MRI localization of the subthalamic nucleus in normal adults and its relation with age

The subthalamic nucleus regulates motor and neurocognitive functions. Because of its small size and close proximity to other small subcortical structures, it has been a challenge to localize and visualize it using MRI. Here, we sought to define the optimal MRI scan method and visualization plane for locating the subthalamic nucleus on MRI images and to further delineate the geometric dimensions of the subthalamic nucleus and their correlation with age, laterality, and sex. Healthy volunteers received axial, sagittal, and coronal T2_3D_DRIVE CLEAR, coronal T1-WI, coronal T2FLAIR, coronal T2, and coronal SWI sequence. The coronal T2-3D-DRIVE CLEAR images were compared with the Schaltenbrand-Wahren Atlas for Stereotaxy of the Human Brain for localizing the subthalamic nucleus. The best visualization plane with the largest sectional area and the most distinct outline was obtained and region of interest was delineated manually on the basis of the contours of the bilateral subthalamic nuclei in T2-WI images. T2-3D-DRIVE CLEAR in the coronal view showed optimal visualization of the subthalamic nucleus and indicated that the subthalamic nucleus showed three morphological types: the double convex lens type (172, 64%), the ram's horn type (62, 23%), and the willow leaf type (34, 13%). There were no statistically significant differences because of laterality, sex, and age in the sectional area, and maximal long and short diameter of the subthalamic nucleus. On the basis of our results, the current study has shown that T2-3D-DRIVE CLEAR in the coronal view provides optimal visualization of the subthalamic nucleus, which shows three distinct morphological types on MRI images, and there is no statistically significant difference in the geometric dimensions of the subthalamic nucleus because of laterality, sex, and age in normal individuals.