A rule-based solver using pre-operative MR brain images can automatically compute relevant and accurate patient-specific DBS electrode trajectories.

ObjectMovement disorders in Parkinson disease patients may require functional surgery, when medical therapy isn't effective. In Deep Brain Stimulation (DBS) electrodes are implanted within the brain to stimulate deep structures such as SubThalamic Nucleus (STN). This paper describes successive steps for constructing a digital Atlas gathering patient's location of electrodes and contacts for post operative assessment. Materials and Method12 patients who had undergone bilateral STN DBS have participated to the study. Contacts on post-operative CT scans were automatically localized, based on black artefacts. For each patient, post operative CT images were rigidly registered to pre operative MR images. Then, pre operative MR images were registered to a MR template (super-resolution Collin27 average MRI template). This last registration was the combination of global affine, local affine and local non linear registrations, respectively. Four different studies were performed in order to validate the MR patient to template registration process, based on anatomical landmarks and clinical scores (i.e., Unified Parkinson's disease rating Scale). Visualisation software was developed for displaying into the template images the stimulated contacts represented as cylinders with a colour code related to the improvement of the UPDRS. ResultsThe automatic contact localization algorithm was successful for all the patients. Validation studies for the registration process gave a placement error of 1.4 +/-0.2 mm and coherence with UPDRS scores. ConclusionThe developed visualization tool allows post-operative assessment for previous interventions. Correlation with additional clinical scores will certainly permit to learn more about DBS and to better understand clinical side-effects.

Abstract. Movement disorders in patients withParkinson's disease may require functional surgery, when medical therapy isn't effective. In Deep Brain Stimulation (DBS), electrodes are implanted within the brain to stimulate deep structures such as SubThalamic Nucleus (STN). This paper describes successive steps for constructing digital atlases gathering patient's location of electrode contacts and clinical scores. Three motor and three neuropsychological scores were integrated in the study. Correlations between active contacts localization and clinical data were carried out using an adapted Hierarchical Ascendant Classification and have enabled the extraction of clusters aiming to suggest optimum sites for therapeutic STN DBS. The postero-superior region has been found to be effective for motor score improvement whereas the antero-inferior region revealed noticeable neuropsychological scores deterioration. Comparison with existing results has shown that such atlases are very promising for understanding phenomena better.

The need for cheaper and more precise localisation techniques has recently amplified. The initial approach has been to roll out high-level software running on smartphones and leveraging Bluetooth proximity sensing. However this approach lacks both precision in terms of ranging, and flexibility in terms of experimental framework to fully explore alternative schemes for contact event tracing. In this context, we thus provide openaccess nodes in an open-access experimental platform for ranging and proximity tracking, letting researchers tinker freely with the full software stack on a swarm of multi-radio, low-power devices based on cheap microcontrollers. We provide a tutorial on how to use the platform and open source code building blocks to to program the devices, bare-metal. We then report on initial measurements we have performed using the platform. Perspectives with our platform include applicability studies and comparative evaluation for a large variety of localisation schemes combining the use of Ultra-Wide Band and Bluetooth Low-Energy for better precision and smaller energy budgets -and the use of complementary mechanism guaranteeing privacy protection, able to run directly on-board cheap IoT microcontrollers.

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