Electrophysiological atlas and applications of same

• US 20050070781A1
• Filed: 07/01/2004
• Published: 03/31/2005
• Est. Priority Date: 04/28/2003
• Status: Abandoned Application

• Current Assignee: Vanderbilt University
• Original Assignee: Vanderbilt University
• Inventors: Cetinkaya, Ebru, Kao, Changquing C., Konrad, Peter E., D'Haese, Pierre-Francois Dominique, Dawant, Benoit M.
• Application Number:
  US10/883,233
• Publication Number:
  US 20050070781A1
• Time in Patent Office: Days
• US Class Current: 600/407
• CPC Class Codes: A61B 34/10 Computer-aided planning, simulation or modelling of surgical operations
• CPC Class Codes: A61B 90/10 for stereotaxic surgery, e.g. frame-based stereotaxis
• CPC Class Codes: A61N 1/3605 Implantable neurostimulators for stimulating central or peripheral nerve system
• CPC Class Codes: A61N 1/36067 Movement disorders, e.g. tremor or Parkinson disease stimulating motor muscle A61N1/36003

Abstract

A method of creating an atlas that contains electrophysiological information related to at least one of a plurality of living subjects. In one embodiment, the method includes the steps of choosing a brain image volume as a common image volume of reference, acquiring electrophysiological information for a target of interest, relating the acquired electrophysiological information to spatial coordinates in the brain image volume of the target of interest, and registering the brain image volume of the target of interest to the common image volume of reference so as to create an atlas in which any spatial coordinates of the brain of the target of interest are related to atlas coordinates in the atlas such that the acquired electrophysiological information associated with the related spatial coordinates in the brain image volume of the target of interest can be related to atlas coordinates in the atlas, and vice versa.

Claims

1. A system for creating an atlas for optimal placement of a deep brain stimulator in a brain of a target of interest, comprising:

a. a data storage device;

b. an image acquisition device for acquiring a brain image volume from the brain of the target of interest;

c. a data acquisition device for acquiring electrophysiological information from the brain of the target of interest; and

d. a data processing device operably coupled to the data storage device, the image acquisition device and the data acquisition device, respectively, and performing the steps of;

(a). relating the acquired electrophysiological information to spatial coordinates in the acquired brain image volume of the target of interest; and

(b). registering the acquired brain image volume of the target of interest to a common image volume of reference so as to create an atlas in which spatial coordinates of the brain of the target of interest are related to atlas coordinates such that the acquired electrophysiological information associated with the related spatial coordinates in the acquired brain image volume of the target of interest can be related to atlas coordinates in the atlas, and vice versa.

2. The system of claim 1, wherein the data processing device further performs the step of storing the atlas in a digitized format in the data storage device.

3. The system of claim 1, wherein the atlas has an architecture to be accessible over a network.

4. The system of claim 3, further comprising a user interface in communication with the atlas.

5. The system of claim 4, wherein the user interface is used for populating the atlas with new electrophysiological information acquired from a target of interest.

6. The system of claim 4, wherein the user interface is used for accessing the electrophysiological information from the atlas.

7. The system of claim 6, wherein the user interface is used for obtaining the electrophysiological information from the atlas in one of a text format, an image format and a mixture thereof.

8. The system of claim 7, wherein the obtained electrophysiological information includes an initial optimal position for at least one deep brain stimulator to be, placed in a brain of a target of interest.

9. The system of claim 1, wherein the data storage device comprises a memory.

10. The system of claim 1, wherein the image acquisition device is arranged, in use, to acquire a computerized tomographical image and/or a magnetic resonance image for a target of interest.

11. The system of claim 1, wherein the data acquisition device comprises at least one microelectrode placed in a brain of a target of interest.

12. The system of claim 1, wherein the data acquisition device comprises at least one stimulation electrode placed in a brain of a target of interest.

13. The system of claim 1, wherein the data acquisition device comprises at least one deep brain stimulator placed in a brain of a target of interest.

14. The system of claim 1, wherein the electrophysiological information comprises pre-operative information, intra-operative information and post-operative information for a target of interest, respectively.

15. The system of claim 14, wherein the pre-operative information comprises at least one piece of information associated with presenting complaints, locations of symptoms related to one or more diseases, type and degree of the one or more diseases, unified Parkinson'"'"'s disease rating scale scores both on and off medications, mini-mental status examination, medications and dosages, cognitive performance, gait performance, pre-operative target positions, and any mixture thereof.

16. The system of claim 15, wherein the symptoms comprise at least one of upper extremity rigidity, lower extremity rigidity, upper extremity dystonia and lower extremity dystonia.

17. The system of claim 15, wherein the unified Parkinson'"'"'s disease rating scale scores are a rating tool for evaluating mentation, behavior and mood, activities of daily living, motor activity, and complication of therapy for a target of interest undergoing treatment.

