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AJNR News Digest - The Latest Insights and Technology in Neuroimaging
November-December 2022
Introduction
Figure 3 from Middlebrooks

Functional Neurosurgery

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Alexandre Boutet

Evolution in neuroradiology, and indeed the wider radiology field, is in part dictated by novel diagnoses, therapies, and imaging techniques. The most frequently encountered indications and imaging modalities have changed drastically over the past decades. The expectations of radiology reports are also changing, with a trend toward the use of standardized reporting and quantitative scales. One clinical specialty in particular has contributed to these changes in neuroradiology: functional neurosurgery. In its broadest sense, functional neurosurgery includes the surgical treatment of pain, movement disorders, epilepsy, and psychiatric conditions. In this edition of the AJNR News Digest, we showcase several articles that highlight recent developments in this field and explore their potential impact on neuroradiology.

Functional neurosurgery is largely dedicated to modulating aberrant circuits associated with a wide range of neurologic conditions. Generally speaking, this can be achieved through stereotactic methods, including lesioning or electrically stimulating key brain structures. As a basic principle, the targeted structure represents a crucial hub of the circuit of interest; the motor circuit is targeted in Parkinson disease whereas structures implicated in mood regulation and cognition are targeted in psychiatric disorders and Alzheimer disease, respectively.1,2 Deep brain stimulation (DBS) has emerged as the dominant stereotactic functional … more »

Functional

Corticopallidal Connectome of the Globus Pallidus Externus in Humans: An Exploratory Study of Structural Connectivity Using Probabilistic Diffusion Tractography

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Erik Middlebrooks

The globus pallidus externus (GPe) is an important node in the basal ganglia circuitry that has been shown to be dysfunctional in numerous disorders, such as Parkinson disease and dystonia. Despite this, there has been relatively little investigation of the GPe in the realm of neuromodulation, with far more focus on the … more »

Interventional

Transcranial MR Imaging–Guided Focused Ultrasound Interventions Using Deep Learning Synthesized CT

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Jiachen Zhuo

I work with a group of researchers at the University of Maryland School of Medicine who have been at the forefront of MR imaging–guided focused ultrasound (MRgFUS) development to treat movement disorders including essential tremor, Parkinson disease, and neuropathic pain and develop other techniques including blood-brain barrier opening and neuromodulation. A key question … more »

Functional

Segmentation of the Globus Pallidus Internus Using Probabilistic Diffusion Tractography for Deep Brain Stimulation Targeting in Parkinson Disease

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Erik Middlebrooks

Parkinson disease is a relatively common and debilitating neurologic disorder. One of the most widely used indications for deep brain stimulation (DBS) worldwide has been in Parkinson disease, in which it has been shown to not only be highly effective in symptom control, but also allow the reduction of other medications that have … more »

Functional

Functional Connectivity Targeting for Deep Brain Stimulation in Essential Tremor

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Jeffrey Anderson

Functional MRI connectivity is an exciting technique that has redefined functional network neuroanatomy. Yet few clinical applications have emerged using this technique. One of the key limitations in using this approach in individual patients has been the inherent noise in the images, which limits the precision with which functional mapping targets can be … more »

Functional

Functional and Structural Connectivity Patterns Associated with Clinical Outcomes in Deep Brain Stimulation of the Globus Pallidus Internus for Generalized Dystonia

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Erik Middlebrooks

Dystonia is a debilitating condition for which deep brain stimulation (DBS) has been suggested as an effective and minimally invasive therapy; however, experience with DBS for dystonia has been mixed. One of the major barriers with dystonia DBS is the lack of immediate clinical biofeedback, such as that seen with Parkinson disease and … more »