It was demonstrated in recent studies that Complementary Limb Motion Estimation (CLME) is robust approach for controlling active knee prostheses. A wearable sensor system is then needed to provide inputs to the controller in a real-time platform. In the present work, a wearable sensor system based on magnetic and inertial measurement units (MIMU) together with a simple calibration procedure were proposed. This sensor system was intended to substitute and extend the capabilities of a previous device based on potentiometers and gyroscopes. The proposed sensor system and calibration were validated with an Optical Tracking System (OTS) in a standard gait lab and first results showed that the proposed solution had a performance comparable to similar studies in the literature.

Background: Deep brain stimulation (DBS) systems in current mode and new lead designs are recently available. To switch between DBS-systems remains complicated as clinicians may lose their reference for programming. Simulations can help increase the understanding.

Objective: To quantitatively investigate the electric field (EF) around two lead designs simulated to operate in voltage and current mode under two time points following implantation.

Methods: The finite element method was used to model Lead 3389 (Medtronic) and 6148 (St Jude) with homogenous surrounding grey matter and a peri-electrode space (PES) of 250 μm. The PES-impedance mimicked the acute (extracellular fluid) and chronic (fibrous tissue) time-point. Simulations at different amplitudes of voltage and current (n=236) were performed using two different contacts. Equivalent current amplitudes were extracted by matching the shape and maximum EF of the 0.2 V/mm isolevel.

Results: The maximum EF extension at 0.2 V/mm varied between 2-5 mm with a small difference between the leads. In voltage mode EF increased about 1 mm at acute compared to the chronic PES. Current mode presented the opposite relationship. Equivalent EFs for lead 3389 at 3 V were found for 7 mA (acute) and 2.2 mA (chronic).

Conclusions: Simulations showed a major impact on the electric field extension between postoperative time points. This may explain the clinical decisions to reprogram the amplitude weeks after implantation. Neither the EF extension nor intensity is considerably influenced by the lead design.

New deep brain stimulation (DBS) electrode designs offer operation in voltage and current mode and capability to steer the electric field (EF). The aim of the study was to compare the EF distributions of four DBS leads at equivalent amplitudes (3 V and 3.4 mA). Finite element method (FEM) simulations (n = 38) around cylindrical contacts (leads 3389, 6148) or equivalent contact configurations (leads 6180, SureStim1) were performed using homogeneous and patient-specific (heterogeneous) brain tissue models. Steering effects of 6180 and SureStim1 were compared with symmetric stimulation fields. To make relative comparisons between simulations, an EF isolevel of 0.2 V/mm was chosen based on neuron model simulations (n = 832) applied before EF visualization and comparisons. The simulations show that the EF distribution is largely influenced by the heterogeneity of the tissue, and the operating mode. Equivalent contact configurations result in similar EF distributions. In steering configurations, larger EF volumes were achieved in current mode using equivalent amplitudes. The methodology was demonstrated in a patient-specific simulation around the zona incerta and a “virtual” ventral intermediate nucleus target. In conclusion, lead design differences are enhanced when using patient-specific tissue models and current stimulation mode.

Objective: To quantitatively compare the electric field generated by voltage and current controlled deep brain stimulation systems.

Background: Traditionally deep brain stimulation (DBS) systems have used voltage control however more recently, current controlled systems have been approved to treat Parkinson's disease and related movement disorders. In the endeavor of understanding the behavior of DBS systems a common approach is the use of computer models suitable to simulate the electric field, current density and other related electric parameters.

Methods: 2D finite element models based on commercially available DBS systems have been built for each system: I. Model 3389, Medtronic Inc., USA for voltage control; and II. Model 6142, St Jude Medical Inc. USA for current control. The brain tissue has been simplified to homogeneous and isotropic medium. The electric settings correspond to a monopolar configuration, using one of the four contacts available as the active electrode and the outer boundary of the tissue as the reference. Three simulations were performed to mimic different stages of the leads implantation: a) an original stage where the brain tissue is considered as pure gray matter, b) an acute stage that simulates the leakage of cerebral spinal fluid immediately after the electrodes' insertion; and c) a chronic stage mimicking fibrous tissue created around the electrodes some weeks after implantation. Both systems were submitted to the same conditions using as active electrode the third contact from the tip of the lead. The comparison is based on the maximal distance reached by the isopotential of 0.2 V/mm.

