Intraoperative functional mapping using infrared thermography

项目总结 大脑皮层的功能激活通过增加血液使局部体温显著升高 流动和新陈代谢。清醒患者进行运动、感觉、脑表面温度的变化， 或者语言任务可以用来推断活动的空间模式。清醒神经外科被用于 治疗难治性癫痫、神经胶质瘤和神经血管畸形，以便定位癫痫发作 和/或生理活动。保护关键功能区是避免术后神经损伤的关键 赤字。目前，直接电刺激(DES)是最常用的术中方法 外科标测，识别大脑功能关键区域，因此不会被切除。然而，DES是 空间分辨率低(~1厘米)，可能会引发癫痫发作，一次只能测试一个区域。这个项目 探讨了一种新的基于红外热像的术中功能定位方法，该方法具有较高的临床应用价值 分辨率(~100微米)，并同时监测所有暴露的大脑区域，没有癫痫发作的风险。 该装置将在清醒开颅后在啮齿动物的胡须桶皮质上进行测试。随之而来的胶质瘤 将对患者进行研究，因为与致痫相比，肿瘤对大脑温度的影响相对稳定。 病灶和血管畸形。一个马达测绘案例的初步数据显示， 对侧运动皮质，与DES有很强的一致性。目标一号将建立热特征 清醒开颅手术中的皮质激活。我们将优化红外线记录程序， 手术工作流程，以最大限度地提高信号收集和质量，同时最大限度地减少治疗干扰。一个 移动三脚架将稳定连接到笔记本电脑上的红外摄像头。计算机将会 通过附属的手术设备监控和收集行为数据。DES中当前使用的患者任务将是 适用于热像仪记录。目标2将利用红外热像仪的高时间分辨率 用于绘制大脑网络图。独立成分分析将热活动分解为 与大脑网络相对应的离散、独立的模式。这些地区的连通性模式 可以分析以提取相位信息。然后将测试网络激活信号的特征 DES结局的预测价值。如果成功，该项目将创造一种新的术中方法 清醒神经外科手术中的功能定位。未来的工作将整合术前功能标测 信息输入到热成像程序中。最终，我们希望提高手术中的精确度 脑电地形图，为了提高难治性癫痫患者手术的安全性和有效性， 神经胶质瘤和神经血管畸形。

PROJECT SUMMARY Functional activation of the cerebral cortex creates a robust increase in local temperature by increasing blood flow and metabolism. Changes in surface brain temperature while an awake patient performs a motor, sensory, or language task can be used to infer spatial patterns of activity. Awake neurosurgery is used in the management of drug-resistant epilepsy, glioma, and neurovascular malformation, in order to localize seizure and/or physiologic activity. Protection of key functional areas is imperative to avoiding postoperative neurologic deficits. Currently, direct electrical stimulation (DES) is the most commonly used method of intraoperative surgical mapping, which identifies functionally critical brain regions so they are not resected. However, DES is low spatial resolution (~1 cm), may provoke seizures, and can only test one area at a time. This project investigates a new method of intraoperative functional mapping based on infrared thermography, which is high resolution (~100 micron) and simultaneously monitors the all exposed brain regions without risk for seizures. The device will be tested on the rodent whisker barrel cortex following awake craniotomy. Subsequently glioma patients will be studied, as tumors have relatively static impact on brain temperature compared to epileptogenic foci and vascular malformations. Preliminary data in a motor mapping case shows strong thermal activation of contralateral motor cortex, and strong agreement with DES. Aim 1 will establish the thermal signature of cortical activation during awake craniotomy. We will optimize the infrared recording procedure within the surgical workflow, as to maximize signal collection and quality while minimizing treatment interference. A mobile tripod will stabilize the infrared camera, which is connected to a laptop computer. The computer will monitor and collect behavioral data via adjunct surgical devices. Patient tasks currently used in DES will be adapted for thermographic recording. Aim 2 will leverage the high temporal resolution of infrared thermography for mapping brain networks. Independent components analysis will decompose the thermal activity into discrete, independent patterns which correspond to brain networks. The connectivity patterns of these regions may be analyzed to extract phase information. Features of the network activation signal will then be tested for predictive value of DES outcomes. If successful, this project will create a new method for intraoperative functional mapping during awake neurosurgery. Future work will integrate preoperative functional mapping information into the thermal mapping procedure. Ultimately, we hope to improve the precision of intraoperative brain mapping, in order to increase the safety and efficacy of surgery for patients with drug-resistant epilepsy, glioma, and neurovascular malformations.