Intraoperative functional mapping using infrared thermography

项目摘要 大脑皮层的功能性激活通过增加血液循环， 流动和新陈代谢。当清醒的病人进行运动，感觉， 或语言任务可以用来推断活动的空间模式。清醒神经外科用于 管理耐药性癫痫、神经胶质瘤和神经血管畸形，以定位癫痫发作 和/或生理活动。保护关键功能区是避免术后神经功能障碍的必要条件。 赤字目前，直接电刺激（DES）是术中最常用的方法。 外科映射，它确定功能关键的大脑区域，使它们不被切除。然而，DES是 空间分辨率低（~1 cm），可能引起癫痫发作，并且一次只能检测一个区域。这个项目 研究了一种基于红外热像图的术中功能标测的新方法， 分辨率（~100微米），同时监测所有暴露的大脑区域，而没有癫痫发作的风险。 该器械将在清醒开颅术后的啮齿动物须桶皮质上进行测试。随后胶质瘤 将对患者进行研究，因为与致癫痫相比，肿瘤对脑温度的影响相对静态。 病灶和血管畸形。运动映射病例的初步数据显示， 对侧运动皮层，与DES高度一致。目标1将确定 清醒开颅手术时大脑皮层激活我们将优化红外记录程序内， 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 移动的三脚架将稳定红外摄像机，这是连接到笔记本电脑。计算机将 通过辅助手术装置监测和收集行为数据。目前在DES中使用的患者任务将 适用于热成像记录。AIM 2将利用红外热成像的高时间分辨率 用于绘制大脑网络。独立成分分析将热活动分解为 与大脑网络相对应的离散的、独立的模式。这些区域的连通模式 可以被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方法， 清醒状态下的神经外科手术中的功能映射。未来的工作将整合术前功能标测 将信息导入热成像程序。最终，我们希望提高术中的精确度， 脑地形图，为了增加耐药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.