Computer-Assited Functional Neurosurgery

 描述(申请人提供)：脑深部刺激(DBS)程序，越来越多地用于治疗一系列运动、情绪和行为障碍，是复杂的。有效的电极植入需要一个艰苦的过程，首先是一项具有挑战性的任务，即将解剖靶点选择与生理矫正相关联，以考虑患者的差异和术中脑移位。植入后，需要通过测试和观察过程来选择在减少症状的同时将副作用降至最低的刺激参数，该过程可能很长，并分散在几次访问中。在该项目的最后两个资助期内，我们开发了一个系统，为程序的所有阶段提供援助。该系统是第一个允许捕获、存储和空间标准化与DBS案件有关的所有数据的系统。这允许创建基于人群的统计地图集，为个别患者定制该信息，并在护理时间和地点访问该信息。该系统已经整合到我们机构的临床流程中，包含了从多个机构获得的1400多名受试者的数据。我们已经证明，这个系统对手术的规划、安置和编程阶段有积极的影响，由于我们建立了商业合作伙伴关系，我们系统的组件已经可以用于常规临床使用。在此资助期间，我们将在之前努力的基础上，继续对或系统进行临床评估，扩展其功能，并将其部署在合作地点。我们的长期目标是开发和部署(1)第一个集成的DBS解决方案，它将允许在程序的所有阶段之间无缝交换信息，以及(2)一个共享的全球资源，将允许快速传播与特定大脑目标相关的发现和结果。它将会因此 成为一种催化剂，既可以加快神经科学的发现，又可以改善临床过程。

 DESCRIPTION (provided by applicant): Deep-brain stimulation (DBS) procedures, which are increasingly used to treat a spectrum of movement, mood and behavioral disorders, are complex. Effective electrode implantation requires a painstaking procedure that begins with the challenging task of correlating anatomical target selection with physiological correction to account for patient variance and intraoperative brain shift. Following implantation, stimulation parameters that reduce symptoms while minimizing side effects need to be selected through a test-and-observe process that can be lengthy and spread over several visits. Over the last two funding periods of this project we have developed a system that provides assistance for all phases of the procedure. This system is the first one that permits the capture, storage, and spatial normalization of all data pertaining to DBS cases. This permits the creation of population-derived statistical atlases, customization of this information to individual patients, ad access to this information at the time and point of care. This system has been integrated into the clinical flow at our institution and contains data from more than 1400 subjects acquired at multiple institutions. We have shown that this system has a positive impact on the planning, placement, and programming phases of the procedure and, thanks to commercial partnerships we have established, components of our system are already available for routine clinical use. In this funding period, we will build on our previous efforts to continue the clinical evaluation of or system, expand its functionality, and deploy it at collaborating sites. Our long term goals are to develop and field (1) the first integrated DBS solution that will permit seamless exchange of information between all phases of the procedure and (2) a shared and global resource that will allow rapid dissemination of discovery and outcomes related to specific brain targets. It will thus be a catalyst that can both speed up discoveries in neurological sciences and improve clinical processes.