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Deep brain stimulation (DBS) is an established therapy for movement disorders such as in Parkinson's disease (PD) and essential tremor (ET). Adjusting the stimulation parameters, however, is a labour-intensive process and often requires several patient visits. Physicians prefer objective tools to improve (or maintain) the performance in DBS. Wearable motion sensors (WMS) are able to detect some manifestations of pathological signs, such as tremor in PD. However, the interpretation of sensor data is often highly technical and methods to visualise tremor data of patients undergoing DBS in a clinical setting are lacking. This work aims to visualise the dynamics of tremor responses to DBS parameter changes with WMS while patients performing clinical hand movements. To this end, we attended DBS programming sessions of two patients with the aim to visualise certain aspects of the clinical examination. PD tremor and ET were effectively quantified by acceleration amplitude and frequency. Tremor dynamics were analysed and visualised based on setpoints, movement transitions and stability aspects. These methods have not yet been employed and examples demonstrate how tremor dynamics can be visualised with simple analysis techniques. We therefore provide a base for future research work on visualisation tools in order to assist clinicians who frequently encounter patients for DBS therapy. This could lead to benefits in terms of enhanced evaluation of treatment efficacy in the future.
Deep brain stimulation (DBS) is a neurosurgical intervention where electrodes are permanently implanted into the brain in order to modulate pathologic neural activity. The post-operative reconstruction of the DBS electrodes is important for an efficient stimulation parameter tuning. A major limitation of existing approaches for electrode reconstruction from post-operative imaging that prevents the clinical routine use is that they are manual or semi-automatic, and thus both time-consuming and subjective. Moreover, the existing methods rely on a simplified model of a straight line electrode trajectory, rather than the more realistic curved trajectory. The main contribution of this paper is that for the first time we present a highly accurate and fully automated method for electrode reconstruction that considers curved trajectories. The robustness of our proposed method is demonstrated using a multi-center clinical dataset consisting of N = 44 electrodes. In all cases the electrode trajectories were successfully identified and reconstructed. In addition, the accuracy is demonstrated quantitatively using a high-accuracy phantom with known ground truth. In the phantom experiment, the method could detect individual electrode contacts with high accuracy and the trajectory reconstruction reached an error level below 100 μm (0.046 ± 0.025 mm). An implementation of the method is made publicly available such that it can directly be used by researchers or clinicians. This constitutes an important step towards future integration of lead reconstruction into standard clinical care.
Gait analysis is a systematic study of human movement. Combining wearable foot pressure sensors and machine learning (ML) solutions for a high-fidelity body pose tracking from RGB video frames could reveal more insights into gait abnormalities. However, accurate detection of heel strike (HS) and toe-off (TO) events is crucial to compute interpretable gait parameters. In this work, we present an experimental platform to study the timing of gait events using a new wearable foot pressure sensor (ActiSense System, IEE S.A., Luxembourg), and Google’s open-source ML solution MediaPipe Pose. For this purpose, two StereoPi systems were built to capture stereoscopic videos and images in real time. MediaPipe Pose was applied to the synchronized StereoPi cameras, and two algorithms (ALs) were developed to detect HS and TO events for gait and analysis. Preliminary results from a healthy subject walking on a treadmill show a mean relative deviation across all time spans of less than 4% for the ActiSense device and less than 16% for AL2 (33% for AL1) employing MediaPipe Pose on StereoPi videos. Finally, this work offers a platform for the development of sensor- and video-based ALs to automatically identify the timing of gait events in healthy individuals and those with gait disorders.