Results: The simulations showed that voltage controlled stimulation systems are more susceptible to changes in the electrical conductivity of the medium i.e. change over time of the tissue around the electrode. This agrees with the adjustment of the stimulation amplitude often necessary a few weeks postoperatively. Current controlled stimulation in turn, presented a linear behavior of the distance reached at different stimulation amplitudes at all stages.

Conclusions: Current controlled stimulation might be a good option due to its linear behavior over time, nevertheless more studies including a more realistic brain model, different designs of DBS electrodes and different electric parameter, are needed to encourage the use of this type of systems.

Since the introduction of deep brain stimulation (DBS) the technique has been dominated by Medtronic sys-tems. In recent years, new DBS systems have become available for patients, and some are in clinical trials. The present study aims to evaluate three DBS leads operated in either voltage or current mode. 3D finite element method (FEM) models were built in combination with a neuron model for this purpose. The axon diameter was set to D = 5 μm and simulations performed in both voltage (0.5-5 V) and current (0.5-5 mA) mode. The evaluation was achieved based on the distance from the lead for neural activation and the electric field (EF) extension at 0.1 V/mm. The results showed that the neural activation distance agrees well between the leads with an activation distance dif-ference less than 0.5 mm. The shape of the field at the 0.1 V/mm isopotential surface in 3D is mostly spherical in shape around the activated section of the steering lead.

SINCE the introduction of deep brain stimulation (DBS) about 20 years ago, the stimulation technique has been dominated by Medtronic DBS-system setup. In recent years, new DBS systems have become available, of which some are in clinical trials or available to patients [1]. In the present study three different lead designs are investigated via computer simulation:

Medtronic 3389, St. Jude 6148 and Sapiens SureStim. The aim was to compare the neural activation distance and the electric field (EF) maximum spatial extension for each lead.

A 3D finite element method model was built using COMSOL Multiphysics 4.4a (COMSOL AB, Stockholm, Sweden) to simulate the electric potential around the DBS lead. Brain tissue was modelled as a homogeneous volume of grey matter (electric conductivity of 0.09 S/m). The electrode-tissue interface was modelled with a 250μm thick peri-electrode space mimicking the fibrous tissue which covers the lead at the chronic stimulation stage (σ = 0.06S/m, equivalent to white matter electric conductivity). The stimulation amplitude was set to 1V in monopolar configuration using C1 electrode or equivalent in all cases. Each simulated electric potential distribution was exported to MatLab (The MathWorks, USA) and used as input to a cable neuron simulation.

An axon cable model with 21 nodes based on the concept by Åström et al., [2] was set up in MatLab and combined with the exported field distributions. The model considered a 5 μm thick neuron, a pulse width of 60 μs and a drive potential ranging from 0.5 V to 5 V in 0.5 V steps.

The SureStim lead results showed a shorter neural activation distance and EF extension. The distance to the isolevel of 0.2 V/mm is close to the neural activation distance at each stimulation amplitude, and we conclude that the electric field is a suitable predictor to visualize the stimulated regions.

Microdialysis makes possible in vivo estimation of endogenous and exogenous substances in the dermal extracellular space. Insertion of the microdialysis probe and its subsequent presence in the skin may affect both the reactivity of the skin test site and the measurement of target substances. Laser Doppler flowmetry is a non-invasive method for estimating cutaneous blood flow. A further development of this technique, laser Doppler perfusion imaging, has been used to study the time course of the circulatory changes caused in the area of microdialysis probe insertion. Laser Doppler perfusion imaging was performed prior to, during, and after microdialysis probe insertion in the skin of the ventral forearm in three subjects. Probe insertion caused an increase in skin blood perfusion in the whole test area. About 15 min after probe insertion, the flare, which is presumed to be of chiefly axon reflex origin, began to subside and the circulatory response could be seen to center around the site of insertion and the tip of the probe. Skin perfusion levels had returned to near normal levels within 60 min. Local anesthesia of the point of guide insertion inhibited the flare, but did not affect circulatory reactivity in the skin nearby. Both microdialysis and laser Doppler perfusion imaging seem to be promising new methods in dermatologic research.

A novel bioanalytical in vivo sampling technique, cutaneous microdialysis, was used to follow the chronology of skin histamine release in 3 patients with cold urticaria and in 2 healthy volunteers. Laser Doppler perfusion imaging was used simultaneously to monitor the skin circulatory response. Microdialysis samples were collected at 10-min intervals and analysed by radioimmunoassay technique. Fifty minutes after probe insertion, the ventral forearm skin in the area of the dialysis membrane was provoked for 5-15 min with a 25 x 40 mm ice cube covered with plastic foil. In the cold urticaria patients, an up to 80-fold increase of histamine was observed, with peak levels 20-30 min after challenge. Histamine levels then fell to reach "baseline" levels within 50 min. In the healthy subjects, the histamine increase was earlier, less pronounced and of shorter duration. Cutaneous microdialysis and laser Doppler imaging offer new possibilities for the chronological multiparameter assessment of inflammatory skin disorders in vivo.

