{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T10:12:33Z","timestamp":1780395153605,"version":"3.54.1"},"reference-count":49,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T00:00:00Z","timestamp":1780358400000},"content-version":"vor","delay-in-days":1,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100008967","name":"Philipps-Universit\u00e4t Marburg","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100008967","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Acta Neurochir"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Accurate segmentation of the subthalamic nucleus (STN) is paramount for optimising outcomes under deep brain stimulation (DBS) in Parkinson\u2019s disease (PD). Clinically available tools like Brainlab Elements (BL-E) enable automated segmentations for surgical planning, yet their spatial relationship with postoperative volumes of tissue activated (VTAs) remains insufficiently characterised. Using multi-atlas segmentation (MAS) as an external anatomical reference, we compared the spatial correspondence of STN segmentations derived from BL-E with effective VTAs following monopolar contact review.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We analysed imaging data from 40 PD patients with chronic STN-DBS. Segmentations were obtained using BL-E based on T1w and T2w scans and MAS derived from a library of 20 manually segmented midbrain nuclei atlases. Spatial correspondence was assessed using Dice Coefficients, Jaccard Indices, and Euclidean centroid distances. Distances between VTA centroids and clinically established settings for STN-DBS were calculated to evaluate targeting consistency. Statistical differences between metrics were assessed using Wilcoxon signed-rank tests.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      BL-E segmentations demonstrated superior spatial correspondence with VTAs compared to MAS, with smaller Euclidean distances between centroids (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Dice Coefficients and Jaccard Indices showed no significant differences (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.18). VTA centroid distances to the most efficient stimulation location were consistent across hemispheres (left: 2.54\u00a0mm [1.92\u20133.25]; right: 2.87\u00a0mm [1.85\u20133.82]) MAS targets were positioned more inferiorly and anteriorly compared to BL-E targets.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Clinically applied VTAs showed good spatial correspondence with planning segmentations, suggesting within-workflow reproducibility but not superior correspondence to anatomical ground truth per se. Future studies should incorporate connectomic information to more accurately reflect the functional relevance of stimulation and its therapeutic effects.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00701-026-06930-3","type":"journal-article","created":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T15:18:27Z","timestamp":1780327107000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Subthalamic segmentations in relation to deep brain stimulation volumes in Parkinson\u2019s disease"],"prefix":"10.1007","volume":"168","author":[{"given":"Alexander","family":"Calvano","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yiming","family":"Xiao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenan","family":"Steidel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philipp A.","family":"Loehrer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marina C.","family":"Ruppert-Junck","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher","family":"Nimsky","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lars","family":"Timmermann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miriam H. 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Patient consent was not required in accordance with local or national guidelines.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval"}},{"value":"AC has participated in a training course, which was industry funded by Stada Arzneimittel AG and received a travel grant from the Prof. Klaus Thiemann Foundation in the German Society of Neurology. LT reports grants, personal fees, and non-financial support from SAPIENS Steering Brain Stimulation, Medtronic, Boston Scientific, and St. Jude Medical, anhas received payments from Bayer Healthcare, UCB Schwarz Pharma, and Archimedes Pharma and also honoraria as a speaker on symposia sponsored by Teva Pharma, Lundbeck Pharma, Bracco, Gianni PR, Medas Pharma, UCB Schwarz Pharma, Desitin Pharma, Boehringer Ingelheim, GSK, Eumecom, Orion Pharma, Medtronic, Boston Scientific, Cephalon, Abbott, GE Medical, Archimedes, and Bayer. DP received honoraria as a speaker at symposia sponsored by Boston Scientific Corp, Medtronic, AbbVie Inc., Zambon, and Esteve Pharmaceuticals GmbH. He received payments as a consultant for Boston Scientific Corp and Bayer, and he received a scientific grant from Boston Scientific Corp for a project entitled: \u2018Sensor-based optimisation of Deep Brain Stimulation settings in Parkinson\u2019s disease\u2019 (compareDBS). Finally, DP was reimbursed by Esteve Pharmaceuticals GmbH and Boston Scientific Corp for travel expenses to attend congresses. MB and CN are scientific consultants for Brainlab. The remaining authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"125"}}