1. abstracts selected for oral and flash presentations 2 2. abstracts selected for poster ...

262 Pages·2014·1.2 MB·English

1. ABSTRACTS SELECTED FOR ORAL AND FLASH PRESENTATIONS 2
1.1 Abstracts selected for Oral Presentations 2
1.1.1 Movement disorders 2
1.1.2 Psychiatric Disorders 24
1.1.3 Epilepsy 29
1.1.4 Pain 36
1.1.5 Spasticity 43
1.1.6 Neuroimaging 47
1.1.7 Neuro-oncology 49
1.1.8 Neurotransplantation 52
1.1.9 Radiosurgery 53
1.1.10 Experimental studies 61
1.1.11 Brain-Machine Interface 74
1.2 Abstracts selected for Flash Oral Presentations 79
1.2.1 Movement disorders 79
1.2.2 Psychiatric Disorders 104
1.2.3 Epilepsy 113
1.2.4 Pain 120
1.2.5 Neuroimaging 124
1.2.9 Radiosurgery 128
1.2.10 Experimental studies 129
2. ABSTRACTS SELECTED FOR POSTER PRESENTATIONS 139
2.1 Movement disorders 139
2.2 Psychiatric Disorders 201
2.3 Epilepsy 211
2.4 Pain 217
2.5 Spasticity 227
2.6 Neuroimaging 230
2.7 Neuromonitoring 244
2.8 Neuro-oncology 246
2.9 Neurotransplantation 252
2.10 Radiosurgery 253
2.11 Experimental studies 255

Stereotact Funct Neurosurg 2014;92(suppl 2) : 1 - 262 p.1
1. Abstracts selected for Oral and Flash Presentations
1.1 Abstracts selected for Oral Presentations
1.1.1 Movement disorders

#11
A prospective pilot trial for Pallidal Deep Brain Stimulation in Huntington´s Disease

Jan Vesper (1), Alfons Schnitzler (2), Lars Wojtecki (3)
1. Dept. of Functional Neurosurgery and Stereotaxy, University Duesseldorf, Duesseldorf, Germany
2. Dept of Movement disorder and neuromodulation, University of Duesseldorf, Düsseldorf, Germany
3. Dept. of Movement disorder and neuromodulation, University of Duesseldorf, Düsseldorf, Germany

Introduction: Severe forms of movement disorders in Huntington´s disease are often medially
refractive. Case reports suggest deep brain stimulation as treatment option, but the exact target for
stimulation is under debate. We assessed procedure safety, equality of internal and external pallidal
stimulation and efficacy in patients with Huntington´s disease followed up for 6 months in a
prospective pilot trial.

Methods: We studied 6 Huntington´s Disease patients (4 chorea-dominant, 2 Westphal variant) with
stable predominant movement disorder. After surgery, patients were randomly assigned either the
sequence of 6 week internal/6 week external pallidum stimulation or vice versa followed by 6 months
chronic pallidal stimulation. Primary endpoints were changes in the Unified Huntington´s Disease
Rating Scale (UHDRS) Motor Score, Chorea Subscore and Total Motor Score 4 (TMS-4) comparing
internal versus external pallidum stimulation and 6 month versus baseline. Secondary endpoints
assessed scores on dystonia, hypokinesia, cognition, mood, functionability/disability and quality of life.
Scores were rated double-blinded using standardized video recordings. Data was analyzed on
intention-to-treat basis. The trial is registered with ClinicalTrials.gov (NCT00902889).

Results: Intention to treat analysis included all 6 patients with n=3 in each treatment sequence.
Internal and external pallidal stimulation was equally in terms of efficacy. Chorea sub score decreased
significantly within 6 months (-5.3 (60.2%), p=0.037). Effects on dystonia were not significant over the
group due to three responders (>50% improvement) and three non-responders. Westphal patients did
not improve. Cognition was stable over 6 months. Mood and several functionability/disability and
quality of life scores improved significantly. Eight adverse events and two additional serious adverse
events were recorded. Most of them were stimulation related and under internal pallidum stimulation
with bradykinesia, gait impairment, hyperkinesia and hyperthermia as the most common ones. All
adverse events resolved without sequelae. No procedure related complication occurred.

Conclusion: Internal as well external pallidal deep brain stimulation occurred as safe treatment option
for reduction of chorea in Huntington´s Disease. Effects on chorea, dystonia and long-term effect on
quality of life should be examined in further larger trials.

