Neuroimaging Tools for Assessing Visual System Pathology

描述（由申请人提供）：该项目的目标是开发功能性磁共振成像（fMRI）应用于评估人类大脑相关视觉病理。这项工作将满足临床对复杂的术前评估方法的关键需求，这些方法可以提供局灶性病理部位与周围视觉皮层功能状态之间关系的精确、详细的图像。这些信息对于计划手术治疗是必不可少的，以最佳方式切除或修复病理（如肿瘤），同时避免严重的视力丧失。生物工程将用于开发、优化和验证方法，以绘制病理部位内和周围的视觉皮质功能，并将皮质功能紊乱与视觉紊乱联系起来。交互式医师界面将允许临床医生以易于使用的格式查看这些分析结果，并允许模拟手术策略并立即显示对视力的潜在影响。患者将能够体验预期视力丧失的模拟，从而使医生和患者都能评估所建议的治疗方法。开发的工具也将应用于假设驱动的实验，旨在表征局灶病理、皮层功能和视觉感知之间的基本相互关系，无论是急性的，还是随着它们在治疗和恢复过程中的演变。不同的病理，包括中风，AVM，癫痫灶和肿瘤的皮质效应将进行比较和对比。不同的神经机制对视觉功能恢复的相对贡献也将被测试。该项目的最终目标是为保健专业人员和患者提供新的信息，他们可以利用这些信息来评估不同的治疗方案，并预测获得最佳结果的可能性。新的病理与功能脑图应该使曾经被认为过于冒险的外科手术成为一个可行的选择。这项实验工作将建立皮层病理、功能损伤和恢复之间相互联系的原理，这些原理可以扩展到大脑的大部分，如果不是全部的话。最后，该项目将为基础神经科学研究转化为临床应用提供一个有用的模型。

DESCRIPTION (provided by applicant): The goal of this project is to develop functional magnetic resonance imaging (fMRI) applications for the assessment of brain-related visual pathology in humans. The work will address a critical clinical need for sophisticated methods of preoperative assessment that can provide a precise, detailed picture of the relationship between a site of focal pathology and the functional status of surrounding visual cortex. Such information can be essential for planning surgical treatment that optimally removes or repairs a pathology (e.g. tumor) yet avoids significant vision loss. Bioengineering will be used to develop, optimize and validate methods for mapping visual cortex function in and around a site of pathology and relating disturbances of cortical function to disturbances of vision. An interactive physician interface will allow the clinician to view the results of these analyses in an easy to use format and will permit simulation of surgical strategies with immediate display of the potential impact on vision. The patient will be able to experience a simulation of the expected vision loss, thereby allowing both physician and patient to evaluate the proposed treatment. The developed tools will also be applied to hypothesis-driven experimentation designed to characterize the fundamental interrelationships of focal pathology, cortical function, and visual perception both acutely and as they evolve over the course of treatment and recovery. The cortical effects of different pathologies including stroke, AVM's, epileptic foci and tumors will be compared and contrasted. The relative contributions of different neural mechanisms to recovery of visual function will also be tested. The ultimate goal of this project will be to provide health-care professionals and patients with new information they can use to evaluate different treatment options and predict the potential for an optimal outcome. The new brain maps of pathology vs. function should make surgical procedures, once considered too risky, a viable option. The experimental work will establish principles interrelating cortical pathology, functional impairment, and recovery that can be extended too much, if not all, of the brain. Finally, this project will provide a useful model for the translation of basic neuroscience research into clinically useful applications.