Quantifying changes in patient tremor using accelerometer during deep brain stimulation surgery
Abstract
Objective Deep brain stimulation (DBS), a routine neurosurgical treatment for movement related disorders, has few uncertainties associated with suboptimal target selection. Our aim is to evaluate the feasibility to objectively assess clinical effects on tremor obtained during intraoperative test stimulation based on acceleration measurements. Methods Five patients (1 Parkinson's disease and 4 Essential Tremor) referred for bilateral DBS-implantation were included in the study. Tremor was evaluated by fixing a 3-axis accelerometer on the patient's wrist during intraoperative test stimulation. The accelerometer data was post-operatively analyzed, statistical features were extracted and effective stimulation amplitudes (thresholds) identified (Fig 1). Wilcoxon two sided rank test was used to identify significance of changes in the statistical values before and at thresholds identified by medical experts and those before and at thresholds found using acceleration data alone. Results Out of the statistical features identified, the standard deviation, signal energy and peak frequency amplitude were the most sensitive to changes in patient tremor. The thresholds identified based on acceleration data were lower in 65% of the cases compared to the one chosen by the neurologist. The results of the statistical test showed higher significance for the changes at the acceleration thresholds than the ones identified subjectively.
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