Augmented Reality Platform for Deep Brain Stimulation

项目摘要 丘脑底脑深部电刺激（DBS）治疗帕金森病（PD）可以高度 有效改善运动症状并提高患者的生活质量。然而，具体细节 用于治疗刺激的解剖学目标仍然没有解决。近期DBS手术靶向 假设已经发展到考虑直接刺激底丘脑内特定轴突通路 区域可能与特定症状的控制有关。不幸的是， 在人类底丘脑区域中的各种不同的轴突通路是非常有限的， 可视化复杂的神经解剖目前集中在2D计算机屏幕上。这些限制阻碍了我们 创建准确模型并解释DBS效果的能力。因此，我们建议， 存在一个解剖驱动的模型，丘脑底轴突通路，可以交互式可视化 全息3D成像并结合患者特定的DBS模拟。 这项生物工程研究资助（PAR-16-242）的目标是创建下一代可视化 用于临床DBS的工具和手术靶向模型。这项研究的第一步将依赖于来自一个 收集了世界上基底神经节神经解剖学的专家，帮助我们建立了一个虚拟的3D图谱模型， 丘脑底区的轴突通路。这种发展将发生在HoloLens增强 现实（AR）环境，从而使解剖专家之间能够进行面对面的讨论， 可视化模型全息图及其交互式调整。本研究的第二步将评估 各种纤维束成像算法能够重建解剖专家描述的路径。我们 假设纤维束成像将不能准确地捕获大多数丘脑底核的解剖轨迹， 轴突通路而没有广泛的建模约束。这一分析的结果将具有重要意义。 对DBS研究中纤维束成像的快速发展以及临床实践的影响。最后我们将 将我们的底丘脑轴突通路模型系统转化为交互式HoloLens AR应用程序， 与患者特异性MRI数据集和DBS通路激活建模相一致。我们建议， 工具将是特别有用的DBS手术教育和研究调查。

PROJECT SUMMARY Subthalamic deep brain stimulation (DBS) for the treatment of Parkinson's disease (PD) can be highly effective at improving motor symptoms and enhancing the patient's quality of life. However, the specific details of the anatomical target(s) for therapeutic stimulation remain unresolved. Recent DBS surgical targeting hypotheses have evolved to consider that direct stimulation of specific axonal pathways within the subthalamic region may be linked to the control of specific symptoms. Unfortunately, 3D anatomical characterization of the wide array of different axonal pathways in the human subthalamic region is very limited and techniques to visualize the complex neuroanatomy currently focus on 2D computer screens. These limitations hinder our ability to create accurate models and interpret the effects of DBS. Therefore, we propose that significant need exists for an anatomically driven model of subthalamic axonal pathways that can be interactively visualized with holographic 3D imaging and coupled to patient-specific DBS simulations. The goal of this Bioengineering Research Grant (PAR-16-242) is to create next generation visualization tools and surgical targeting models for clinical DBS. The first step of this study will rely on direct input from a collection of world experts in basal ganglia neuroanatomy to help us build a virtual 3D atlas model of 8 different axonal pathways in the subthalamic region. This development will occur within the HoloLens augmented reality (AR) environment, thereby enabling face-to-face discussion among the anatomy experts while visualizing the model hologram and its interactive adjustment. The second step of this study will evaluate the ability of various tractography algorithms to recreate the pathways described by the anatomy experts. We hypothesize that tractography will fail to accurately capture the anatomical trajectory of most subthalamic axonal pathways without extensive modeling constraints. Results from this analysis will have important implications for the rapid growth of tractography in DBS research, as well as clinical practice. Finally, we will translate our subthalamic axonal pathway model system into an interactive HoloLens AR application that works in concert with patient-specific MRI datasets and DBS pathway-activation modeling. We propose that such a tool will be especially useful for DBS surgical education and research investigation.