18. The system of claim 14, wherein the intra-operative information comprises at least one piece of information associated with at least one microelectrode, wherein the information includes microelectrode recordings, a position of the microelectrode recordings, a label of a structure in which the microelectrode recordings is located, and any mixture thereof.

19. The system of claim 18, wherein the microelectrode recordings are characterized by a firing rate that measures tonic activity and indices that measures phasic activity, wherein the indices include a burst index, a pause ratio, a pause index, and an interspike interval histogram.

20. The system of claim 14, wherein the intra-operative information comprises at least one piece of information associated with at least one stimulation electrode, wherein the information includes voltages applied to the at least one stimulation electrode, a response of a target of interest undergoing treatment to the stimulation, differences in voltage between disappearance of symptoms and appearance of side effects, a position of the at least one stimulation electrode, a final intra-operative target position of a deep brain stimulator to be placed, and any mixture thereof.

21. The system of claim 20, wherein the response of the target of interest undergoing treatment to the stimulation includes loss of rigidity, location where the loss of rigidity is observed, appearance of side effects, and/or location affected by these side effects.

22. The system of claim 14, wherein the post-operative information comprises at least one piece of information associated with at least one deep brain stimulator, wherein the information includes a position of the at least one deep brain stimulator in post-operative computerized tomographical images, optimal setting of the at least one deep brain stimulator, overall assessment of a target of interest after placement of the at least one deep brain stimulator, and any mixture thereof.

73. The method of claim 71, further comprising the steps of downloading information related to the optimal position in the brain of the target of interest for placing a deep brain stimulator from the matched information to a local computer and adjusting the optimal position in the brain of the target of interest for placing a deep brain stimulator from the downloaded information.

23. A method of creating an atlas that contains electrophysiological information related to at least one of a plurality of living subjects, wherein any portion of a brain of one of the plurality of living subjects and corresponding brain image volume may be identified by a set of corresponding spatial coordinates, comprising the steps of:

a. choosing a brain image volume as a common image volume of reference from a plurality of brain image volumes, each of the plurality of brain image volumes being acquired pre-operatively from a brain of one of the plurality of the living subjects;

b. acquiring electrophysiological information for one of the plurality of living subjects;

c. relating the acquired electrophysiological information to spatial coordinates in the brain image volume of the corresponding living subject; and

d. registering the brain image volume of the corresponding living subject to the common image volume of reference so as to create an atlas in which any spatial coordinates of the brain of the corresponding living subject are related to atlas coordinates in the atlas such that the acquired electrophysiological information associated with the related spatial coordinates in the brain image volume of the corresponding living subject can be related to atlas coordinates in the atlas, and vice versa.

24. The method of claim 23, further comprising the step of storing the atlas in a digitized format.

25. The method of claim 23, wherein the atlas has an architecture to be accessible over a network.

26. The method of claim 25, further comprising the step of populating the atlas with new electrophysiological information acquired from a target of interest.

27. The method of claim 25, further comprising the step of accessing the electrophysiological information from the atlas.

28. The method of claim 27, further comprising the step of obtaining the electrophysiological information from the atlas in one of a text format, an image format and a mixture thereof.

29. The method of claim 28, wherein the obtained electrophysiological information includes an initial optimal target position for at least one deep brain stimulator to be placed in a brain of a target of interest.

30. The method of claim 23, wherein the electrophysiological information comprises pre-operative information, intra-operative information and post-operative information for each of the plurality of living subjects, respectively.

31. The method of claim 30, wherein the pre-operative information comprises at least one piece of information associated with presenting complaints, locations of symptoms related to one or more diseases, type and degree of the one or more diseases, unified Parkinson'"'"'s disease rating scale scores both on and off medications, mini-mental status examination, medications and dosages, cognitive performance, gait performance, pre-operative target positions, and any mixture thereof.

32. The method of claim 31, wherein the symptoms comprise at least one of upper extremity rigidity, lower extremity rigidity, upper extremity dystonia and lower extremity dystonia.

33. The method of claim 31, wherein the unified Parkinson'"'"'s disease rating scale scores are a rating tool for evaluating mentation, behavior and mood, activities of daily living, motor activity, and complication of therapy for a target of interest undergoing treatment.

34. The method of claim 30, wherein the intra-operative information comprises at least one piece of information associated with at least one microelectrode, wherein the information includes microelectrode recordings, a position of the microelectrode recordings, a label of a structure in which the microelectrode recordings is located, and any mixture thereof.

35. The method of claim 34, wherein the microelectrode recordings are characterized by a firing rate that measures tonic activity and indices that measures phasic activity, wherein the indices include a burst index, a pause ratio, a pause index, and an interspike interval histogram.

