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This study aimed to find out whether preoperative diffusion tensor imaging (DTI) and probabilistic tractography could help with surgical planning for deep brain stimulation in the periaqueductal/periventricular grey area (PAG/PVG) in a patient with lower leg stump pain. A preoperative DTI was obtained from the patient, who then received DBS surgery in the PAG/PVG area with good pain relief. The postoperative MRI scan showing electrode placement was used to calculate four seed areas to represent the contacts on the Medtronic 3387 electrode. Probabilistic tractography was then performed from the pre-operative DTI image. Tracts were seen to connect to many areas within the pain network from the four different contacts. These initial findings suggest that preoperative DTI scanning and probabilistic tractography may be able to assist surgical planning in the future.

Original publication




Journal article


Br J Neurosurg

Publication Date





485 - 490


Amputees, Deep Brain Stimulation, Humans, Magnetic Resonance Imaging, Male, Middle Aged, Pain, Postoperative, Periaqueductal Gray, Phantom Limb, Preoperative Care, Time, Treatment Outcome