Stereotact Funct Neurosurg 2014;92(suppl 2) : 1 - 262 p.2
Movement disorders

#18
Microelectrode recording in subthalamic nucleus deep brain stimulation: advantage or
loss of time?

Ersoy Kocabicak (1), Dursun Aygun (2), Kemal Paksoy (1), Musa Onar (2), Hatice Guz (3), Omer Boke (3), Murat Kurt (4),
Murat Terzi (2), Onur Alptekin (5), Onur Yildiz (2), Yasin Temel (6)
1. Department of Neurosurgery, Ondokuz Mayis University, School of Medicine, Samsun, Turkey
2. Department of Neurology, Ondokuz Mayis University, School of Medicine, Samsun, Turkey
3. Department of Psychiatry, Ondokuz Mayis University, School of Medicine, Samsun, Turkey
4. Department of Psychology, Ondokuz Mayis University, School of Medicine, Samsun, Turkey
5. Neuromodulation, Medtronic. Inc, Istanbul, Turkey
6. Departments of Neuroscience and Neurosurgery, Maastricht University Medical Center, Maastricht, Netherlands

Introduction: Subthalamic nucleus (STN) deep brain stimulation (DBS) in Parkinson's disease with
microelectrode recording (MER) was initially started by the Grenoble group in 1993. With the
improvement of the MR imaging techniques in the following years, the dorsolateral part of the STN
which is known as the motor part has started to become much better visualized. Therefore, some
centers only used preoperative MRI for targeting in STN DBS and abandoned MER due to the
reasons that it increases operation time and bleeding risks. In our study we present the effect of MER
on operation time with the clinical results.

Methods: 18 Parkinson's disease patients (10 male- 8 female) who underwent bilateral STN DBS
were included in this study. Preoperative dorsolateral STN targeting was performed by indirect-direct
targeting combination and MRI-CT fusion. Number of the microelectrodes used, number of electrodes
placed at the central and other trajectories were recorded seperately. The time spent for MER in
surgery was calculated as the time between the first microelectrode placement and the testing of the
effects and side effects in macrostimulation. Early postoperative surgical and hardware-related
adverse affects were noted.

Results: 117 microelectrodes were used in this study (mean: 6.5±1.3 ). 36 microelectrodes were
placed in STN. The number of permanent electrodes placed in the central trajectory was 25 (69.4%).
MER extended operation time for 43.2±5.5 minutes. Bleeding, contusion or infection wasn't detected in
the early postoperative period.

Conclusion: STN DBS with MER extends surgical time. However, considering that we didn't use
central trajectory for permanent electrode in 1/3 of our patients, we still think that MER decreases time
loss and provides optimal response in situations where optimal clinical response can't be obtained
intraoperatively by making the other appropriate trajectories available.

Stereotact Funct Neurosurg 2014;92(suppl 2) : 1 - 262 p.3
Movement disorders
#36
STN-DBS for Parkinson´s disease: correlation between the active contact electrode
and oscillatory activity

Jorge Guridi (1), David Garcia-Garcia (2), Manuel Alegre (3), Maria Cruz Rodriguez-Oroz (4), Jose A. Obeso (2)
1. Neurosurgey Department, Clinica Universidad de Navarra, Pamplona, Spain
2. Neurosciences Area, CIMA, University of Navarra, Pamplona, Spain
3. Neurophysiology Department, Clinica Universidad de Navarra, Pamplona, Spain
4. Neurosciences Area, CIMA, Universidad de Navarra, Pamplona, Spain

Introduction: An excessive oscillatory activity synchronization occurs in the basal ganglia in
Parkinson´s disease (PD) and this has a predilection for the beta frequency band centred around 20
Hz. This activity is recorded in the dorsal portion of STN. This study analyzes the correlation between
this beta activity and the active contact used in STN-DBS

Methods: Localization was determined in 30 patients with PD and treated with STN-DBS surgery.
MRI preop and postoperative has been corregistrated and precise placement of each electrode
contact evaluated in correlation with the stereotactic volume created based in the AC-PC line, thalamic
height and III ventricle width. A 3-dimensional (3-D) atlas STN model was created based in Morel
atlas and corregistrated with the stereotactic volume created. Finally the electrode active contact was
accurately located within or out of the STN. Active contact is defined as the contact that induce the
best clinical benefit reducing the motor UPDRS and the study has been performed only in monopolar
stimulation contacts. Local field potentials recorded oscillatory activity 3-4 days after implantation
surgery with the patient in “off” and “on” dopaminergic condition.

