The development of image-guided and electrophysiological navigation for deep brain stimulation surgery

对术中微电极记录(MER)的帕金森病(PD)患者进行丘脑底核(STN)深部脑刺激(DBS)，以确定最佳部位。在STN DBS患者中，分别检查微电极标准与手术结果的相关性。记录到的STN神经元总数、运动相关神经元数目和STN长度与手术效果的改善显著相关，其中运动相关神经元的数目与手术结果相关性最强。我们发展了基于非线性变换理论的图像分析新技术。根据术中摄取的头颅X-P片(正位和侧位)中的自由空气量来评估脑移位，从而计算AC和PC移位。总之，我们开发了电生理导航，其中考虑了与手术结果显著相关的单个单元记录数据，并且实时电生理数据可以适用于3D虚拟Schaltenbland和Wahren图谱

Deep brain stimulation(DBS) of the subthalamic nucleus(STN) for the patients with Parkinson disease(PD) is performed using intraoperative microelectrode recording(MER) to define the optimal site. The correlation between microelectrode criteria and surgical outcome was respectively examined in the patients with STN DBS. The number of total STN neurons, movement-related neurons and the length of STN recorded were significantly correlated with improvement of the surgical outcome and the number of movement-related neurons was most strongly related with the surgical outcome. We developed the new image analysis technique based on non-linear transformation theory. The brain shift is evaluated according to the volume of free air in the skull X-P(front and lateral view) taken intraoperatively, resulting calculation of AC and PC displacement. Totally, we developed the electrophysiological navigation of which the single unit recording data significantly correlated to the surgical outcome is considered and the real-time electrophysiological data can be fitted to the 3Dvirtual Schaltenbland and Wahren atlas