Patient-adjustable MRI technology for high-resolution imaging of deep brain stimulation

用于深部脑刺激高分辨率成像的患者可调 MRI 技术

• 批准号: 9179807
• 负责人: Laleh Golestani Rad
• 金额: $ 9.46万
• 依托单位: MASSACHUSETTS GENERAL HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-09-01 至 2018-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9179807
• 关键词: Address; Affect; Age; American; Americas; Amyotrophic Lateral Sclerosis; Anatomy; Architecture; Basal Ganglia; Brain; Brain imaging; Cell Nucleus; Clinical; Clinical Protocols; Corpus striatum structure; Deep Brain Stimulation; Deposition; Detection; Diagnosis; Drug resistance; Effectiveness; Electrodes; Electromagnetic Fields; Electromagnetics; Ensure; Fiber; Functional Imaging; Functional Magnetic Resonance Imaging; Future; Geometry; Goals; Gold; Grant; Hand; Head; Image; Imaging Device; Imaging technology; Implant; Implanted Electrodes; Location; Magnetic Resonance Imaging; Major Depressive Disorder; Maps; Methodology; Modeling; Monitor; Morphologic artifacts; Motion; Motor Cortex; Movement Disorders; Multiple Sclerosis; Muscular Dystrophies; Neurodegenerative Disorders; Neurosurgical Procedures; Noise; Obsessive-Compulsive Disorder; Operative Surgical Procedures; Outcome; Parkinson Disease; Patients; Pattern; Phase; Physiologic pulse; Postoperative Period; Procedures; Protocols documentation; Refractory; Resolution; Rest; Safety; Series; Signal Transduction; Structure; System; Technology; Testing; Therapeutic; Thermometry; Time; Uncertainty; United States Food and Drug Administration; Ursidae Family; Validation; Work; absorption; abstracting; base; chronic neuropathic pain; chronic pain; cohort; design; electric field; hazard; independent component analysis; neuroimaging; non-invasive imaging; novel; programs; radiofrequency; research study; simulation; soft tissue; standard care; symptom treatment; tool

Project Summary/Abstract Deep brain stimulation (DBS) is a Food and Drug Administration (FDA) approved neurosurgical procedure that has emerged as the gold-standard treatment for drug-resistant Parkinson's disease (PD), the second most common neurodegenerative disorder, which affects more patients than the combined number of people diagnosed with multiple sclerosis, muscular dystrophy, and Lou Gehrig's disease. DBS is also used to treat refractory chronic pain, a debilitating condition that affects more than 100 million Americans. Despite the general effectiveness of DBS, its underlying mechanisms of action are still unclear. Uncertainties remain about which circuits are affected, which exact fiber bundles need to be targeted, and the most efficacious stimulation protocol. The meticulous use of neuroimaging, both for target verification and for monitoring treatment-induced changes in the functional connectivity of affected brain networks is an essential step in interpreting clinical outcomes, testing new hypotheses and, consequently, designing enhanced therapeutic protocols. In this regard, magnetic resonance imaging (MRI) appears excellently poised as a high-resolution, non-invasive imaging tool, which could help address these open questions. However, the interaction of the radiofrequency (RF) fields of MRI scanners and the implanted electrodes imposes serious safety hazards that restrict the applicability of MRI for DBS patients. As a result, available MRI methodologies for DBS patients are limited in resolution and suffer from severe image artifacts that confound studies of the functional connectivity of affected brain networks. This program develops and validates novel MRI methodologies tailored and validated for patient-specific geometries, which will bring MRI to bear on the clinical questions regarding the mechanism and targeting of DBS treatment. The specific aims of this project are, therefore: (1) to develop and validate a patient-adjustable, reconfigurable MRI transmit coil, integrated with a 32-channel close-fit brain array, which enables the reduction of the unwanted interaction of RF fields and implanted electrodes up to 100-fold below levels produced by currently available systems, while increasing the signal-to-noise ratio (SNR) up to four times at the level of cortical structures; (2) the validation of developed methodologies with comprehensive electromagnetic simulations and phantom experiments to determine the safe range of imaging parameters and optimize clinical imaging protocols; and (3) devising methodologies which use the developed technology to enhance prediction of altered patterns of functional connectivity of the cortico-striatal loops in advanced Parkinson's patients. The immediate goal of this project is to develop and optimize MRI methodologies to enhance structural and functional imaging of PD-affected brain networks at field intensities that are FDA approved for DBS imaging and to apply these methodologies for enhanced functional mapping of cortico-striatal loops in advanced PD patients. The outcome serves as the launching point for the long-term goal of enabling the study of dynamic DBS-induced changes in the functional architecture of the brain.

项目概要/摘要 深部脑刺激 (DBS) 是美国食品和药物管理局 (FDA) 批准的神经外科手术， 已成为治疗耐药性帕金森病 (PD) 的金标准，该病是第二大治疗药物 常见的神经退行性疾病，其影响的患者数量比总人数还要多 被诊断患有多发性硬化症、肌营养不良症和卢伽雷氏病。 DBS 也用于治疗 难治性慢性疼痛是一种使人衰弱的疾病，影响着超过一亿美国人。尽管 DBS 的总体有效性，其潜在的作用机制仍不清楚。仍存在不确定性 哪些回路受到影响，需要针对哪些确切的纤维束，以及最有效的刺激 协议。神经影像学的精心使用，既用于目标验证，又用于监测治疗引起的 受影响的大脑网络功能连接的变化是解释临床的重要一步 结果，测试新假设，从而设计增强的治疗方案。在这个 就这一点而言，磁共振成像 (MRI) 似乎非常适合作为一种高分辨率、非侵入性的技术 成像工具，可以帮助解决这些悬而未决的问题。然而，射频的相互作用 MRI 扫描仪和植入电极的 (RF) 场会带来严重的安全隐患，限制了 MRI 对 DBS 患者的适用性。因此，适用于 DBS 患者的 MRI 方法仅限于 分辨率并遭受严重的图像伪影，这混淆了受影响的功能连接的研究 大脑网络。 该计划开发并验证针对特定患者量身定制和验证的新型 MRI 方法 几何形状，这将使 MRI 能够解决有关机制和靶向的临床问题 深部脑刺激治疗。因此，该项目的具体目标是：（1）开发和验证患者可调节的、 可重构 MRI 发射线圈，与 32 通道紧密贴合脑阵列集成，可减少 射频场和植入电极产生的不必要的相互作用比以下产生的水平低 100 倍 目前可用的系统，同时将信噪比（SNR）提高至四倍 皮质结构； (2) 综合电磁场验证所开发的方法 模拟和模型实验以确定成像参数的安全范围并优化临床 成像协议； (3) 设计使用已开发技术来增强预测的方法 晚期帕金森病患者皮质纹状体环功能连接模式的改变。 该项目的近期目标是开发和优化 MRI 方法，以增强结构和 在 FDA 批准用于 DBS 成像的场强度下对受 PD 影响的大脑网络进行功能成像 并应用这些方法来增强晚期 PD 皮质纹状体环的功能映射 患者。该成果是实现动态研究这一长期目标的起点 DBS 引起大脑功能结构的变化。