Results: Active contact electrode was placed in the dorsolateral portion of STN (X. 11.52, Y: 1.22
posterior mid point, Z: 1.08 below the AC-PC line). Beta oscillatory activity was recorded (LFP) in the
dorsal portion of the nucleus. There was no statistical difference between both.

Conclusion: Active contact electrode and beta oscillatory activity are localized in the motor portion of
STN. The results indicates that stimulating the dorso-lateral oscillatory region leads to an effective
clinical outcome for STN-DBS surgery.

Stereotact Funct Neurosurg 2014;92(suppl 2) : 1 - 262 p.4
Movement disorders
#37
Resting state cortical oscillations of Parkinson’s disease patients without and with
subthalamic deep brain stimulation, a MEG study

Cao Chunyan (1), Jang Tianxiao (2), Li Dianyou (3), Zhan Shikun (4), Firat Ince Nuri (2), Sun Bomin (4)
1. Department of Functional Neurosurgery, Ruijin Hospital, Shanghai, China
2. Department of Biomedical Engineering, University of Houston, Houston, China
3. Department of Functional Neurosurgery, Ruijin Hospital Shanghai Jiaotong University, School of Medicine, Shanghai, China
4. Department of Functional Neurosurgery, Ruijin Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China

Objective: To investigate the modification to cortical oscillations of Parkinson’s disease (PD) patients
by the subthalamic deep brain stimulation (STN-DBS).

Methods: Detected with magnetoencephalography (MEG), the cortical spontaneous oscillations of PD
patients undergoing STN-DBS at stimulation ON and OFF statuses were compared, accompanied by
UPDRS III evaluation. Same features of PD patients without surgery and healthy controls were also
compared,

Results: In PD patients without surgery, the cortical average frequency slowed down and average
power incremented significantly, with an increase in relative power in θ, and a parallel decrease in β
and γ over temporal and occipital cortex relative to healthy controls; the UPDRS III rigidity score
correlated with average frequency of frontal, and also correlated with the relative power of β and γ in
frontal. In PD patients with STN-DBS, the average frequency increased significantly at stimulation ON
comparing to stimulation OFF status, accompanied by drop in the relative power of δ and rise in the
relative power of β over the whole cortex; at stimulation ON status, the UPDRS III rigidity and tremor
scores correlated with the relative power of α over left parietal.

Conclusion: STN-DBS improves the symptoms of PD by suppressing the synchronization of α in left
somatomotor region.

Stereotact Funct Neurosurg 2014;92(suppl 2) : 1 - 262 p.5
Movement disorders
#53
Deep Brain Stimulation of the internal globus pallidus in severe Tourette Syndrome.

Anouk Smeets (1), Annelien Duits (2), Albert Leentjens (3), Mayke Oosterloo (4), Veerle Visser-Vandewalle (5), Birgit Plantinga
(6), Yasin Temel (1), Linda Ackermans (1)
1. Neurosurgery, Maastricht University Medical Centre, Maastricht, Netherlands
2. Psychiatry and Psychology, Maastricht University Medical Centre, Maastricht, Netherlands
3. Department of psychiatry and psychology, Maastricht University Medical Centre, Maastricht, Netherlands
4. Department of neurology, Maastricht University Medical Centre, Maastricht, Netherlands
5. Department of Functional and Stereotactic Neurosurgery, University of Cologne, Cologne, Germany
6. Department of neuroscience, Maastricht University Medical Centre, Maastricht, Netherlands

Introduction: Tourette Syndrome (TS) is a complex childhood-onset neuropsychiatric disorder
characterized by multiple motor- and vocal tics. The exact pathophysiology is unknown but TS is
thought to result from dysfunction of the basal ganglia and the related thalamocortical circuits. Deep
Brain Stimulation (DBS) of different output or relay stations in this circuit has been proposed as a
therapeutic option for severe therapy refractory TS, including the limbic internal globus pallidus (GPi).
In this case series we describe the effects of limbic GPi stimulation on tics and associated behavioural
disorders, whereas adverse events and cognition are carefully monitored.