The face reveals the healthy status of an individual, through a combination of physical signs and facial expressions. The project SEMEOTICONS is translating the semeiotic code of the human face into computational descriptors and measures, automatically extracted from videos, images, and 3D scans of the face. SEMEOTICONS is developing a multisensory platform, in the form of a smart mirror, looking for signs related to cardio-metabolic risk. The goal is to enable users to self-monitor their well-being status over time and improve their life-style via tailored user guidance. Building the multisensory mirror requires addressing significant scientific and technological challenges, from touch-less data acquisition, to real-time processing and integration of multimodal data.

Radio frequency (RF) lesioning and deep brain stimulation (DBS) are the two prevailing surgical treatments for movement disorders within the field of stereotactic and functional neurosurgery. For RF-lesioning, a small volume of brain tissue is coagulated and knowledge of the lesion size and growth is of great importance for the safety and outcome of the procedure. This thesis deals with adapting the laser Doppler perfusion monitoring (LDPM) technique for measurements in brain tissue during RF-lesioning. The relation between LDPM signal changes and developed lesion size was investigated. LDPM measurements were evaluated both in vitro (albumin protein solution) and in vivo in the porcine brain during RF-lesioning corresponding to a bilateral thalamotomy in man. The investigated signals from the LDPI measurements can be used for following the lesioning time course and to detect if a lesion was created, both in vitro and in the animal model. For the albumin model, both the total backscattered light intensity and the perfusion signal can be used as markers for estimating the final coagulation size, while in the animal model this conclusion was not statistical verified.

Independent on surgical method, RF-lesioning or DBS, intracerebral guidance is an important aspect within stereotactic and functional neurosurgery. To increase the accuracy and precision of reaching the correct target, different methods for intracerebral guidance exist, such as microelectrode recording and impedance methods. In this thesis, the possibility of developing an optical intracerebral guidance method has been investigated. Diffuse reflectance spectroscopy served as technology and all measurements were performed stereotactically in both porcine and human brain. Measurements of white and gray matter showed large differences, with higher reflectivity for white brain matter, both in porcine and in human brain. For the human measurements during DBS-implants, large differences between white matter and functional targets were found. Additionally, differences between native and lesioned porcine brain matter were detected. Both studies support the idea of using diffuse reflectance spectroscopy for developing an intracerebral guidance method.

Radio frequency (RF) lesioning is a well well-known procedure within the field of stereotactic neurosurgery, commonly used for the treatment of movement disorders. During the intervention, an RF-electrode is inserted into the deeper parts of the brain, where a small volume of malfunctioning brain tissue will be coagulated. This procedure is irreversible, as a result, the size and position of the created lesion is crucial in order to avoid unwanted side effects. In this thesis a further development of the RF-technology is presented in order to follow a lesioning process and to estimate the created lesion size. Software, electronics, fiber optics and an RF-electrode equipped with optical fibers was developed and evaluated.

Diffuse reflectance spectroscopy measurements at 450-800 nm in the central gray of porcine brain have been performed with the developed RF-electrode. Measurements of white and gray brain matter showed a large reflectance difference in the investigated wavelength interval, with higher reflectivity for white brain matter. Reflectance differences between native and coagulated, white and gray brain matter were also found .

In-vitro laser Doppler perfusion monitoring measurements at 633 nm have also been performed in a newly designed flow model. An albumin solution with added glass microspheres was placed on top of a revolving disc. The motion of the liquid surrounding the electrode tip simulated a perfusion situation. Changes in both laser Doppler perfusion and total backscattered light intensity signals were collected during the creation of different sized coagulations. The volume, width and length of the created coagulations are correlated to the measured signal changes in-vitro, where larger coagulations displayed larger signal changes. The laser Doppler perfusion and backscattered light intensity signals can be used to follow the lesioning time course and estimate the developed lesion size in-vitro.

