Software Guided Localization of the Subthalamic Nucleus During DBS Surgeries

描述（由申请人提供）：丘脑底核（DBS）脑深部电刺激（DBS）是帕金森病的有效治疗方法。由于牙槽嵴很小（9 X 7 X 4 mm），使用传统成像技术无法很好地观察到，因此使用微电极记录（MER）来确保牙槽嵴边界的准确检测。常用的MER技术是主观的，耗时的，需要有经验的电生理学家。因此，迫切需要开发新的方法，以准确和客观的检测丘脑底核在微电记录。在这个建议中，我们将利用多单位尖峰活动（MSA）的检测的边缘。STN内的MSA典型地升高，这有助于清楚地描绘STN的背侧和腹侧边界。所提出的方法使得能够准确和均匀地放置刺激电极，这可以改善DBS手术的结果。所提出的方法是简单的，并有可能在临床实践中广泛使用。拟议的项目将涉及将独立的离线MSA分析转化为真实的时间分析工具的工作，该工具集成到当前可用的临床电生理工作站（FHC指南4000）中，用于当前的功能性神经外科手术。公共卫生相关性：使用电流对丘脑底核进行脑深部刺激是帕金森病的有效治疗方法（1-2）。缺乏准确可靠的刺激靶点检测方法。在该项目中，我们实现了一种基于目标（22）中的细胞的活动的目标检测方法，其使得能够准确放置刺激电极。这种方法可以广泛应用于临床实践，并可以改善脑深部电刺激手术的结果。

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.