Computer-assisted functional neurosurgery

在美国，运动障碍影响着500多万人。两种最常见的类型 运动障碍中最常见的是影响超过400万人的原发性震颤(ET)和帕金森氏症 (PD)，影响到50多万人。这些疾病的当代治疗包括高频 通过脑深部刺激(DBS)进行刺激。这种形式的治疗是为已经开始治疗的患者提供的 看到标准药物治疗的失败，以及药物治疗效果不佳的患者。 DBS程序包括以毫米级精度将电极放置在 功能区称为目标。 该程序的主要困难是感兴趣的目标在任何 因此，植入DBS电极的过程是一种 迭代过程。根据以下位置在手术前确定近似目标位置 在MR图像中可见的相邻结构。随着病人的清醒，这个位置随后被调整到 在操作上，这是一个漫长的过程。整个过程可能需要5-6个小时，需要专业知识 来自神经外科医生、电生理学家和神经科医生。此综合专业知识仅在以下位置提供 中心数量有限，这是每年只进行3000例手术的原因之一 尽管可以从中受益的患者数量要多得多。 该项目的目标是开发一种手术指导系统，以帮助神经外科医生 术前识别感兴趣的靶点，术中调整靶点位置。如果成功， 这个项目的结果将是一个系统，它将缩短程序的持续时间，提高其速度 成功，并使其在不具备领先研究机构的专业知识的网站上可行

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