Computer-assisted functional neurosurgery

在美国，运动障碍影响超过5，000，000人。两种最常见的类型 运动障碍的主要症状是原发性震颤（ET），影响超过4，000，000人，以及帕金森病 (PD)，影响超过50万人。这些疾病的当代治疗涉及高频率的 脑深部电刺激（DBS）这种形式的治疗提供给已经开始 看到标准药物治疗的失败，也看到药物治疗效果不佳的患者。 DBS手术涉及以毫米精度将电极放置在 功能区称为目标。 该过程的主要困难在于，感兴趣的目标在任何环境中都不可见或可见性差。 成像模态（例如，因此，植入DBS电极的过程是一个复杂的过程。 迭代过程近似的目标位置在术前从以下位置确定： 在MR图像中可见的相邻结构。当患者清醒时，该位置然后在内部调整。 这是一个漫长的过程。整个过程可能需要5-6个小时，需要专业知识 来自神经外科医生、电生理学家和神经科医生。这种综合的专业知识仅在 中心数量有限，这也是每年仅进行3000例手术的原因之一 尽管可以从中受益的患者数量要多得多。 本项目的目标是开发一种手术导航系统，以帮助神经外科医生 在术前识别感兴趣的目标和在术中调整目标位置。如果成功， 该项目的成果将是一个系统，将减少程序的持续时间，增加其速度， 成功，并使其在不具备领先研究机构专业知识的地点可行

Movement disorders affect over 5,000,000 people in the United States. The two most common types of movement disorders are essential tremor (ET),which affects over 4,000,000 and Parkinson's Disease (PD), which affects over 500,000 people. Contemporary treatment of these diseases involves high-frequency stimulation through deep brain stimulation (DBS). This form of therapy is offered to patients who have begun to see failure with standard medical therapy and also to patients in which medical therapy is poorly effective. A DBS procedure involves the placement, with millimetric accuracy, of an electrode in the proximity of functional areas referred to as targets. The main difficulty with the procedure is the fact that targets of interest are not or poorly visible in any imaging modality (e.g., MRI or X-ray CT).Hence, the process of implantation of a DBS electrode is an iterative procedure. An approximate target position is determined pre-operatively from the position of adjacent structures that are visible in MR images. With the patient awake, this position is then adjusted intra- operatively, which is a lengthy process. The entire procedure can take 5-6 hours, and requires expertise from a neurosurgeon, an electrophysiologist, and a neurologist. This combined expertise is only available at a limited number of centers, which is one of the reasons why only 3000 procedures are performed annually despite the much larger number of patients who could benefit from it. The goal of this project is to develop a surgical guidance systems that will assist neurosurgeons in identifying targets of interest pre-operatively and in adjusting target position intra-operatively. If successful, the outcome of this project will be a system that will reduce the duration of the procedure, increase its rate of success, and make it feasible at sites that do not have the expertise found at leading research institutions