2003

Identification of regeneration-associated genes after central and peripheral nerve injury in the adult rat.

BACKGROUND: It is well known that neurons of the peripheral nervous system have the capacity to regenerate a severed axon leading to functional recovery, whereas neurons of the central nervous system do not regenerate successfully after injury. The underlying molecular programs initiated by axotomized peripheral and central nervous system neurons are not yet fully understood. RESULTS: To gain insight into the molecular mechanisms underlying the process of regeneration in the nervous system, differential display polymerase chain reaction has been used to identify differentially expressed genes following axotomy of peripheral and central nerve fibers. For this purpose, axotomy induced changes of regenerating facial nucleus neurons, and non-regenerating red nucleus and Clarke's nucleus neurons have been analyzed in an intra-animal side-to-side comparison. One hundred and thirty five gene fragments have been isolated, of which 69 correspond to known genes encoding for a number of different functional classes of proteins such as transcription factors, signaling molecules, homeobox-genes, receptors and proteins involved in metabolism. Sixty gene fragments correspond to genomic mouse sequences without known function. In situ-hybridization has been used to confirm differential expression and to analyze the cellular localization of these gene fragments. Twenty one genes (approximately 15%) have been demonstrated to be differentially expressed. CONCLUSIONS: The detailed analysis of differentially expressed genes in different lesion paradigms provides new insights into the molecular mechanisms underlying the process of regeneration and may lead to the identification of genes which play key roles in functional repair of central nervous tissues.

Animals↗

PubMed1980

The efferent projections of the pretectal complex: an autoradiographic and horseradish peroxidase analysis.

Anterograde autoradiographic data reveal that neurons within the pretectal complex of the tree shrew possess axons which terminate within three general categories of targets. First, there are targets of a major ipsilateral descending pathway which include: the dorsal cap of Kooy of the inferior olivary complex, the dorsolateral and dorsomedial regions of the griseum pontis, the mesencephalic reticular formation which lies immediately dorsal and lateral to the red nucleus, the medial terminal nucleus and the superficial layers of the superior colliculus. A second category of targets receive their pretectal input from a large ascending bundle which projects ipsilaterally to: the reticular and lateral nuclei of the thalamus, the zona incerta, the central lateral and paracentral intralaminar nuclei of the thalamus and bilaterally to the ventral lateral geniculate nucleus. A third category of targets include cranial nerve and closely associated nuclei which play a role in eye movements. Pretectofugal fibers projecting to nuclei in this third category terminate ipsilaterally within the nucleus of Darkschewitsch, bilaterally within the nucleus of the posterior commissure and the interstitial nucleus of Cajal, and contralaterally within the somatic cell column of the oculomotor and trochlear nuclei. There are also commissural projections to contralateral pretectal cell groups. Injections of horseradish peroxidase were placed within 11 pretectal targets. These data, which confirm and extend our autoradiographic findings, show that the majority of pretectal targets receive input from several pretectal nuclei, and that the size of pretectal neurons, rather than the cell groups in which they are located, dictates the termination site(s) of their axons.

Animals↗

PubMed1992

[Magnetic resonance imaging in multiple system atrophy].

We studied 18 patients with multiple system atrophy (MSA) by high field strength MRI: 6 striatonigral degeneration (SND), 4 Shy-Drager syndrome (SDS), and 8 olivo-ponto-cerebellar atrophy (OPCA). We also studied 30 Parkinson's disease (PD) and 10 age-matched controls. The diagnoses of SND, SDS, and OPCA were based on criteria after Hirayama et al (1985). Bradykinesia, rigidity, and tremor were assessed with the summed scores of the signs used as the extrapyramidal scores. The mean extrapyramidal scores were not significantly different in patients with SND, SDS, OPCA, and PD. MRI studies were performed on 1.5 tesla MRI unit, using a T2 weighted spin echo pulse sequence (TR2500 ms/TE40 ms). The width of the pars compacta signal in all subjects was measured by the method of Duguid et al (1986). Intensity profiles were made on a straight line perpendicular to the pars compacta through the center of the red nucleus on an image of the midbrain. We measured the width of the valley at half-height between the peaks of intensity representing the red nucleus and the crus cerebri-pars reticulata complex and used this measurement as an index of the width of the pars compacta signal. The mean widths of the pars compacta signal were: 2.8 +/- 0.4 mm (SND), 2.8 +/- 0.7 mm (SDS), 3.6 +/- 0.6 mm (OPCA), 2.7 +/- 0.3 mm (PD), and 4.3 +/- 0.6 mm (control). The mean widths of the pars compacta signal in PD, SND, and SDS were significantly narrower than that in the control group (p < 0.05), while the OPCA group was not significantly narrower.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMed1997

