{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T01:55:43Z","timestamp":1787018143911,"version":"build-2736575974"},"reference-count":48,"publisher":"MIT Press","license":[{"start":{"date-parts":[[2025,6,5]],"date-time":"2025-06-05T00:00:00Z","timestamp":1749081600000},"content-version":"vor","delay-in-days":155,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001659","name":"German Research Foundation","doi-asserted-by":"publisher","award":["424778381 \u2013TRR 295"],"award-info":[{"award-number":["424778381 \u2013TRR 295"]}],"id":[{"id":"10.13039\/501100001659","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001659","name":"German Research Foundation","doi-asserted-by":"publisher","award":["424778381 \u2013 TRR 295"],"award-info":[{"award-number":["424778381 \u2013 TRR 295"]}],"id":[{"id":"10.13039\/501100001659","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100013278","name":"EU Joint Programme \u2013 Neurodegenerative Disease Research","doi-asserted-by":"publisher","award":["DynaSti grant"],"award-info":[{"award-number":["DynaSti grant"]}],"id":[{"id":"10.13039\/100013278","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["R01MH130666, 1R01NS127892-01, 2R01 MH113929 & UM1NS132358"],"award-info":[{"award-number":["R01MH130666, 1R01NS127892-01, 2R01 MH113929 & UM1NS132358"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100016766","name":"New Venture Fund","doi-asserted-by":"publisher","award":["FFOR Seed Grant"],"award-info":[{"award-number":["FFOR Seed Grant"]}],"id":[{"id":"10.13039\/100016766","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["direct.mit.edu"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,6,24]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Deep Brain Stimulation (DBS) is a well-established approach to treat movement disorders such as Parkinson\u2019s Disease, dystonia or essential tremor. For optimal therapy response, accurate electrode placement is critical requiring high signal-to-noise of target areas in preoperative MRI. Currently, imaging protocols vary considerably between DBS centers, making it difficult to compare results or pool data for research purposes. Here, various currently employed MRI sequences from several DBS centers are evaluated regarding their suitability for DBS targeting and a protocol is suggested taking image quality and practical considerations into account. Two healthy subjects (52-year-old female and a 37-year-old male) were each scanned with various sequences (5 T2w, 1 PDw, 4 T2FLAIRw, 2 T2*w, 5 SWI, 2 FGATIR, 1 T1TIR, and 2 QSM techniques) that then were rated by 12 experienced DBS surgeons for their suitability for targeting the subthalamic nucleus (STN), the internal globus pallidus internus (GPi), and the ventrointermediate (VIM) thalamic nucleus. For a subset of sequences, surgeons were asked to identify the optimal DBS target in the STN and GPi. Contrast-to-noise ratios (CNR) were calculated and correlated to intra-rater z-scores and distances of target coordinates. For STN-DBS, surgeons rated T2w, most SWI, QSM, and T2FLAIRw the highest. For GPi-DBS, FGATIR, PDw, and SWI and for VIM-DBS, FGATIR were deemed the most suitable. Higher CNR correlated with higher intra-rater z-scores (R2 = 0.29, p &amp;lt; .005) which improved targeting (R2 = 0.18, p &amp;lt; .05). Our MRI protocol suggestion is a first step toward standardizing preoperative imaging. All imaging data, MRI sequence parameters, and protocol files are made openly available.<\/jats:p>","DOI":"10.1162\/imag.a.52","type":"journal-article","created":{"date-parts":[[2025,6,5]],"date-time":"2025-06-05T16:02:23Z","timestamp":1749139343000},"update-policy":"https:\/\/doi.org\/10.1162\/mitpressjournals.corrections.policy","source":"Crossref","is-referenced-by-count":4,"title":["Toward a standard preoperative MRI protocol for functional neurosurgery"],"prefix":"10.1162","volume":"3","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2448-3986","authenticated-orcid":false,"given":"Christopher","family":"G\u00fcttler","sequence":"first","affiliation":[{"name":"Institute of Radiology, Charit\u00e9 - Universit\u00e4tsmedizin Berlin, Corporate Member of Freie Universit\u00e4t Berlin, Humboldt-Universit\u00e4t zu Berlin, and Berlin Institute of Health (BIH), Berlin, Germany"},{"name":"Movement Disorders and Neuromodulation Unit, Department of Neurology, Charit\u00e9 - Universit\u00e4tsmedizin Berlin, Corporate Member of Freie Universit\u00e4t Berlin, Humboldt-Universit\u00e4t zu Berlin, and Berlin Institute of Health (BIH), Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0657-6516","authenticated-orcid":false,"given":"Johannes","family":"Achtzehn","sequence":"additional","affiliation":[{"name":"Movement Disorders and Neuromodulation Unit, Department of Neurology, Charit\u00e9 - Universit\u00e4tsmedizin Berlin, Corporate Member of Freie Universit\u00e4t Berlin, Humboldt-Universit\u00e4t zu Berlin, and Berlin Institute of Health (BIH), Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patric","family":"Blomstedt","sequence":"additional","affiliation":[{"name":"Dept of Clinical Neuroscience \/ Unit for Deep Brain Stimulation, University Hospital of Northern Sweden, Ume\u00e5, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"St\u00e9phan","family":"Charbard\u00e8s","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Universit\u00e9 Joseph Fourier, Grenoble, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katharina","family":"Faust","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Charit\u00e9 - Universit\u00e4tsmedizin Berlin, Corporate Member of Freie Universit\u00e4t Berlin, Humboldt-Universit\u00e4t zu Berlin, Berlin Institute of Health, Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1773-1518","authenticated-orcid":false,"given":"Stefan","family":"Hetzer","sequence":"additional","affiliation":[{"name":"Berlin Center for Advanced Neuroimaging, Charit\u00e9 \u2013 Universit\u00e4tsmedizin Berlin, Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian H.","family":"Kopell","sequence":"additional","affiliation":[{"name":"Nash Family Center for Advanced Circuit Therapeutics, Icahn School of Medicine at Mount Sinai, New York, NY, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joachim K.","family":"Krauss","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Hannover Medical School, Hannover, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8257-3694","authenticated-orcid":false,"given":"Andres","family":"Lozano","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery, Department of Surgery, University of Toronto, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1114-8938","authenticated-orcid":false,"given":"Joseph","family":"Neimat","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Louisville, School of Medicine, Louisville, KY, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francisco A.","family":"Ponce","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Barrow Neurological Institute, St. Joseph\u2019s Hospital and Medical Center, Phoenix, Arizona"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pratik","family":"Rohatgi","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Boston University, Boston, MA, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Rolston","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Utah, Salt Lake City, UT, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mathieu","family":"Santin","sequence":"additional","affiliation":[{"name":"Sorbonne Universit\u00e9, Institut du Cerveau - Paris Brain Institute - ICM, INSERM, CNRS, Paris, France"},{"name":"ICM, Centre de NeuroImagerie de Recherche - CENIR, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philip A.","family":"Starr","sequence":"additional","affiliation":[{"name":"Weill Institute for Neurosciences, University of California, San Francsico, CA, United States"},{"name":"Department of Neurosurgery, University of California, San Francisco, San Francisco, CA, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Veerle","family":"Visser-Vandewalle","sequence":"additional","affiliation":[{"name":"Network Stimulation Institute, Department of Stereotactic and Functional Neurosurgery, University Hospital Cologne, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea A","family":"K\u00fchn","sequence":"additional","affiliation":[{"name":"Movement Disorders and Neuromodulation Unit, Department of Neurology, Charit\u00e9 - Universit\u00e4tsmedizin Berlin, Corporate Member of Freie Universit\u00e4t Berlin, Humboldt-Universit\u00e4t zu Berlin, and Berlin Institute of Health (BIH), Berlin, Germany"},{"name":"NeuroCure Cluster of Excellence, Charit\u00e9 - Universit\u00e4tsmedizin Berlin, Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas","family":"Horn","sequence":"additional","affiliation":[{"name":"Network Stimulation Institute, Department of Stereotactic and Functional Neurosurgery, University Hospital Cologne, Germany"},{"name":"Center for Brain Circuit Therapeutics Department of Neurology Brigham & Women\u2019s Hospital, Harvard Medical School, Boston, MA, United States"},{"name":"MGH Neurosurgery & Center for Neurotechnology and Neurorecovery (CNTR) at MGH Neurology Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Tietze","sequence":"additional","affiliation":[{"name":"Institute of Neuroradiology, Charit\u00e9-Universit\u00e4tsmedizin Berlin, Corporate Member of Freie Universit\u00e4t Berlin, Humboldt-Universit\u00e4t zu Berlin, and Berlin Institute of Health (BIH), Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"281","published-online":{"date-parts":[[2025,6,24]]},"reference":[{"key":"2025062417205211800_IMAG.a.52-b1","doi-asserted-by":"crossref","first-page":"332","DOI":"10.1016\/j.neuroimage.2017.07.012","article-title":"Subthalamic deep brain stimulation sweet spots and hyperdirect cortical connectivity in Parkinson\u2019s disease","volume":"158","author":"Akram","year":"2017","journal-title":"NeuroImage"},{"issue":"10","key":"2025062417205211800_IMAG.a.52-b2","doi-asserted-by":"crossref","first-page":"4734","DOI":"10.1073\/pnas.0911855107","article-title":"Toward discovery science of human brain function","volume":"107","author":"Biswal","year":"2010","journal-title":"Proceedings