Grant: Operating Grant

Major advances in brain imaging have resulted in improvements in diagnosis and surgical treatment of diseases of aging, including Parkinson's disease. However, even the best brain scans (e.g. MRI), especially those in practical clinic use cannot visualize individual areas (nuclei) deep in the brain that have distinct functions. In order to treat Parkinson's disease by surgical means, it is crucial to obtain better brain maps for these areas. We will design an atlas for Parkinson's brain that will be derived from post-mortem brains studied by advanced imaging methods, and examined using modern staining tools for delineating individual nuclei. A road-map of brain structures will be created by anatomists, and computer engineers will then integrate the roadmap into a template high resolution MRI scan, appropriate for normal ageing brain or patients with Parkinson's disease. Using methods already developed, the reference roadmaps will then be individualized for patients by integrating with patient MRIs prior to surgery. Surgeons will therefore have customized roadmaps when targeting structures deep in the brain, increasing safety and efficacy of surgery. The enhanced roadmap will be validated at surgery using traditional "goal-standard" methods for identifying deep brain nuclei, including electro-physiological mapping. In addition, advanced imaging tools will be used to identify connections between brain structures, which will also be cross-validated with the road-maps from postmortem brain structure, allowing development of non-invasive tools for determining how different parts of the brain communicate with each other, and how they may be damaged as a result of Parkinson's disease. This research will therefore use imaging methods and advanced brain processing methods to provide a unique validated roadmap of deep nuclei and connections of the Parkinson brain, and result in improved understanding the system that controls normal movements and treatment of its disorders