Developmental expression of the CD15-epitope in the brainstem and spinal cord of the mouse.

The expression of the 3-fucosyl-N-acetyl-lactosamine (FAL, CD15, Le(x)) epitope has been examined immunohistochemically in paraffin sections of the brainstem of the mouse. The initial appearance of labelling was at embryonic day (E)11, when immunoreactivity of radial glial fibres was noted in the medulla, pons and dorsal isthmus, while the spinal cord was immunoreactive from E12. Labelling remained faint until E14, when a distinctive radial pattern appeared in the medulla, pons and spinal cord. Immunoreactivity at E14 in both the spinal cord and medulla was strongest in a band in line with the sulcus limitans, passing ventrolaterally through the nucleus of the solitary tract in the case of the medulla. In both the spinal cord and the medulla, CD15 immunoreactivity divided the brainstem into radially arranged compartments, with an immunonegative paramedian region, strongly labelled ventrolateral segments, and moderately labelled lateral regions. Labelling of midline radial fibres was also apparent in the ventral mesencephalon at E14. After E18, labelling appeared in the paramedian region of the medulla, in particular around the inferior olivary nucleus, and gradually adopted a tufted appearance throughout the brainstem. Several regions of the developing brainstem showed specific labelling during fetal life. Distinct labelling of the developing red nucleus was visible from E15 to the time of birth, while some longitudinal bands of labelling were noted in the deeper layers of the superior colliculus from E17 until postnatal day (P)2. The adult pattern of immunolabelling was achieved by the end of the second postnatal week. The striking concentration of CD15 along the sulcus limitans of both the spinal cord and brainstem may serve to demarcate and separate dorsal (sensory) and ventral (motor) columns in a similar fashion to Pax gene expression. The precise timing of transient CD15 expression in the developing inferior olive and red nucleus is suggestive of a role for this epitope in developmental events of those structures.

Aging↗

PubMed2005

Claude's syndrome associated with supranuclear horizontal gaze palsy caused by dorsomedial midbrain infarction.

Claude's syndrome caused by dorsal midbrain lesion is characterized by ipsilateral third nerve palsy and contralateral ataxia. To date, reports in the literature concerning Claude's syndrome associated with the midbrain paresis of horizontal gaze are rare. A 62-year-old man suddenly developed left third cranial nerve palsy, right lateral gaze palsy, and right ataxia. Intact Bell's phenomenon and preserved right horizontal oculocephalic reflex suggested the lateral gaze palsy in the right eye was supranuclear in nature. Magnetic resonance imaging (MRI) revealed an infarction in the left dorsomedial midbrain. Although the red nucleus has often been suggested as the lesion site responsible for Claude's syndrome, a lesion of the superior cerebellar peduncle just below and medial to the red nucleus could be responsible for this syndrome. This case demonstrates neurological heterogeneity of midbrain infarction.

Ataxia↗

PubMed1991

[MRI in Parkinson's disease and vascular parkinsonism--study on the lesion of substantia nigra].