Methods: Five patients with severe therapy refractory TS were selected for bilateral DBS of the limbic
GPi. Patients were evaluated twice: once in the month before surgery and once after surgery, on all
primary and secondary outcome measures, as well as on cognition. Follow-up duration was variable,
but at least 12 months. The primary outcome measure was tic severity, assessed by the Yale Global
Tic Severity Scale (YGTSS), the modified Rush Video-Based Tic Rating Scale (mRVRS) and the
amount of video-tics in 10 minutes.
Secondary outcome measures were the effects on potentially associated behavioural disorders, such
as Attention Deficit Hyperactivity Disorder (ADHD) and Obsessive Compulsive behavior (OCb), as well
as mood (depression and anxiety). A neuropsychological examination was performed to assess
cognition. Complications and side-effects related to the surgery or the stimulation were carefully
monitored. The final position of the active contacts of the implanted electrodes was visualized.

Results: Five patients, three male and two female were selected for DBS of the limbic GPi between
2010 and 2013. Follow-up duration ranged from 12 to 38 months (SD 13.7). The mean age of the
group was 41.6 years (SD 9.7) and the mean disease duration was 33.2 years (SD 8.9). The position
of the implanted electrodes showed adequate anatomic localization in all patients. The average
postoperative score on the YGTSS was significantly lower than the preoperative score (42.2 ± 4.8
versus 12.8 ± 3.8, P=0.043). There was also a significant reduction of 80.9% on the total amount of
video-rated tics (259.6 ± 107.3 versus 49.6 ± 24.8, P=0.043) and of 46.2% on the mRVRS (13.0 ± 2.0
versus 7.0 ± 1.6, P=0.041). There was no significant difference between pre- and postoperative
secondary outcome measures. However, on an individual level (four of the four patients with elevated
levels prior to surgery) we found a positive trend for an improvement in obsessive-compulsive
behaviour. Cognitive re-assessment revealed no changes. Complications included one infection of the
pulse generator and one case of lead traction. Side effects were apathy and passive behaviour in two
patients, and weight loss and agitation in one other patient.

Conclusion: Our findings suggest that stimulation of the limbic GPi is effective in reducing tic severity,
and possibly also OCb, in therapy refractory Tourette patients. This is in line with most previous
reports targeting this area. The absence of effect on ADHD, anxiety and depression could be due to
the fact that these symptoms were absent or mild in our patients prior to surgery, and the low power of
this sample. So far, DBS of the limbic GPi seems safe from a cognitive point of view. Adverse events
and side-effects related to the stimulation were minor in this study. Our study adds to the little
available evidence suggesting that limbic GPi stimulation could be effective in severe refractory TS.
We are cautious in over-interpreting the data, but based on this experience and other published
evidence, we will continue targeting the limbic GPi as a first choice in future DBS therapy in refractory
TS patients.

Stereotact Funct Neurosurg 2014;92(suppl 2) : 1 - 262 p.6
Movement disorders
#76
Saccade-related modulation of beta oscillation in the human internal globus pallidus

Akihiro Yugeta (1), Robert Chen (2), William D. Hutchison (3)
1. Department of Neurology, University of Tokyo Hospital, Tokyo, Japan
2. Department of Neurology, University of Toronto, Toronto, Canada
3. Department of Physiology, University of Toronto, Toronto, Canada

Introduction: Antisaccades require inhibition of reflexive responses towards visual cues, and strong
initiation of saccades away from visual cues. Studies in monkeys reported more prominent pallidal cell
firing during antisaccades than prosaccades (Yoshida and Tanaka 2009). We reported beta-SRDs in
the subthalamic nucleus (STN) of Parkinson's disease patients during saccades. Since the STN
projects to the the internal globus pallidus (GPi) we expect that beta-SRDs also occur in the GPi.
Although saccade abnormalities caused by GPi lesions have been reported, saccade-related GPi
oscillations has not been studied in human. Objective: To investigate whether oscillations in the GPi in
primary dystonia patients are modulated by saccades, and to compare the responses to prosaccades
and antisaccades. We hypothesize that antisaccades would produce more prominent saccade-related
beta-band desynchronization (beta-SRD) than prosaccade.

