Computer-Assisted functional neurosurgery

描述（由申请人提供）：用于治疗运动障碍的深部脑刺激程序是复杂的。病人的选择是在会议上完成的，包括神经外科医生、神经科医生和物理治疗师。手术电极的放置通常是具有挑战性的，因为感兴趣的目标缺失或在当前的成像模式下很难看到，或者因为目标由于术中脑转移而移动。这是一个漫长的过程，通常在清醒的患者中进行，需要神经病学、电生理学和功能神经外科方面的专业知识。刺激器的术后规划同样是一项具有挑战性和耗时的任务，需要从4000种可能的参数组合中进行选择，通常需要多次访问神经科医生才能完成。基于我们过去四年的成就，这个项目的目标是：(1)尽可能地自动化这个过程的每一步；(2)创建一个综合系统，将整个过程从必须在许多参与者之间交流信息的过程转变为在护理时间和护理点提供所有信息的过程，并根据正在执行的临床任务进行定制；(3)在Vanderbilt和其他站点实地测试该系统，并与这些站点合作建立一个可供全球从业者使用的DBS中央存储库；(4)与工业伙伴合作推广该系统。

DESCRIPTION (provided by applicant): Deep Brain Stimulation procedures used to treat movement disorders are complex. Patient selection is done in conferences involving neurosurgeons, neurologists, and physical therapists. Surgical placement of electrodes is frequently challenging because targets of interest are absent or poorly visible with current imaging modalities, or because targets move due to intra-operative brain shift. It is a lengthy process performed typically in awake patients that requires expertise in neurology, electrophysiology, and functional neurosurgery. The post-surgical programming of the stimulator is an equally challenging and time consuming task, requiring a choice from among 4000 possible parameter combinations, usually arrived at through an iterative process spanning several visits to the neurologist. Building on our accomplishments over the last four years, the goals of this project are to: (1) automate as much as possible each step in this process; (2) create an integrated system that will transform the overall procedure from a process in which information must be communicated among the many actors to one in which all information will be available at the time and point of care, and tailored to the clinical task being performed; (3) field and test this system at Vanderbilt and at other sites and collaborate with these sites to establish one central repository for DBS that can be used by practitioners around the world; and (4) work with industrial partners to disseminate the system. PUBLIC HEALTH RELEVANCE: The goal of this project is to develop a system that will assist in the planning, placement, and programming phases of Deep Brain Stimulator procedures used to treat patients who suffer from movement disorders such as Parkinson's disease (PD) or essential tremor (ET).