Segmentation and structural connectivity of the putamen for targeted convection enhanced drug delivery in Parkinson’s disease: a tractography-based approach

DWI-based deterministic tractography mapped motor cortical projections most consistently to the superior-posterior putamen in our AC-based segmentation. In our planning simulations, both frontal and occipital trajectories could be planned with similar safety and achieved similar simulated coverage of the segment. These results support using connectivity mapping and simple simulation as a planning adjunct to help select a motor-dominant putaminal target and compare trajectories. If validated clinically, targeting a motor-dominant segment could reduce exposure of non-motor putaminal regions and potentially reduce the required infusion volume.