Diffuse reflectance spectroscopy as a method for improving intracerebral guidance during functional neurosurgery has been investigated. An optical probe was developed for measurements during stereotactic and functional neurosurgery in man. The aim of the study was to investigate the spectral differences between white and grey matter and between white matter and functional targets. Diffuse reflectance spectroscopy measurements in ten patients were recorded at incremental steps towards and in three different functional targets (STN, GPi and Zi). The recorded spectra along the trajectory were sorted into white or grey matter, based on preoperative MRI images or the recorded spectral shape and intensity. The difference between tissue types was calculated as a quotient. Significant intensity differences between white and grey matter were found to be at least 14% (p < 0.05) and 20% (p < 0.0001) for MRI and spectral-sorted data respectively. The reflectance difference between white matter and the functional targets of GPi was higher than for STN and Zi. The results indicate that diffuse reflectance spectroscopy has a potential to be developed to a suitable complement to other intracerebral guidance methods.

The aim of this study was to evaluate in vivo a laser Doppler measurement system in porcine brain tissue during thermal lesioning. A 2-mm monopolar radiofrequency lesioning electrode was equipped with optical fibers in order to monitor the lesioning procedure. Laser Doppler and backscattered light intensity signals were measured along the electrode trajectory and during bilateral lesioning in the central gray (70, 80 and 90°C, n = 14). The time course of the coagulation process could be followed by optical recordings. Two separate groups of tissue were identified from the intensity signals. The changes in the perfusion levels in both groups displayed significant changes (p < 0.05, n = 48) at all temperature settings, while backscattered light intensity was significant for only one group at the different temperatures (p < 0.05, n = 39). These results indicate that optical measurements correlate with lesion development in vivo. The study also indicates that it is possible to follow the lesioning process intra-operatively.

Radiofrequency (RF) lesioning in the human brain is a commonsurgical therapy for relieving severe pain as well as formovement disorders such as Parkinsonia. During the procedure a smallelectrode is introduced by stereotactic means towards a target arealocalized by CT or MRI. An RF-current is applied throughthe electrode tip when positioned in the target area. Thetissue in the proximity of the tip is heated bythe current and finally coagulated.The overall aim of this studywas to improve the RF-technique and its ability to estimatelesion size by means of optical methods. Therefore, the opticaldifferences between white and gray matter, as well as lesionedand unlesioned tissue were investigated. Reflection spectroscopy measurements in therange of 450-800 nm were conducted on fully anesthetized pigsduring stereotactic RF-lesioning (n=6). Light from a tungsten lamp wasguided to the electrode tip through optical fibers, inserted alonga 2 mm in diameter monopolar RF-electrode. Measurements were performedin steps of 0-10 mm from the target in eachhemisphere towards the entry point of the skull. In thecentral gray of the porcine brain measurements were performed bothbefore and after the creation of a lesion. A totalof 55 spectra were collected during this study. Correlation totissue type was done using post-operative MR-images. The spectral signaturefor white and gray matter differs significantly for the entirespectral range of 450-800 nm. Pre- and post-lesioning reflection spectroscopyshowed the largest differences below 600 and above 620 nm,which implies that lasers within this wavelength range may beuseful for in-vivo measurements of tissue optical changes during RF-lesioning.

Radiofrequency(RF) lesioning in the human brain is one possible surgicaltherapy for severe pain as well as movement disorders. Oneobstacle for a safer lesioning procedure is the lack ofsize monitoring. The aim of this study was to investigateif changes in laser Doppler or intensity signals could beused as markers for size estimation during experimental RF lesioning.A 2 mm in diameter monopolar RF electrode was equippedwith optical fibers and connected to a digital laser Dopplersystem. The optical RF electrode's performance was equal to astandard RF electrode with the same dimensions. An albumin solutionwith scatterers was used to evaluate the intensity and laserDoppler signal changes during lesioning at 70, 80, and 90 °C.Significant signal changes were found for these three different clotsizes, represented by the temperatures (p<0.05,  n=10). The volume, width, andlength of the created coagulations were correlated to the intensitysignal changes (r=0.88, n=30, p<0.0001) and to the perfusion signalchanges (r=0.81, n=30, p<0.0001). Both static and Doppler-shifted light canbe used to follow the lesioning procedure as well asbeing used for lesion size estimation during experimental RF lesioning.

