Characterisation of Dentatorubrothalamic tract with Diffusion Spectrum Imaging in Patients suffering from Parkinson’s disease

Abstract Introduction: Clinical data support that the dentatorubrothalamic tract (DRTT) is an effective target for deep brain stimulation (DBS) in medically refractory tremor. Nevertheless, the achievement of a realistically detailed depiction of DRTT for preoperative direct targeting remains a challenge.Methods: Ten patients with Parkinson’s disease from the Inselspital Bern database were selected. We used diffusion spectrum imaging (DSI) scans for deterministic fiber tracking of the DRTT with the Track Vis software. Thereafter we compared our DSI-characterized DRTT with the existing anatomical data.Results: In 6 out of 10 individuals the full course of DRTT has been in high affiliation/consistency/association/adherence with the anatomical course of DRTT as described in literature.Conclusions: In this study DSI fiber tracking was used to characterize successfully the DRTT anatomical course in its complexity in a quest of the optimal DBS target for parkinsonian tremor. To our knowledge such attempt has not occurred before. Further studies are required to standardize the protocol of DRTT fiber Tracking and to implement it as a valid DBS preoperative planning technique.