of the National Academy of Sciences"},{"issue":"5","key":"2025062417205211800_IMAG.a.52-b3","doi-asserted-by":"crossref","first-page":"493","DOI":"10.1136\/jnnp-2017-316907","article-title":"Deep brain stimulation for Parkinson\u2019s disease: Defining the optimal location within the subthalamic nucleus","volume":"89","author":"Bot","year":"2018","journal-title":"Journal of Neurology, Neurosurgery, and Psychiatry"},{"issue":"5","key":"2025062417205211800_IMAG.a.52-b4","doi-asserted-by":"crossref","first-page":"1445","DOI":"10.3171\/2020.8.JNS201125","article-title":"A literature review of magnetic resonance imaging sequence advancements in visualizing functional neurosurgery targets","volume":"135","author":"Boutet","year":"2021","journal-title":"Journal of Neurosurgery"},{"issue":"4","key":"2025062417205211800_IMAG.a.52-b5","doi-asserted-by":"crossref","first-page":"467","DOI":"10.3109\/02688697.2013.854312","article-title":"1.5T versus 3T MRI for targeting subthalamic nucleus for deep brain stimulation","volume":"28","author":"Cheng","year":"2014","journal-title":"British Journal of Neurosurgery"},{"key":"2025062417205211800_IMAG.a.52-b6","doi-asserted-by":"crossref","first-page":"611194","DOI":"10.3389\/fnins.2020.611194","article-title":"Quantitative multi-parameter mapping optimized for the clinical routine","volume":"14","author":"Cooper","year":"2020","journal-title":"Frontiers in Neuroscience"},{"key":"2025062417205211800_IMAG.a.52-b7","doi-asserted-by":"crossref","first-page":"170","DOI":"10.3389\/fnins.2016.00170","article-title":"The International Deep Brain Stimulation Registry and Database for Gilles de la Tourette syndrome: How does it work?","volume":"10","author":"Deeb","year":"2016","journal-title":"Frontiers in Neuroscience"},{"issue":"4","key":"2025062417205211800_IMAG.a.52-b8","doi-asserted-by":"crossref","first-page":"527","DOI":"10.1002\/ana.25567","article-title":"Probabilistic sweetspots predict motor outcome for deep brain stimulation in Parkinson\u2019s disease","volume":"86","author":"Dembek","year":"2019","journal-title":"Annals of Neurology"},{"issue":"9","key":"2025062417205211800_IMAG.a.52-b9","doi-asserted-by":"crossref","first-page":"896","DOI":"10.1056\/NEJMoa060281","article-title":"A randomized trial of deep-brain stimulation for Parkinson\u2019s disease","volume":"355","author":"Deuschl","year":"2006","journal-title":"New England Journal of Medicine"},{"issue":"2","key":"2025062417205211800_IMAG.a.52-b10","doi-asserted-by":"crossref","first-page":"360","DOI":"10.3171\/2018.3.JNS172145","article-title":"High-resolution QSM for functional and structural depiction of subthalamic nuclei in DBS presurgical mapping","volume":"131","author":"Dimov","year":"2018","journal-title":"Journal of Neurosurgery"},{"issue":"9","key":"2025062417205211800_IMAG.a.52-b11","first-page":"1516","article-title":"Is the subthalamic nucleus hypointense on T2-weighted images? A correlation study using MR imaging and stereotactic atlas data","volume":"25","author":"Dormont","year":"2004","journal-title":"AJNR. American Journal of Neuroradiology"},{"issue":"9","key":"2025062417205211800_IMAG.a.52-b12","doi-asserted-by":"crossref","first-page":"e0184661","DOI":"10.1371\/journal.pone.0184661","article-title":"MRIQC: Advancing the automatic prediction of image quality in MRI from unseen sites","volume":"12","author":"Esteban","year":"2017","journal-title":"PLoS One"},{"issue":"10","key":"2025062417205211800_IMAG.a.52-b13","doi-asserted-by":"crossref","first-page":"904","DOI":"10.1016\/j.tibtech.2017.06.010","article-title":"Ultra high field MRI-guided deep brain stimulation","volume":"35","author":"Forstmann","year":"2017","journal-title":"Trends in Biotechnology"},{"issue":"5","key":"2025062417205211800_IMAG.a.52-b14","doi-asserted-by":"crossref","first-page":"777","DOI":"10.1002\/alz.12238","article-title":"Brain structures and networks responsible for stimulation-induced memory flashbacks during forniceal deep brain stimulation for Alzheimer\u2019s 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Parkinson\u2019s disease","volume":"24","author":"Noecker","year":"2021","journal-title":"Neuromodulation: Journal of the International Neuromodulation Society"},{"issue":"5","key":"2025062417205211800_IMAG.a.52-b34","doi-asserted-by":"crossref","first-page":"602","DOI":"10.1002\/ana.26324","article-title":"Probabilistic mapping reveals optimal stimulation site in essential tremor","volume":"91","author":"Nowacki","year":"2022","journal-title":"Annals of Neurology"},{"issue":"5","key":"2025062417205211800_IMAG.a.52-b35","doi-asserted-by":"crossref","first-page":"956","DOI":"10.1002\/ana.25887","article-title":"Deep brain stimulation for chronic cluster headache: Meta-analysis of individual patient data","volume":"88","author":"Nowacki","year":"2020","journal-title":"Annals of Neurology"},{"issue":"4","key":"2025062417205211800_IMAG.a.52-b36","doi-asserted-by":"crossref","first-page":"412","DOI":"10.1093\/ons\/opx131","article-title":"Utilization of quantitative susceptibility mapping 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