Toward the creation of an electrophysiological atlas for the pre-operative planning and intra-operative guidance of deep brain simulators (DBS) implantation

In current practice, optimal placement of deep brain stimulators (DBSs) is an iterative procedure. A target is chosen pre-operatively based on anatomical landmarks identified on MR images. This point is used as an initial position that is refined intra-operatively using both micro-electrode recordings and macro-stimulation. We hypothesize that boundaries of nuclei and sub-nuclei not visible in the anatomic images can be resolved in atlases that include electrophysio logical information, thus improving both pre- and intra-operative guidance. In this work we report on our current progress toward creating such an atlas. We also present results we have obtained in creating an atlas of optimal target points that can be used for automatic pre-operative selection of the targets. We demonstrate that initial points selected with this atlas are closer to the final points than the initial points chosen manually.