We examined the magnetic resonance (MR) image of midbrain and striatum in 30 patients with Parkinson's disease (PD), 10 patients with vascular parkinsonism (VP) and 10 age-matched control subjects. Studies were performed on a high field strength (1.5 tesla) MRI unit. T2 weighted spin echo pulse sequence (TR2500ms/TE40ms) was used. We measured the width of the pars compacta signal in patients and controls on the basis of the method described by Duguid et al. Intensity profiles of a straight line perpendicular to the pars compacta through the center of the red nucleus were made on an image of the midbrain. We measured the width of the valley at half-height between the peaks of intensity representing the red nucleus and the crus cerebri-pars reticulata complex and used this as an index of the width of the pars compacta signal. The results were as follows: 1. The mean width of the pars compacta signal was 2.7 mm (SD = 0.3) in the PD group and 4.3 mm (SD = 0.6) in controls. The difference between the means was highly significant (p less than 0.01). While not significant statistically, there was a trend toward narrowing of the width of pars compacta signal of substantia nigra in the PD group as the Yahr's grade or disease duration progressed. In hemiparkinsonism, MRI revealed significant narrowing of the pars compacta signal on the contra-lateral side to the clinical predominant side compared with the ipsi-lateral side. 2. The mean width of the pars compacta signal was 3.9 mm (SD = 0.4) in the VP group, but the decrease was not significant.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗

PubMed2005

Mice with the deleted neurofilament of low-molecular-weight (Nefl) gene: 1. Effects on regional brain metabolism.

Neuronal intermediate filaments consist of the NFL subunit linked with NFM and NFH, and their alterations have been proposed as a pathogenesic cause in motor neuron diseases. Depletion of the Nefl gene in mice mimicks the reduced NFL mRNA levels seen in amyotrophic lateral sclerosis and causes perikaryal accumulation of neurofilament proteins and axonal hypotrophy in motoneurons. NFL -/- mice were evaluated for regional brain metabolism by means of quantitative histochemical estimation of cytochrome oxidase (COx) activity. The NFL null mice displayed enzymatic activity alterations in numerous hindbrain regions, mainly the cerebellum, connected regions of the brainstem (red nucleus, vestibular nuclei, and reticular formation), and cranial nerve nuclei. All of the affected regions presented elevated COx activity, except for the Purkinje cells of the cerebellum and the magnocellular red nucleus, where enzymatic activity was lower. NFL-disrupted mice displayed functional alterations in brainstem sensorimotor regions affected in amyotrophic lateral sclerosis.

Amyotrophic Lateral Sclerosis↗

PubMed1981

Identification and somatotopic organization of nuclei projecting via the dorsolateral funiculus in rats: a retrograde tracing study using HRP slow-release gels.

Horseradish peroxidase (HRP) in slow-release gel was unilaterally implanted in the transected dorsolateral funiculus (DLF) of either cervical, midthoracic, lumbar or sacral spinal cord levels of adult male rats. Cell mappings were made of all brain areas projecting through the DLF. Following cervical implants, dense labelling was observed within a band along the dorsolateral border of the inferior olive, locus coeruleus, the paralemniscal reticular formation, the mesencephalic central gray, the red nucleus and the paraventricular nucleus of the hypothalamus. The DLF projection from the central gray consisted of a rostrocaudal line of cells extending from the level of the mesen-/diencephalic junction to the rostral red nucleus. The somatotopic organization of labelled nuclei was assessed by comparing the pattern of filled cells following HRP implants at various cord levels. The potential role of these areas in pain modulation was discussed in light of their descending projections through the DLF of the spinal cord.

Afferent Pathways↗

PubMed1975

Regional distribution of norepinephrine and dopamine in brains of depressive suicides and alcoholic suicides.

Norepinephrine (NE) and Dopamine (DA) were measured in 30 brain areas of depressive suicides and alcoholic suicides and in controls who had died of natural causes, in an effort to test directly the "catecholamine hypothesis" of depressive illness. Levels of NE were highest in the hypothalamus, tegmentum of pons, red nucleus and mesencephalic tegmentum; lowest in centrum semi-ovale, hippocampus and cingulate gyrus. Highest values for DA were found in the putamen, head of caudate, substantia nigra, globus pallidus, red nucleus and a few areas of the hypothalamus; lowest in cerebral cortex, ventral pons and thalamus. Our data showing a slight increase in NE levels in four areas of the suicide brains is probably of little clinical importance. In no case were the NE or DA levels in the suicide brains significantly less than in the controls. Alteration of monoamine metabolism as an etiologic factor in depressive illness remains a possibility if the mechanism involves blocking of the uptake of amines into neurons or changes in membrane permeability. It is unlikely that an alteration of amine metabolism per se is involved, since four selected metabolizing enzymes previously studied showed no difference in activity and the present study shows no depletion of amines.

