{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T20:25:28Z","timestamp":1780431928570,"version":"3.54.1"},"reference-count":16,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2020,9,17]],"date-time":"2020-09-17T00:00:00Z","timestamp":1600300800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Brain Sciences"],"abstract":"<jats:p>Automatic anatomical segmentation of patients\u2019 anatomical structures and modeling of the volume of tissue activated (VTA) can potentially facilitate trajectory planning and post-operative programming in deep brain stimulation (DBS). We demonstrate an approach to evaluate the accuracy of such software for the ventral intermediate nucleus (VIM) using directional leads. In an essential tremor patient with asymmetrical brain anatomy, lead placement was adjusted according to the suggested segmentation made by the software (Brainlab). Postoperatively, we used directionality to assess lead placement using side effect testing (internal capsule and sensory thalamus). Clinical effects were then compared to the patient-specific visualization and VTA simulation in the GUIDE\u2122 XT software (Boston Scientific). The patient\u2019s asymmetrical anatomy was correctly recognized by the software and matched the clinical results. VTA models matched best for dysarthria (6 out of 6 cases) and sensory hand side effects (5\/6), but least for facial side effects (1\/6). Best concordance was observed for the modeled current anterior and back spread of the VTA, worst for the current side spread. Automatic anatomical segmentation and VTA models can be valuable tools for DBS planning and programming. Directional DBS leads allow detailed postoperative assessment of the concordance of such image-based simulation and visualization with clinical effects.<\/jats:p>","DOI":"10.3390\/brainsci10090642","type":"journal-article","created":{"date-parts":[[2020,9,17]],"date-time":"2020-09-17T08:29:43Z","timestamp":1600331383000},"page":"642","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Evaluation of Automatic Segmentation of Thalamic Nuclei through Clinical Effects Using Directional Deep Brain Stimulation Leads: A Technical Note"],"prefix":"10.3390","volume":"10","author":[{"given":"Marie T.","family":"Kr\u00fcger","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Cantonal Hospital, 9000 St. Gallen, Switzerland"},{"name":"Department of Stereotactic and Functional Neurosurgery, University Medical Center, 79106 Freiburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3034-5133","authenticated-orcid":false,"given":"Rebecca","family":"Kurtev-Rittstieg","sequence":"additional","affiliation":[{"name":"R&amp;D Functional and Stereotactic Neurosurgery, Brainlab AG, 81829 Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georg","family":"K\u00e4gi","sequence":"additional","affiliation":[{"name":"Department of Neurology, Cantonal Hospital, 9000 St. Gallen, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yashar","family":"Naseri","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Cantonal Hospital, 9000 St. Gallen, Switzerland"},{"name":"Department of Stereotactic and Functional Neurosurgery, University Medical Center, 79106 Freiburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan","family":"H\u00e4gele-Link","sequence":"additional","affiliation":[{"name":"Department of Neurology, Cantonal Hospital, 9000 St. Gallen, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Florian","family":"Brugger","sequence":"additional","affiliation":[{"name":"Department of Neurology, Cantonal Hospital, 9000 St. Gallen, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2020,9,17]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"E314","DOI":"10.1093\/neuros\/nyz018","article-title":"Rescuing Suboptimal Outcomes of Subthalamic Deep Brain Stimulation in Parkinson Disease by Surgical Lead Revision","volume":"85","author":"Nickl","year":"2019","journal-title":"Neurosurgery"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"130","DOI":"10.1016\/j.nicl.2018.01.008","article-title":"Connectivity derived thalamic segmentation in deep brain stimulation for tremor","volume":"18","author":"Akram","year":"2018","journal-title":"NeuroImage Clin."},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Akram, H., Hariz, M., and Zrinzo, L. 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