Software Guided Localization of the Subthalamic Nucleus During DBS Surgeries

描述（由申请人提供）：丘脑底核深部脑刺激（DBS）是治疗帕金森病的有效方法。由于STN很小（9 X 7 X 4 mm），并且使用常规成像技术无法很好地看到，因此使用微电极记录（MER）来确保准确检测STN边界。常用的电磁干扰技术是主观的，耗时的，需要经验丰富的电生理学家。因此，迫切需要开发新的方法，以准确和客观地检测丘脑下核的微电记录。在这个提议中，我们将利用多单元尖峰活动（MSA）来检测STN边界。MSA在STN内明显升高，有助于明确划定STN的背侧和腹侧边界。所提出的方法能够精确和均匀地放置刺激电极，从而改善DBS手术的结果。该方法简单易行，具有广泛应用于临床的潜力。拟议的项目将包括将独立的离线MSA分析转换为实时分析工具，该工具集成到当前可用的临床电生理工作站（FHC的指南4000）中，用于当前的功能性神经外科手术。使用电流对丘脑下核进行深部脑刺激是治疗帕金森病的有效方法（1-2）。目前还缺乏准确可靠的刺激目标检测方法。在这个项目中，我们实现了一种基于目标细胞活动的目标检测方法（22），该方法能够准确地放置刺激电极。该方法可广泛应用于临床，提高脑深部电刺激手术的效果。

DESCRIPTION (provided by applicant): Deep brain stimulation (DBS) of the subthalamic nucleus (STN) is effective treatment of Parkinson disease. Because the STN is small (9 X 7 X 4 mm) and it is not well visible using conventional imaging techniques, microelectrode recordings (MER) is used to ensure accurate detection of the STN borders. Commonly used MER techniques are subjective, time consuming and require an experienced electrophysiologist. Therefore, there is an urgent need to develop new methodologies for accurate and objective detection of the subthalamic nucleus during microelectrographic recordings. In this proposal we will utilize the multi-unit spiking activity (MSA) for detection of the STN borders. The MSA is characteristically elevated within the STN that facilitates unambiguous delineation of both the dorsal and ventral STN borders. The proposed approach enables exact and uniform placement of the stimulation electrodes that can improve outcome of the DBS surgeries. The proposed method is straightforward and has the potential to be used widely in clinical practice. The proposed project will involve work to translate the standalone, off-line MSA analysis into a real time analytical tool that is integrated into a currently available clinical electrophysiological workstation (FHC's Guideline 4000) for use in current functional neurosurgical procedures. PUBLIC HEALTH RELEVANCE: Project Narrative Deep brain stimulation of the subthalamic nucleus using electric current is an effective treatment of Parkinson disease (1-2). The accurate and reliable methods for detection of the target of stimulation are lacking. In this project, we implement a method for target detection based on an activity of the cells in the target (22) that enables accurate placement of the stimulating electrode. This approach can be widely used in clinical practice and it can improve outcomes of deep brain stimulation surgeries.