Deep brain nucleus targeting in Parkinson's disease and essential tremor by image guided surgery using neuronavigation system with tractography and volume of tissue of activated assessment.

IGS using neuronavigation allowed more accurate deep nucleus targeting, minimized intra- and post-operative complications and improved clinical outcome in DBS candidate patients. Our study revealed that increased white matter connections with remote parts of the brain would suggest that isolated deep nucleus stimulation could not explain symptom recovery and that patients' specific white matter stimulation by tractography coupled with IGS should be in priority.