Background on CU5474H Deep brain stimulation (DBS) is commonly used for the treatment of movement disorders, such as Parkinson’s Disease. As part of awake DBS implantation surgery, neural activity is recorded from brain structures to aid in targeting specific anatomic regions. Features of the recorded neural activity (i.e. firing rate, waveform) can be used to discern anatomic localization with higher resolution than conventional MRI/CT imaging. Furthermore, clinical evidence suggests that implanting in regions that are motor responsive leads to better outcomes compared to doing so without assessing motor responsiveness, which is a functional measure of the correlation between movement and changes in neural activity. In the operating room, motor responsiveness is currently assessed by guiding patients through passive and active movements while neural activity is recorded from deep brain structures. Clinicians then subjectively determine whether movements are correlated with neural activity by comparing visual information of the patient moving. However, this process is error prone and requires a significant amount of intraoperative time, resources, and expert personnel. Technical Innovation Dr.’s Thompson and Tekriwal have developed an approach which standardizes how motor responsiveness is assessed and is not dependent on access to a highly trained team. First, a motion sensor camera system and deep learning algorithm automatically track and quantify movement of specific body parts. This extracted kinematic information is then correlated with features of simultaneously recorded neural activity (i.e. firing rate, waveform) pertinent to surgical outcomes. This feedback provides both a general indication of motor responsiveness, as well as more detailed information, such as which portions of a given movement induces the greatest neurophysiologic changes. These endpoints can be used to inform electrode placement in DBS on a case-by-case basis and guide treatment decisions when taken in aggregate across many surgeries post-hoc.
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