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We describe a surgical planning environment that permits the determination or refinement of the location of a therapeutic neurosurgical intervention using information derived from an electrophysiological database. Such intraoperative stimulation-response and microelectrode recording data are generated from subcortical exploration performed as part of neurosurgical interventions at multiple centres. We have quantified and nonlinearly registered these intraoperative data, acquired from a large population of patients, to a reference brain imaging volume to create an electrophysiological database. This database can then be nonlinearly registered to future patient imaging volumes, enabling the delineation of surgical targets, cell types, and functional and anatomical borders prior to surgery. The user interface to our system allows the population-acquired physiology information to be accessed in a fully searchable format within a patient imaging volume. This system may be employed in both preoperative planning and intraoperative guidance of stereotactic neurosurgical procedures. We demonstrate preliminary results illustrating the use of this database approach to predict the optimum surgical site for creating thalamic lesions in the surgical treatment of Parkinson’s disease.

A 3-Dimensional Database of Deep Brain Functional Anatomy, and Its Application to Image-Guided Neurosurgery