Alcoholism↗

PubMed1994

Developmental plasticity of reticulospinal and vestibulospinal axons in the north American opossum, Didelphis virginiana.

We have shown previously that rubral axons grow around a lesion of their spinal pathway in the North American opossum if it is made at early stages of development. In the present experiments, we have asked whether reticular and vestibular axons have the same ability. The spinal cord was hemisected at postnatal day 20, 12, or 5, well within the critical period for rubrospinal plasticity, and, approximately 30 days later, bilateral injections of fast blue were made about four segments caudal to the lesion. The pups were killed 4 or 5 days after the injections. In most of the animals lesioned on postnatal day 20, labeled neurons were not found in the medial part of the pontine reticular nucleus or the dorsal part of the lateral vestibular nucleus ipsilateral to the lesion. The spinal projections from both areas are exclusively ipsilateral. When the lesions were made at postnatal day 12 or 5, however, labeled neurons were present in both areas, suggesting that they supported axons that had grown caudal to the lesion. As was expected from previous studies, rubral neurons were labeled contralateral to the lesion in all three groups. In the opossum, as in other species, the red nucleus projects contralaterally. We conclude that reticular and vestibular axons, like axons from the red nucleus, grow around a lesion of their pathway during development and that the critical period for their plasticity ends earlier than that for rubrospinal axons.

Animals↗

PubMed1998

Single Purkinje cell can innervate multiple classes of projection neurons in the cerebellar nuclei of the rat: a light microscopic and ultrastructural triple-tracer study in the rat.

Two different populations of projection neurons are intermingled in the cerebellar nuclei. One group consists of small, gamma-aminobutyric acid-containing (GABAergic) neurons that project to the inferior olive, and the other group consists of larger, non-GABAergic neurons that provide an input to one or more, usually premotor, centers in the brainstem, such as the red nucleus, the thalamus, and the superior colliculus. All cerebellar nuclear neurons are innervated by GABAergic Purkinje cells. In this study, we investigated whether individual Purkinje cells of the C1 zone of the paramedian lobe of the rat innervate both groups of projection neurons in the anterior interposed nucleus. Two different, retrogradely transported tracers, either cholera toxin beta subunit (CTb) or wheat germ agglutinin coupled to horseradish peroxidase (WGA-HRP) and a gold lectin tracer were injected into the red nucleus and the inferior olive, respectively, whereas Purkinje cell axons were anterogradely labeled with biotinylated dextran amine (BDA) injected into the paramedian lobule. Cerebellar nuclear sections studied with the light microscope demonstrated a close relation of varicosities from BDA-labeled Purkinje cell axons with both gold lectin- and CTb-labeled neurons. Branches of individual axons could be traced to both retrogradely labeled cell populations. At the ultrastructural level, synapses of labeled Purkinje cell terminals with profiles of WGA-HRP-labeled projection neurons predominated over contacts with gold lectin-containing neurons. Nine out of 367 investigated BDA-labeled terminals were observed to be presynaptic to a WGA-HRP-labeled profile as well as to a gold lectin-labeled profile. This indicates that nuclear cells that project to the inferior olive as well as those that project to premotor centers are under the influence of the same Purkinje cells. Such an arrangement would suggest an in-phase cortical modulation of the activation patterns of the inhibitory cells that project to the inferior olive and excitatory cells that project to premotor nuclei, which could explain why olivary neurons, especially those of the rostral part of the dorsal accessory olive, appear to be unresponsive to stimuli generated during active movement.