The microvascular oxygen saturation (SmvO(2)) in the skin and tongue (sublingual mucosa) in pigs (n = 6) was characterised using diffuse reflectance spectroscopy (DRS). The correlation between arterial oxygen saturation (SaO(2)) and SmvO(2) as well as the spatial heterogeneity of SmvO(2) was examined during hypoxia. DRS uses shallow-penetrating visible light to assess microvascular oxygen saturation (SmvO(2)) in superficial tissue. Hypoxia was induced by gradual reduction in ventilation or reduction of the inspiratory oxygen fraction. The spatial heterogeneity of SmvO(2) was expressed as the coefficient of variation (CV) of repeated SmvO(2) measurements. Baseline SmvO(2) before interventions was 20.2% (10.3%-38.1%, median with range) in groin skin, 32.9% (13.0%-49.3%) in the ear and 42.2% (32.1%-51.5%) in the tongue. SmvO(2) in the groin was significantly lower than venous oxygen saturation (SvO(2)) (p andlt; 0.05) and SmvO(2) in the tongue (p = 0.03). There was a significant linear correlation between SaO(2) and SmvO(2) in all measuring sites for both interventions (pandlt;0.05). Similarly there was a significant correlation between CV of repeated SmvO(2) measurements and SmvO(2) in all measuring sites for both interventions (p andlt; 0.01). The results from baseline measurements indicate a surprisingly high oxygen extraction in the measurement volume of DRS, especially in the groin skin. A reduction of SmvO(2) with decreasing SaO(2) was found and additionally the results suggest that spatial heterogeneity of microvascular oxygen saturation increases during hypoxia. Microvascular disturbances have been demonstrated in both local vascular diseases and systemic conditions such as shock and sepsis, an assessment of microvascular oxygen saturation using DRS may be useful in the monitoring of the microcirculation in such patients. This study is a part of an ongoing characterization of the DRS technique.

Background: Glioblastomas are highly aggressive and malignant brain tumors which are difficult to resect totally. The surgical extent of resection constitutes a key role due to its direct influence on the patient’s survival time. To determine the resection extent, the tumor volume on pre-operative and post-operative magnetic resonance (MR) images should be calculated and compared.

Materials and Methods: An active contour segmentation method was implemented to segment glioblastoma brain tumors on pre-operative T1-contrast enhanced MR images in axial, coronal and sagittal planes by self-developed software. The volume was rendered from the tumor  contours using Delaunay triangulation. Besides the segmentation and volume rendering, a graphical user interface was developed to facilitate the rendering, visualization and volume calculation of the brain tumor. The software was implemented in MATLAB (version 7.2). Two MR image data sets from glioblastoma patients were used and the repeatability and reproducibility of volume calculation was tested. Dimensions of the calculated tumor volume were then compared to the dimensions obtained in Amira^® software.

Results: The tumor volumes for data set 1 and data set 2 were 62.7 and 39.0 cm3, respectively. When tumor was segmented by different users (n=4), the volumes were 62.5 ± 0.3 and 42.6 ± 3.5 cm³. Segmentation errors were seen during the segmentation of data set 2. Mainly under- and over-segmentation due to hypointense MR signals caused by cerebrospinal fluid, or hyperintense MR signals caused by skull bone and weak tumor boundaries led to wrong segmentation results.

Conclusion: Segmentation using active contours method is able to detect the brain tumor boundaries. The volume rendering and visualization allows the user to explore the tumor tissue and its surrounding interactively. Using the software, tumor volume is precisely calculated.

OBJECTIVES:

We have developed a method using transthoracic echocardiography in establishing optimal visualization of the aortic root, to reduce the amount of contrast medium used in each patient.

BACKGROUND:

During transcatheter aortic valve implantation, it is necessary to obtain an optimal fluoroscopic projection for deployment of the valve showing the aortic ostium with the three cusps aligned in the beam direction. This may require repeat aortic root angiograms at this stage of the procedure with a high amount of contrast medium with a risk of detrimental influence on renal function.

METHODS:

We studied the conventional way and an echo guided way to optimize visualisation of the aortic root. Echocardiography was used initially allowing easier alignment of the image intensifier with the transducer's direction.

RESULTS:

Contrast volumes, radiation/fluoroscopy exposure times, and postoperative creatinine levels were significantly less in patients having the echo-guided orientation of the optimal fluoroscopic angles compared with patients treated with the conventional approach.

CONCLUSION:

We present a user-friendly echo-guided method to facilitate fluoroscopy adjustment during transcatheter aortic valve implantation. In our series, the amounts of contrast medium and radiation have been significantly reduced, with a concomitant reduction in detrimental effects on renal function in the early postoperative phase.