36. The method of claim 30, wherein the intra-operative information comprises at least one piece of information associated with at least one stimulation electrode, wherein the information includes voltages applied to the at least one stimulation electrode, a response of a target of interest undergoing treatment to the stimulation, differences in voltage between disappearance of symptoms and appearance of side effects, a position of the at least one stimulation electrode, a final intra-operative target position of a deep brain stimulator to be placed, and any mixture thereof.

37. The method of claim 36, wherein the response of the target of interest undergoing treatment to the stimulation includes loss of rigidity, location where the loss of rigidity is observed, appearance of side effects, and/or location affected by these side effects.

38. The method of claim 30, wherein the post-operative information comprises at least one piece of information associated with at least one deep brain stimulator, wherein the information includes a position of the at least one deep brain stimulator in post-operative computerized tomographical images, optimal setting of the at least one deep brain stimulator, overall assessment of a target of interest after placement of the at least one deep brain stimulator, and any mixture thereof.

39. A system that contains electrophysiological information related to at least one of a plurality of living subjects, wherein any portion of interest in the brain of one of the plurality of living subjects and corresponding brain image volume may be identified by a set of corresponding spatial coordinates, comprising:

a. a data storage device; and

b. an atlas stored in the data storage device for containing the electrophysiological information, the atlas being created such that when a brain image volume is registered to the atlas, any spatial coordinates of the brain image volume are related to corresponding atlas coordinates in the atlas, and vice versa.

40. The system of claim 39, wherein the atlas has an architecture to be accessible over a network.

41. The system of claim 40, wherein the atlas can be in communication with a user interface.

42. The system of claim 41, wherein the user interface is used for populating the system with new electrophysiological information acquired from a target of interest.

43. The system of claim 41, wherein the user interface is used for accessing the electrophysiological information from the atlas.

44. The system of claim 39, wherein the electrophysiological information comprises pre-operative information, intra-operative information and post-operative information for each of the plurality of living subjects, respectively.

45. The system of claim 44, wherein the pre-operative information comprises at least one piece of information associated with presenting complaints, locations of symptoms related to one or more diseases, type and degree of the one or more diseases, unified Parkinson'"'"'s disease rating scale scores both on and off medications, mini-mental status examination, medications and dosages, cognitive performance, gait performance, pre-operative target positions, and any mixture thereof.

46. The system of claim 45, wherein the symptoms comprise at least one of upper extremity rigidity, lower extremity rigidity, upper extremity dystonia and lower extremity dystonia.

47. The system of claim 46, wherein the unified Parkinson'"'"'s disease rating scale scores are a rating tool for evaluating mentation, behavior and mood, activities of daily living, motor activity, and complication of therapy for a target of interest undergoing treatment.

48. The system of claim 44, wherein the intra-operative information comprises at least one piece of information associated with at least one microelectrode, wherein the information includes microelectrode recordings, a position of the microelectrode recordings, a label of a structure in which the microelectrode recordings is located, and any mixture thereof.

49. The system of claim 48, wherein the microelectrode recordings are characterized by a firing rate that measures tonic activity and indices that measures phasic activity, wherein the indices include a burst index, a pause ratio, a pause index, and an interspike interval histogram.

50. The system of claim 44, wherein the intra-operative information comprises at least one piece of information associated with at least one stimulation electrode, wherein the information includes voltages applied to the at least one stimulation electrode, a response of a target of interest undergoing treatment to the stimulation, differences in voltage between disappearance of symptoms and appearance of side effects, a position of the at least one stimulation electrode, a final intra-operative target position of a deep brain stimulator to be placed, and any mixture thereof.

51. The system of claim 50, wherein the response of the target of interest undergoing treatment to the stimulation includes loss of rigidity, location where the loss of rigidity is observed, appearance of side effects, and/or location affected by these side effects.

52. The system of claim 44, wherein the post-operative information comprises at least one piece of information associated with at least one deep brain stimulator, wherein the information includes a position of the at least one deep brain stimulator in post-operative computerized tomographical images, optimal setting of the at least one deep brain stimulator, overall assessment of a target of interest after placement of the at least one deep brain stimulator, and any mixture thereof.

53. The system of claim 39, wherein the data storage device comprises a memory.

54. The system of claim 39, further comprising a controller in communication with the data storage device.

55. A computer readable medium or media, comprising:

a. a data structure relating to an atlas that contains electrophysiological information related to at least one of a plurality of living subjects, wherein any portion of interest for the brain of at least one of the plurality of living subjects and corresponding image volume may be identified by a set of corresponding spatial coordinates; and

b. a user interface in communication with the data structure.

56. The computer readable medium or media of claim 55, wherein the data structure comprises a plurality of transformations and corresponding inverses of the plurality of transformations.

57. The computer readable medium or media of claim 56, wherein each of a plurality of transformations registers a brain image volume to the atlas, wherein the brain image volume is acquired from one of the plurality of living subjects.