Animals↗

PubMed1994

Compartmentation of brain-type creatine kinase and ubiquitous mitochondrial creatine kinase in neurons: evidence for a creatine phosphate energy shuttle in adult rat brain.

Multiple isoforms of creatine kinase (CK) are expressed in specific cell types as part of an energy delivery or shuttle system. To test the hypothesis that neurons utilize a creatine phosphate energy shuttle, we examined the pattern of CK isoform expression and localization in adult rat brain. Two isoforms of CK are present in brain extracts, "brain-type," or BCK, and the ubiquitous form of the mitochondrial CK (uMtCK), as detected by enzyme activity following nondenaturing electrophoresis and by Western blotting following denaturing electrophoresis. In formalin-fixed and paraffin-embedded sections of rat brain, uMtCK immunostaining is detected in the somata of all Golgi type I neurons in the cerebellum, pontine reticular formation, red nucleus, hippocampus, and cerebral cortex. Immunostaining for uMtCK appears throughout the cell body but not in nuclei. BCK immunostaining is also present in somata of Golgi type I neurons in the cerebellum, red nucleus, and pons and is distributed throughout the cell body and within nuclei. BCK immunostaining also appears in neuronal processes and is concentrated in the molecular layers of the cerebellum and the hippocampus and in cortical pyramidal cell dendrites. These results demonstrate a coordinate pattern of expression and compartmentation of BCK and uMtCK isoforms in neurons, which provides an anatomic basis for the transfer of metabolic energy via a creatine phosphate energy shuttle.

Animals↗

PubMed1992

[Connections of the posterior region of the thalamus in rats].

Using retrograde and anterograde tracing methods we have studied in the posterior region of the thalamus of the rat the distribution of: (1) the terminal fields of the main afferents arising from somatosensory centers (dorsal column nuclei, interpolar trigeminal subnucleus, somatosensory cortex), motor centers (red nucleus, motor cortex) and multimodal structures (deep layers of the superior colliculus, zona incerta, cingular cortex) and of (2) the neurons giving rise to the main efferents towards the sensorimotor cortex, the red nucleus, the deep layers of the superior colliculus and the zone incerta. The overlap of the retrograde and anterograde labeling reveals a relatively homogeneous region. Considering however the cortical connections, three different subdivisions can be distinguished: a caudal pole completely devoid of cortical connections, a medial subdivision receiving cortical afferents from the sensorimotor and cingulate cortices and a rostral pole reciprocally connected with the sensorimotor cortex. Therefore the rostral pole would be the only part of this region which should be included in the thalamus.

Afferent Pathways↗

PubMed2006

The role of the supramammillary commissure in MR localization of the subthalamic nucleus.

PURPOSE: We have discovered a method for localization of the subthalamic nucleus (STN) utilizing the supramammillary commissure (SMC) as reference point. It is our purpose to present our experience and compare our methods with others. MATERIALS AND METHODS: Sixteen patients targeted for bilateral DBS for 32 total STN targets were studied by 1 mm MP-RAGE images with coronal T2W images. A modified red nucleus and mustache method was applied. The predicted target points were then confirmed with electronic calipers measuring the differences in methods. RESULTS: Modified red nucleus method using Surgiplan, and EBAL and BAGM electronic brain map atlas matched the target loci of 12 mm, -3 mm, -4 mm on an X-, Y-, and Z-coordinate system with zero at the mid-commissural point. From the coronal view Y is fixed at -3 mm. The mustache method was in error with values of X-axis at 14.25 (+/- 1.41 SD) (p = 0.69), and of Z-axis at -5.0 (+/- 1.60 SD) (p = 0.55). Three-fourths had moderate to marked ventricular enlargement of the III, but only 3 had enlargement of the frontal horns. CONCLUSION: The mustache method erred in the X-axis because the thalamocaudate groove was located lateral to the target point of the STN, and in the Z-axis because of varying thicknesses of the SMC. The top of the SMC is directly lateral from the STN target by 12 mm from the anterior and posterior commissures line. The SMC being a recognizable structure with constant relation to the STN should be the target structure.

Brain Mapping↗