Methods: We recorded the local field potentials from DBS electrodes implanted in the GPi in 7
primary focal dystonia patients 1 to 5 days after electrodes implantation when the leads were
externalized. The patients performed visually guided prosaccade and antisaccade tasks. We analyzed
the Molet wavelet power spectrum averaged on saccade onset using bipolar derivations.

Results: The beta-SRDs were observed in the GPi just prior to and during saccades in 6 patients.
Beta-SRD were observed in the contralateral or the ipsilateral GPi, and in some patients bilaterally.
The onsets, durations, and amplitudes of beta-SRDs were not different between prosaccades and
antisaccades.

Conclusion: Beta-SRDs were observed in the GPi of dystonia patients. Unlike beta-SRD in the STN,
beta-SRDs in the GPi were not related to inhibition of unwanted saccades, because they were not
different between prosaccades and antisaccades. While it is well known that the basal ganglia output
from the substantia nigra pars reticulata strongly inhibits the superior colliculus, our results suggest
that the basal ganglia output from the GPi, especially the beta-band desynchronization, may also be
involved in control of saccades.

Stereotact Funct Neurosurg 2014;92(suppl 2) : 1 - 262 p.7
Movement disorders
#94
Cerebellar peduncle stimulation reduces symptoms of dystonia in patients with
cerebral palsy treated due to spasticity

Pawel Sokal (1), Marek Harat (1), Marcin Rudas (1), Łukasz Szylberg (2), Marcin Rusinek (1)
1. Neurosurgery, Military Research Hospital, Bydgoszcz, Poland
2. Pathology, Collegium Medicum Univ Nicoalus Copernicus, Bydgoszcz, Poland

Introduction: Cerebellar Peduncle Stimulation (CPS) is a neuromodulative method of treatment of
spasticity. Bilateral CPS is applied in young patients with cerebral palsy (CP). In these patients
symptoms of spasticity coexist with symptoms of focal or segmental dystonia, which can cause
chronic pain. We performed the study in order to determine the efficacy of CPS.

Methods: We examined 10 patients with CP treated with CPS due to spasticity in years 2006-2012.
We compared Ashworth scores of spasticity, VAS score of pain and UDRS (Unified Dystonia Rating
Scale) score before CPS and after in follow-ups lasting from 2 to 11 years in these patients. We also
asked them or their parents on the impact of CPS on pain syndrome coexisting with spasticity and
dystonic involuntary movements.

Results: We received statistically significant reduction of spasticity in upper extremities (median :
from 3 to 1,5 in Ashwort scale) in 8 patients (p=0,01), in lower extremities in 7 patients (median : from
3 to 1,75 in Ashwort scale) (p=0,02). Better results were observed in elder patients over 26 years old.
Decrease in intensity of symptoms of dystonia measured in consecutive parts of UDRS in 7 patients
was statistically significant (median: from 1,6 to 1,0) (p=0,017). Symptoms of focal dystonia
(involuntary movements of neck and hand) were decreased by 45% and 40% respectively in 50% of
patients, in others reduction was ranging from 25 to 33%. Duration of these symptoms in 50% of
patients was reduced by 40%. Relief in pain was not statistically significant.

Conclusion: Chronic bilateral CPS aimed for spasticity treatment not only decreases muscular tone in
quadriplegic or paraplegic patients with CP but also is associated with reduction of symptoms of focal
or segmental dystonia.

Stereotact Funct Neurosurg 2014;92(suppl 2) : 1 - 262 p.8
Movement disorders
#102
Assessment of neural activation using directional deep brain stimulation leads

Christopher Butson (1), Lalit Venkatesan (2)
1. Biomedical Engineering, University of Utah, Salt Lake City, United States
2. Neuromodulation, St Jude Medical, Plano, TX, United States

Submitter: Mr Butson Christopher (US)

Introduction: Deep brain stimulation (DBS) therapy is applied using multi-contact leads that are
implanted in subcortical regions. Commercially available DBS leads contain cylindrical electrodes that
provide relatively uniform current spread radially outward. However, for more localized stimulation it
may be desirable to apply current preferentially in one direction, for example to steer current toward
one anatomical region that mediates therapeutic effects while avoiding another region where
stimulation causes side effects. A potential solution to this would be to divide each cylindrical electrode
into multiple radial segments and to activate these segments independently. In this study we used a
computational model to evaluate whether a novel DBS lead could provide preferential activation using
such segmented electrodes.

