Augmented Reality Platform for Deep Brain Stimulation

项目总结 丘脑深部电刺激(DBS)治疗帕金森病(PD) 有效地改善运动症状，提高患者的生活质量。不过，具体细节是 治疗刺激的解剖靶点(S)的问题仍未解决。星展银行最近的手术靶向 假说已经进化到认为直接刺激丘脑底核内的特定轴突通路 区域可能与特定症状的控制有关。不幸的是，关节的3D解剖特征 人类丘脑底区不同轴突通路的广泛排列是非常有限的，并且技术 想象一下目前集中在2D计算机屏幕上的复杂神经解剖学。这些限制阻碍了我们的 能够创建准确的模型并解释星展银行的效果。因此，我们提出这一重大需求 存在一个可以交互可视化的丘脑下部轴突路径的解剖驱动模型 具有全息3D成像，并与患者特定的DBS模拟相结合。 这项生物工程研究基金(PAR-16-242)的目标是创造下一代可视化 临床DBS的工具和外科靶向模型。这项研究的第一步将依赖于来自 汇集世界各地的基底节神经解剖学专家，帮助我们构建8个不同的虚拟3D图谱模型 丘脑下部的轴突通路。这一发展将发生在全息透镜增强 现实(AR)环境，从而使解剖专家能够面对面地讨论，同时 模型全息图的可视化及其交互调整。这项研究的第二步将评估 不同的纤维束成像算法重建解剖专家描述的路径的能力。我们 假设脑束造影术不能准确地捕捉大多数丘脑下部的解剖轨迹 没有大量建模约束的轴突路径。这一分析的结果将具有重要的 对DBS研究和临床实践中快速发展的纤维束造影术的影响。最后，我们会 将我们的丘脑下部轴突通路模型系统转换为可工作的交互式HoloLens AR应用程序 与患者特定的MRI数据集和DBS途径激活建模相结合。我们建议这样一个 该工具将特别适用于星展银行的外科教学和研究调查。

PROJECT SUMMARY Subthalamic deep brain stimulation (DBS) for the treatment of Parkinson's disease (PD) can be highly effective at improving motor symptoms and enhancing the patient's quality of life. However, the specific details of the anatomical target(s) for therapeutic stimulation remain unresolved. Recent DBS surgical targeting hypotheses have evolved to consider that direct stimulation of specific axonal pathways within the subthalamic region may be linked to the control of specific symptoms. Unfortunately, 3D anatomical characterization of the wide array of different axonal pathways in the human subthalamic region is very limited and techniques to visualize the complex neuroanatomy currently focus on 2D computer screens. These limitations hinder our ability to create accurate models and interpret the effects of DBS. Therefore, we propose that significant need exists for an anatomically driven model of subthalamic axonal pathways that can be interactively visualized with holographic 3D imaging and coupled to patient-specific DBS simulations. The goal of this Bioengineering Research Grant (PAR-16-242) is to create next generation visualization tools and surgical targeting models for clinical DBS. The first step of this study will rely on direct input from a collection of world experts in basal ganglia neuroanatomy to help us build a virtual 3D atlas model of 8 different axonal pathways in the subthalamic region. This development will occur within the HoloLens augmented reality (AR) environment, thereby enabling face-to-face discussion among the anatomy experts while visualizing the model hologram and its interactive adjustment. The second step of this study will evaluate the ability of various tractography algorithms to recreate the pathways described by the anatomy experts. We hypothesize that tractography will fail to accurately capture the anatomical trajectory of most subthalamic axonal pathways without extensive modeling constraints. Results from this analysis will have important implications for the rapid growth of tractography in DBS research, as well as clinical practice. Finally, we will translate our subthalamic axonal pathway model system into an interactive HoloLens AR application that works in concert with patient-specific MRI datasets and DBS pathway-activation modeling. We propose that such a tool will be especially useful for DBS surgical education and research investigation.