58. The computer readable medium or media of claim 57, wherein the atlas is created such that when a brain image volume of a living subject is registered to the atlas, any spatial coordinates in the brain image volume of the living subject are related to corresponding atlas coordinates in the atlas, and vice versa.

59. The computer readable medium or media of claim 58, wherein the electrophysiological information associated with spatial coordinates from which the electrophysiological information is acquired in the brain of the living subject can be related to atlas coordinates in the atlas, and vice versa.

60. The computer readable medium or media of claim 59, wherein the user interface is used for populating the atlas with new electrophysiological information acquired from a target of interest.

61. The computer readable medium or media of claim 59, wherein the user interface is used for accessing the electrophysiological information from the atlas.

62. The computer readable medium or media of claim 61, wherein the user interface is used for obtaining the electrophysiological information from in the atlas in one of a text format, an image format and a mixture thereof.

63. The computer readable medium or media of claim 62, wherein the obtained electrophysiological information includes an initial optimal target position for at least one deep brain stimulator to be placed in a brain of a target of interest.

64. The computer readable medium or media of claim 57, wherein the atlas is stored in a digitized format of files.

65. The computer readable medium or media of claim 57, wherein the electrophysiological information comprises pre-operative information, intra-operative information and post-operative information for each of the plurality of living subjects, respectively.

66. A method for optimal placement of a deep brain stimulator in a brain of a target of interest, comprising the steps of:

a. acquiring from the target of interest pre-operatively at least one piece of information associated with a state of brain condition of the target of interest;

b. accessing remotely an atlas that contains electrophysiological information related to a plurality of living subjects, wherein any portion of the brain of one of the plurality of living subjects and corresponding brain image volume may be identified by a set of corresponding spatial coordinates;

c. entering the acquired information from the target of interest to the atlas to find a match between the acquired information and the electrophysiological information contained in the atlas; and

d. automatically obtaining an optimal position in the brain of the target of interest for placing a deep brain stimulator from the matched information.

67. The method of claim 66, wherein the atlas is stored in a memory device associated with a central host computer.

68. The method of claim 67, wherein the accessing step comprises the step of accessing the atlas over a network from a client computer, and wherein the central host computer and client computer are coupled to and in communication with the network, respectively.

69. The method of claim 68, wherein the network comprises at least one of a public network, a dedicated network, a local network, and any combination of them.

70. The method of claim 69, wherein the public network comprises the Internet.

71. The method of claim 66, further comprising the steps of acquiring electrophysiological information intra-operatively from the brain of the target of interest and adjusting the optimal position in the brain of the target of interest for placing a deep brain stimulator accordingly.

72. The method of claim 71, further comprising the steps of finding a final optimal position in the brain of the target of interest for placing a deep brain stimulator from the adjusted optimal position and placing a deep brain stimulator in the brain of the target of interest.

74. The method of claim 66, further comprising the step of updating the atlas from information related to the target of interest.

75. The method of claim 66, wherein the information associated with the state of brain condition of the target of interest comprises presenting complaints, locations of symptoms related to one or more diseases, type and degree of the one or more diseases, unified Parkinson'"'"'s disease rating scale scores both on and off medications, mini-mental status examination, medications and dosages, cognitive performance, gait performance, pre-operative target positions, and any mixture thereof of the target of interest.

76. The method of claim 66, wherein the state of brain condition is related to a type of a disease.

77. The method of claim 76, wherein the state of brain condition is related to a degree of a disease.

78. A method for optimal placement of a deep brain stimulator in a brain of a target of interest, comprising the steps of:

a. acquiring from the target of interest pre-operatively at least one piece of information associated with a state of brain condition of the target of interest;

b. accessing remotely an atlas that contains electrophysiological information related to a plurality of living subjects, wherein the atlas is formed with a plurality of clusters, each cluster being related to a state of brain condition and having a plurality of optimal positions for a deep brain stimulator distributed therein;

c. entering the acquired information from the target of interest to the atlas to find a match between the acquired information and the electrophysiological information contained in the atlas; and

d. automatically obtaining an optimal position in the brain of the target of interest for placing a deep brain stimulator from one of the plurality of optimal positions for a deep brain stimulator distributed in the plurality of clusters.

79. The method of claim 78, wherein the state of brain condition is related to a type of a disease.

80. The method of claim 79, wherein the state of brain condition is related to a degree of a disease.

81. The method of claim 78, wherein the information associated with the state of brain condition of the target of interest comprises presenting complaints, locations of symptoms related to one or more diseases, type and degree of the one or more diseases, unified Parkinson'"'"'s disease rating scale scores both on and off medications, mini-mental status examination, medications and dosages, cognitive performance, gait performance, pre-operative target positions, and any mixture thereof of the target of interest.