Computer-Assisted functional neurosurgery

描述（由申请人提供）：用于治疗运动障碍的脑深部电刺激程序很复杂。病人的选择是在神经外科医生、神经科医生和物理治疗师参加的会议上进行的。电极的手术放置通常具有挑战性，因为感兴趣的目标不存在或在当前成像模式下可见性差，或者因为目标由于术中脑移位而移动。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的专业知识。刺激器的术后编程同样具有挑战性且耗时，需要从4000种可能的参数组合中进行选择，通常通过多次拜访神经科医生的迭代过程来实现。 基于我们过去四年的成就，这个项目的目标是：（1）尽可能自动化这个过程中的每一步;（2）建立一个综合系统，将整个程序从一个必须在许多参与者之间交流信息的过程转变为一个在护理的时间和地点都可以获得所有信息的过程，并针对正在执行的临床任务进行定制;（3）在范德比尔特和其他地点现场测试该系统，并与这些地点合作，建立一个可供世界各地从业人员使用的DBS中央储存库;以及（4）与工业合作伙伴合作，传播该系统。 公共卫生相关性：该项目的目标是开发一种系统，该系统将有助于脑深部刺激器程序的规划，放置和编程阶段，用于治疗患有运动障碍的患者，如帕金森病（PD）或原发性震颤（ET）。

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).