Creating a Low-Cost Brain Atlas: A Step-by-Step Guide and Historical Aspects

Abstract Brain atlases are indispensable for comparing findings between different individuals and for consolidating data from multiple sources. Anatomical-functional atlases developed from data collected from brain mapping in awake neurosurgical procedures for oncological treatment are the gold standard for studying the cortex and white matter. However, non-medical knowledge required for this purpose is not readily available in the neurosurgical literature and is especially difficult with limited financial resources. To describe a method for creating a brain atlas in a public hospital, at low cost, using conventional computers and without professionals versed in coding. We describe the step-by-step use of a free program with an intuitive graphical interface (MRIcroGL, open source) for normalization of intraoperative data and plotting on the Montreal Neurological Institute brain template. Intraoperative monitoring of two patients with diffuse low-grade glioma undergoing awake surgery for brain mapping was normalized and plotted on the Montreal Neurological Institute brain template to exemplify the practicality of the proposed methodology. Most articles on creating brain atlases based on intraoperative brain mapping findings use programs that are not understandable to most neurosurgeons. In developing countries, there is often no additional support from a team specializing in data processing. With the technique presented, we believe it is possible to create accurate brain atlases in a free, simple, and reproducible manner.