High-resolution Infrared Thermal Imaging (ITI) for Simultaneous Functional Mapping of the Entire Craniotomy in Awake Patients NIH NINDS R01 – PIs: Parrish, Todd and Matthew Tate, Co-I: Melissa-Ann Mackie. Staff: Michael Iorga (team leader), Nils Schneider. Awake neurosurgery is used in the management of drug-resistant epilepsy, glioma, and neurovascular malformation, in order to localize seizure and/or physiologic activity. Protection of key functional areas is imperative to avoiding postoperative neurologic deficits. Currently, direct electrical stimulation (DES) is the most commonly used method of intraoperative surgical mapping, which identifies functionally critical brain regions so they are not resected. However, DES has low spatial resolution (~1 cm), may provoke seizures, and can only test one area at a time. This newly NIH-funded R01 project will develop a new method of intraoperative functional mapping based on infrared thermography, which has high resolution (~100 micron) and simultaneously monitors the entire exposed brain surface without risk for seizures. The Intraoperative Mapping System will be developed and tested on glioma patients, as tumors have relatively static impact on brain temperature compared to epileptogenic foci and vascular malformations. If successful, this project will create a new method for intraoperative functional mapping during awake neurosurgery. Ultimately, the goal is to improve the precision of intraoperative brain mapping while increasing the safety and efficacy of surgery for patients with
drug-resistant epilepsy, glioma, and neurovascular malformations.
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A visual-spectrum craniotomy image of the frontal language area in the left hemisphere (A) and thermal functional heat map overlaid on grayscale version of the same image (B). Letters correspond to positive electrical stimulation sites and numbers denote electrocorticography grids. The same Picture Naming task was used for stim and thermal mapping. Functional areas were determined with 1 minute of thermal mapping, whereas, the electrical stim mapping took 15 minutes. The stim and thermal results are in good agreement indicating that thermal mapping
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