Methods: A previously published computational model of DBS (Butson et al, 2007) was used to
characterize neural activation for a novel lead design with two standard cylindrical electrodes and six
directional electrodes. All electrodes are 1.5 mm long (along the axis of the lead) and 1.27 mm
diameter. Of the four “rows” of electrodes in the directional lead, two are standard cylindrical contacts
and two are divided into thirds, where each contact has an arc length of 1.1 mm. A three-dimensional
finite element model of the electrodes and surrounding tissue medium was created in COMSOL
version 4.3 to compute the electric fields produced during stimulation with the standard cylindrical
electrodes as well as segmented electrodes. Multi-compartmental models of myelinated axons were
used to predict the neural response. This model takes into account the time-dependence of the
stimulation waveform and the electrical properties of tissue encapsulation surrounding the lead. The
volume of tissue activated (VTA) were determined for current-controlled stimulation (130 Hz, 60 µsec,
-.25 mA to -5 mA), and the size and radial directionality of VTAs for each electrode design was
assessed.

Results: The extent and direction of neural activation varied depending on the number of active
contacts. Standard cylindrical electrodes produced VTAs that were roughly spherical. However, when
individual segmented electrodes were activated, the VTA was displaced toward the side of the lead
with the active contact, creating preferential activation on one side. Compared to the standard
cylindrical electrode, VTA sizes were larger when fewer contacts were used. Stimulation with a single
directional electrode contact at common stimulation settings (2.5mA, 60 µsec, 130Hz) generated VTAs
that were 60% larger (196mm3) than the standard cylindrical electrode (179mm3); stimulation with two
adjacent active directional contacts generated VTAs that were 46% larger (166mm3); stimulation with
three active directional electrodes generated VTAs that were 36% larger (196mm3). When three
directional electrodes in one row were simultaneously activated, the VTA was of a very similar location
and shape compared to a standard cylindrical electrode.

Conclusion: This lead design could provide comparable capabilities to existing leads, but more
precise activation of targeted regions and better energy efficiency if incorporated into existing DBS
systems.

Stereotact Funct Neurosurg 2014;92(suppl 2) : 1 - 262 p.9
Movement disorders
#106
STUDY OF SUBTHALAMIC MOTOR CORTICAL CONNECTIVITY IN PARKINSON ́S
DISEASE AS PREDICTIVE FACTOR FOR DEEP BRAIN STIMULATION

Rebeca Conde (1), Antonio Gutierrez (1), Irene Martinez (2), Ignacio Rubio (2), Vicente Belloch (3), Carlos Botella (1)
1. Neurosurgery, Hospital Universitari i Politecnic La Fe, Valencia, Spain
2. Neurology, Hospital Universitari i Politecnic La Fe, Valencia, Spain
3. Radiology, Hospital Universitari i Politécnic La Fe, Valencia, Spain

Introduction: Identification of the motor part of the subthalamic nucleus as part of the pre-surgical
workup could minimize adverse effects and improved motor effects. We describe the subthalamic
patterns connectivity with IRM-DTI analysis and make a correlation study of DTI patterns with
hyperdirect pathway with MER and clinical effect of DBS therapy.

Methods: We analyzed 25 patients, 90 MER, and 50 DBS. Stereotactic procedure with Leksell frame
in 18 and Medtronic Nextframe in 17.
Alpha Omega software microguide system for MER. All patients have a study with T1 and T2 3T IRM,
3D CT scan co-register (stealthstation S7), sequential intraoperative Oarm, and postoperative CT
scan. DTI 3T IMR Philips 32 gradients in StealthViz and AMIRA System computer processed. We
made an analysis of subthalamic points of connectivity with motor cortical surface.

Results: The premotor cortical connectivity is 30% anterior and 70% central, and motor connection is
100% posterior. The circuit substantia nigra, red nucleus, mesencephalum and cerebellum is constant.
There is a intrathalamic connection between motor and premotor tracks. The part of subthalamic
nucleus connected with the motor system is central and lateral.

Conclusion: We could study the level of segregation of the STN motor part, which is relevant for the
planning of STN DBS procedures. We observe a correlation with motor recruitment and better clinical
results in patients with DBS sets near motor connectivity points.

Stereotact Funct Neurosurg 2014;92(suppl 2) : 1 - 262 p.10