Computer-Assisted functional neurosurgery

描述(由申请人提供)：用于治疗运动障碍的大脑深部刺激程序很复杂。患者的选择是在神经外科医生、神经学家和理疗师参加的会议上进行的。电极的外科放置经常是具有挑战性的，因为在目前的成像方式下，感兴趣的目标不存在或很难被看到，或者由于术中脑转移而目标移动。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。刺激器的术后编程是一项同样具有挑战性和耗时的任务，需要从4000个可能的参数组合中进行选择，这些参数组合通常是通过多次拜访神经科医生的迭代过程得出的。在我们过去四年取得的成就的基础上，该项目的目标是：(1)尽可能地使这一过程中的每个步骤自动化；(2)创建一个综合系统，将整个过程从一个必须在多个参与者之间交流信息的过程转变为一个所有信息都可以在护理时间和时间点获得并根据正在执行的临床任务量身定做的过程；(3)在范德比尔特和其他地点对该系统进行现场和测试，并与这些地点合作，为全球的从业者建立一个星展银行的中央储存库；以及(4)与行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，该系统将有助于深部脑刺激器程序的规划、放置和编程阶段，用于治疗患有运动障碍的患者，如帕金森氏病(PD)或特发性震颤(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).