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Direct localisation of the human pedunculopontine nucleus using MRI: a coordinate and fibre-tracking study

  • Magnetic Resonance
  • Published:
European Radiology Aims and scope Submit manuscript

Abstract

Objectives

To image the pedunculopontine tegmental nucleus (PPN), a deep brain stimulation (DBS) target for Parkinson disease, using MRI with validated results.

Methods

This study used the MP2RAGE sequence with high resolution and enhanced grey-white matter contrast on a 7-T ultra-high-field MRI system to image the PPN as well as a diffusion spectrum imaging method on a 3-T MRI system to reconstruct the main fibre systems surrounding the PPN. The coordinates of the rostral and caudal PPN poles of both sides were measured in relation to the third and fourth ventricular landmarks on the 7-T image.

Results

The boundary of the PPN was delineated, and showed morphology consistent with previous histological works. The main fibres around the PPN were reconstructed. The pole coordinate results combined with the fibre spatial relationships validate the imaging results.

Conclusions

A practical protocol is provided to directly localise the PPN using MRI; the position and morphology of the PPN can be obtained and validated by locating its poles relative to two ventricular landmarks and by inspecting its spatial relationship with the surrounding fibre systems. This technique can be potentially used in clinics to define the boundary of the PPN before DBS surgery for treatment of Parkinson disease in a more precise and reliable manner.

Key points

• Combined information helps localise the PPN as a DBS target for PD patients

• Scan the PPN at 7 T and measure its coordinates against different ventricular landmarks

• Reconstruct the main fibres around the PPN using diffusion spectrum imaging

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Abbreviations

AC:

Anterior commissure

CA:

Cerebral aqueduct

CTT:

Central tegmental tracts

DBS:

Deep brain stimulation

DIV:

MP2RAGE two-echo divided image

DSCP:

Decussation of the superior cerebellar peduncle

DSI:

Diffusion spectrum imaging

DSI0:

DSI image with b value = 0

DTI:

Diffusion tensor imaging

ML:

Medial lemniscus

PAG:

Periaqueductal grey

PC:

Posterior commissures

PD:

Parkinson disease

Point B:

Base point of the B-F coordinate

Point F:

Fastigial point of the B-F coordinate

PPN:

Pedunculopontine tegmental nucleus

QA:

Mean quantitative anisotropy

REF:

Second echo of the MP2RAGE image

SCP:

Superior cerebellar peduncle

SNc:

Substantia nigra pars compacta

STN:

Subthalamic nucleus

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Acknowledgements

We thank Mr. Jing Luo and Ms. Hong Xu for their assistance with the experimental conditions and Dr. Penghu Wei and Dr. Xu Yan for their technical advice.

Funding

This study has received funding from the Chinese MOST (Ministry of Science and Technology of China) “973” grant (2015CB351701), NSFC (National Natural Science Foundation of China) grants (31730039, 81601060), and Beijing Municipal Commission of Science and Technology grant (Z161100000116059).

Author information

Author notes

  1. Fei Cong and Jia-Wei Wang are co-first authors and contributed equally to this article.

Authors and Affiliations

  1. State Key Laboratory of Brain and Cognitive Science, Beijing MR Center for Brain Research, Institute of Biophysics, Chinese Academy of Sciences, 15 Datun Road, Chaoyang District, Beijing, 100101, China

    Fei Cong, Bo Wang, Zhangyan Yang, Zhentao Zuo, Zihao Zhang & Yan Zhuo

  2. University of Chinese Academy of Sciences, No. 19(A) Yuquan Road, Shijingshan District, Beijing, 100049, China

    Fei Cong, Bo Wang, Zhangyan Yang, Zhentao Zuo, Zihao Zhang & Yan Zhuo

  3. Department of Neurosurgery, Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, 17 Panjiayuan Nanli, Chaoyang District, Beijing, 100021, China

    Jia-Wei Wang

  4. Siemens Shenzhen Magnetic Resonance Ltd., Siemens MRI Center, Gaoxin C. Ave., 2nd, Hi-Tech Industrial Park, Shenzhen, Guangdong, 518057, China

    Jing An

  5. Beijing Institute of Functional Neurosurgery, Department of Functional Neurosurgery, Xuanwu Hospital, Capital Medical University, 45 Changchun Street, Xicheng District, Beijing, 100053, China

    Yu-Qing Zhang

Authors
  1. Fei Cong
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Corresponding authors

Correspondence to Yu-Qing Zhang or Yan Zhuo.

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Guarantor

The scientific guarantor of this publication is Yan Zhuo.

Conflict of interest

The author Jing An is an employee of Siemens responsible for customer research support. The other authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article.

Statistics and biometry

No complex statistical methods were necessary for this paper.

Informed consent

Written informed consent was obtained from all subjects (patients) in this study.

Ethical approval

Institutional Review Board approval was obtained.

Methodology

• experimental

• performed at one institution

Additional information

Yu-Qing Zhang and Yan Zhuo are joint corresponding authors.

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Cong, F., Wang, JW., Wang, B. et al. Direct localisation of the human pedunculopontine nucleus using MRI: a coordinate and fibre-tracking study. Eur Radiol 28, 3882–3892 (2018). https://doi.org/10.1007/s00330-017-5299-5

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  • DOI: https://doi.org/10.1007/s00330-017-5299-5

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