How Do Craniometric Measurements and Skull Morphology Influence Subthalamic Nucleus Target Coordinations in Deep Brain Stimulation Surgery for Parkinson Disease?

Objective: This study investigates the correlation among craniometric measurements, skull morphology, and subthalamic nucleus (STN) target coordinates in DBS surgery.

Methods: We conducted a retrospective study of 77 Parkinson disease patients who underwent bilateral STN-DBS surgery at Nguyen Tri Phuong Hospital and University Medical Center in Ho Chi Minh City, Vietnam. Craniometric measurements and STN target coordinates were analyzed using Pearson correlation and multivariate linear regression. The coordinates of the STN were compared between 2 hemispheres in the same patient, based on skull morphology indices, including the Cephalic Index and the Cranial Vault Asymmetry Index.

Results: Significant gender-based differences were observed in craniometric measurements, with males exhibiting larger dimensions. STN coordinates demonstrated correlations with various cranial measurements, notably with X-coordinates correlating most strongly with horizontal arc and third ventricle width (r = 0.4 and r = 0.42, respectively). The linear regression equation: X (mm) = 0.967 + 0.202∗ Third ventricle width (mm) + 0.024∗Horizontal arc (mm) with R2 = 0.32. Skull morphology revealed potential asymmetries affecting STN coordinates.

Conclusions: Craniometric measurements and third ventricle width correlate significantly with STN coordinates, particularly the X-coordinates. Our study highlights the importance of individualized craniometric considerations in DBS surgery planning to optimize electrode placement and therapeutic outcomes.