Direct Targeting of the Nucleus Basalis of Meynert Based on Probability Cytoarchitectonic Maps for Deep Brain Stimulation Surgery

Li-Chuan Huang; Li-Guo Chen; Sheng-Huang Lin; Sheng-Tzung Tsai; Ping-An Wu; Shin-Yuan Chen

Direct Targeting of the Nucleus Basalis of Meynert Based on Probability Cytoarchitectonic Maps for Deep Brain Stimulation Surgery

by Li-Chuan Huang^1,2, Li-Guo Chen¹, Sheng-Huang Lin^3,5, Sheng-Tzung Tsai^4,5, Ping-An Wu^1,2, Shin-Yuan Chen^4,5*

¹Department of Medical Imaging, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan

²Department of Medical Imaging and Radiological Sciences, Tzu Chi University, Hualien, Taiwan

³Department of Neurology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan

⁴Department of Neurosurgery, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan

⁵School of Medicine, Tzu Chi University, Hualien, Taiwan

^*Corresponding author: Shin-Yuan Chen, Department of Neurosurgery, Tzu Chi General Hospital, 707, Sec 3, Chung-Yang Road, Hualien 97002, Taiwan

Received Date: 25 February 2025

Accepted Date: 03 March 2025

Published Date: 05 March 2025

Citation: Huang LC, Chen LG, Lin SH, Tsai ST, Wu PA, et al. (2025) Direct Targeting of the Nucleus Basalis of Meynert Based on Probability Cytoarchitectonic Maps for Deep Brain Stimulation Surgery. J Surg 10: 11268 https://doi.org/10.29011/2575-9760.011268

Abstract

Purpose: The Nucleus Basalis Of Meynert (NBM) is a potential target for Deep Brain Stimulation(DBS) in treating dementia and Alzheimer's Disease (AD). However, direct targeting methods remain undefined due to the lack of distinct anatomical boundaries. This study aimed to develop and assess a direct localization method for NBM targeting in presurgical DBS planning.

Methods: Fourteen dementia patients (6 males, 8 females, aged 71.2±5.8 years; range 59-79years) were recruited for the study. Three-dimensional T1-weighted images were acquired using a 1.5T MRI system with a 20-channel phased-array head coil and a magnetization-prepared rapid gradient echo (MPRAGE) sequence. T1 raw images and NBM Cholinergic Nucleus 4 (Ch4) probabilistic cytoarchitectonic maps were processed using Statistical Parametric Mapping (SPM12). Consistency between original and normalized T1 images was evaluated based on the Region of Interest (ROI) coordinates. One patient underwent NBM-DBS and was followed for 12 months.

Results: The mean coordinates (x, y, z) for the left and right ROI-NBMs were (-18.1, -5.0, -4.8) and (21.1, -6.5, -3.5), respectively. High consistency was observed between Ch4 maps and both the original and reversed normalized T1-weighted images. In the post-DBS patient, the surgical targets demonstrated close alignment with the planned targets. Furthermore, the patient exhibited transient improvements in emotional compliance, alongside enhancements in language, social functioning, mood, and behavioral regulation.

Conclusion: Combining Ch4 probabilistic cytoarchitectonic maps with 3D T1 imaging enablesaccurate NBM localization. This method facilitates precise DBS targeting in presurgical planning, providing reliable physician reference coordinates.

Keywords: Alzheimer's disease (AD); Cholinergic nucleus 4 (Ch4); Deep brain stimulation (DBS); Nucleus basalis ofMeynert (NBM), Probabilistic cytoarchitectonic maps