Computer-assisted functional neurosurgery

描述（由申请人提供）：运动障碍影响美国超过5，000，000人。两种最常见的运动障碍类型是原发性震颤（ET），影响超过4，000，000人，以及帕金森病（PD），影响超过500，000人。这些疾病的当代治疗涉及通过脑深部电刺激（DBS）的高频刺激。这种形式的治疗提供给那些已经开始看到标准药物治疗失败的患者，也提供给那些药物治疗效果不佳的患者。DBS手术涉及以毫米精度将电极放置在被称为目标的功能区域附近。该过程的主要困难是感兴趣的目标在任何成像模态中都不可见或可见性差（例如，MRI或X射线CT）。因此，DBS电极的植入过程是一个迭代过程。术前根据MR图像中可见的相邻结构的位置确定近似目标位置。在患者清醒的情况下，然后在术中调整该位置，这是一个漫长的过程。整个过程可能需要5-6个小时，需要神经外科医生，电生理学家和神经科医生的专业知识。这种结合的专业知识只在有限数量的中心，这是为什么只有3000程序每年进行的原因之一，尽管有更多的患者谁可以从中受益。本项目的目标是开发一个手术导航系统，将有助于神经外科医生在术前确定目标的利益和在术中调整目标位置。如果成功，该项目的成果将是一个系统，将减少程序的持续时间，提高其成功率，并使其在不具备领先研究机构专业知识的地点可行

DESCRIPTION (provided by applicant): Movement disorders affect over 5,000,000 people in the United States. The two most common types of movement disorders are essential tremor (ET), which affects over 4,000,000 and Parkinson's Disease (PD), which affects over 500,000 people. Contemporary treatment of these diseases involves high-frequency stimulation through deep brain stimulation (DBS). This form of therapy is offered to patients who have begun to see failure with standard medical therapy and also to patients in which medical therapy is poorly effective. A DBS procedure involves the placement, with millimetric accuracy, of an electrode in the proximity of functional areas referred to as targets. The main difficulty with the procedure is the fact that targets of interest are not or poorly visible in any imaging modality (e.g., MRI or X-ray CT). Hence, the process of implantation of a DBS electrode is an iterative procedure. An approximate target position is determined pre-operatively from the position of adjacent structures that are visible in MR images. With the patient awake, this position is then adjusted intra- operatively, which is a lengthy process. The entire procedure can take 5-6 hours, and requires expertise from a neurosurgeon, an electrophysiologist, and a neurologist. This combined expertise is only available at a limited number of centers, which is one of the reasons why only 3000 procedures are performed annually despite the much larger number of patients who could benefit from it. The goal of this project is to develop a surgical guidance systems that will assist neurosurgeons in identifying targets of interest pre-operatively and in adjusting target position intra-operatively. If successful, the outcome of this project will be a system that will reduce the duration of the procedure, increase its rate of success, and make it feasible at sites that do not have the expertise found at leading research institutions