Software Guided Localization of the Subthalamic Nucleus During DBS Surgeries

DBS 手术期间软件引导的丘脑底核定位

• 批准号: 7749485
• 负责人: LEE D MARGOLIN
• 金额: $ 20.22万
• 依托单位: FHC, INC.
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-12-15 至 2010-12-14
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7749485
• 关键词: Adverse effects; Algorithms; Application procedure; Brain region; Cells; Characteristics; Clinical; Computer software; Contralateral; Data; Deep Brain Stimulation; Detection; Devices; Dorsal; Electrodes; Ensure; Foundations; Goals; Guidelines; Imagery; Imaging Techniques; Implantation procedure; Lead; Limb structure; Location; Magnetic Resonance Imaging; Maps; Marketing; Massachusetts; Medical center; Methodology; Methods; Microelectrodes; Modification; Movement; Neurons; Neurosurgical Procedures; Operative Surgical Procedures; Outcome; Parkinson Disease; Patients; Performance; Phase; Positioning Attribute; Postoperative Period; Procedures; Production; Research Personnel; Signal Transduction; Structure of subthalamic nucleus; System; Techniques; Testing; Thick; Time; Translating; Translations; Universities; Validation; Width; Work; analytical tool; base; clinical practice; effective therapy; experience; implantation; improved; indexing; intraoperative imaging; novel; phase 1 study; phase 2 study; prototype; public health relevance; relating to nervous system

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.

描述(申请人提供)：丘脑底核(STN)深部脑刺激(DBS)是治疗帕金森病的有效方法。由于STN很小(9X7X4毫米)，使用常规成像技术不能很好地看到它，因此使用微电极记录(MER)来确保STN边界的准确检测。常用的MER技术主观性强，耗时长，需要有经验的电生理学家。因此，迫切需要开发新的方法来在显微电信号记录中准确和客观地检测丘脑底核。在这个方案中，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，便于明确界定STN的背侧和腹侧边界。所提出的方法能够准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。拟议的项目将涉及将独立的、离线的MSA分析转化为实时分析工具的工作，该工具被集成到目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程序。公共卫生相关性：项目叙述使用电流对丘脑底核进行脑深部刺激是治疗帕金森病的有效方法(1-2)。缺乏准确可靠的检测刺激目标的方法。在这个项目中，我们实现了一种基于目标(22)中细胞的活动来进行目标检测的方法，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实践，可改善脑深部刺激手术的效果。

项目成果

Localization of the subthalamic nucleus in Parkinson disease using multiunit activity.

• DOI: 10.1016/j.jns.2011.07.027
• 发表时间: 2011-11-15
• 期刊: JOURNAL OF THE NEUROLOGICAL SCIENCES
• 影响因子: 4.4
• 作者: Novak, Peter;Przybyszewski, Andrzej W.;Barborica, Andrei;Ravin, Paula;Margolin, Lee;Pilitsis, Julie G.
• 通讯作者: Pilitsis, Julie G.