In case a tumour grows in a tissue close to the lymphatic system, biopsies of the first draining lymph nodes connected to the tumour, also known as sentinel lymph nodes, allow determining if the cancer has already metastasized. Lymph node mapping is used in oncology surgery to find the patients lymph nodes connected to the tumour. The fluorescence marker indocyanine green (ICG) has shown successful results to trace the lymph nodes and arise to replace the currently used radioactive tracers. Because the ICG fluorescence is in the near infrared region and not visible to the human eye, imaging systems are used to visualise the fluorescence. A preliminary spectroscopy measurement system was developed at the Department of Biomedical Engineering, Linköping University. The aim of this thesis was to develop a combined spectroscopy and imaging set-up for simultaneous recordings of ICG fluorescence and suggest further developments.

The combined system consisted of a fibre-optical based spectroscopy system together with a camera imaging system. An optical phantom that mimicked breast tissue (μ_s = 4.66 mm^-1) was developed for the measurements. Phantoms with different ICG concentrations of 6.45 μM, 64.5 μM and 645 μM simulated different concentrations of fluorescence dye in the lymph system. The set-up and the settings of the devices were adjusted to enable simultaneous measurements with both systems. The phantoms were solidified with agar to measure the fluorescence decay (photobleaching) of ICG. To simulate a lymph node deep in the tissue, a tube containing pure ICG was covered with different layer thicknesses of breast tissue-like phantom.

Measurements at the same time with both systems were possible when the probe was positioned in an 80 degree angle with 5 mm distance relative to the phantom surface and the camera in 10 cm distance with a 30 degree angle. To visualise the ICG fluorescence emission with the excitation light (4 mW) and an integration time of 600 ms was necessary for the camera. Higher laser power caused saturation in the spectrometer. The spectroscopy measurements and camera images showed maximum fluorescence intensity at an optimal ICG concentration (10-16 μM) in the phantom. Also the photobleaching measurements showed to be dependent on the ICG concentration and associated with the optimal concentration. ICG concentrations equal and lower than the optimal concentration decayed with exposure to the excitation light. The fluorescence intensity of higher concentrations initially increased and decayed after reaching a maximum intensity when exposed to the excitation light. The detection depth in the simulated tissue was limited to 0.3 mm for spectroscopy. A detection depth of 2 mm was achieved with the camera while using the maximum excitation power of 50 mW and integration time of 700 ms.

Simultaneous measurements were possible with the set-up on the same phantom. An optimal concentration of ICG was found for the developed phantom. The ICG fluorescence intensity was concentration dependent and showed a relatively slow photobleaching. The fibre-optical based spectroscopy system was able to measure low ICG emissions. Subtracting the background spectrum of surrounding tissue might increase the detection of weak ICG signals in depth. High excitation power and an increased integration time were needed to record ICG fluorescence emission with the camera. The obtained results allowed suggestions for the further improvement of set-up and its intraoperative use.

The objective of this paper is to investigate if bioelectrical signals, generated from trunk muscles identified in an electrocardiogram (ECG) signal presented in this paper as ECG-Trunk Muscles Signals amplitude (Ecg-TMSA) are correlated with Heart rate (HR) during different levels of physical activity and also if Ecg-TMSA is not influenced by mental activity. HR and Ecg-TMSA were derived from ECG in 14 subjects when walking and jogging at different treadmill velocities from 4–10 (km h⁻¹). The mean relationship for all 14 subjects was HR = (42.3 ± 0.2) + (45.3 ± 2.8) Ecg-TMSA, r²= 0.91. The result of one individual data points example for a 21 min experiment was (r²= 0.93, p < 0.0001, n = 336). The obtained results show a linear relationship between Ecg-TMSA and HR. Moreover, the Ecg-TMSA was not affected by mental activity

Background: The subthalamic nucleus is currently the target of choice in deep brain stimulation (DBS) for Parkinsons disease (PD), while thalamic DBS is used in some cases of tremor-dominant PD. Recently, a number of studies have presented promising results from DBS in the posterior subthalamic area, including the caudal zona incerta (cZi). The aim of the current study was to evaluate cZi DBS in tremor-dominant Parkinsons disease. less thanbrgreater than less thanbrgreater thanMethods: 14 patients with predominately unilateral tremor-dominant PD and insufficient relief from pharmacologic therapy were included and evaluated according to the motor part of the Unified Parkinson Disease Rating Scale (UPDRS). The mean age was 65 +/- 6.1 years and the disease duration 7 +/- 5.7 years. Thirteen patients were operated on with unilateral cZi DBS and 1 patient with a bilateral staged procedure. Five patients had non-L-dopa responsive symptoms. The patients were evaluated on/off medication before surgery and on/off medication and stimulation after a minimum of 12 months after surgery. less thanbrgreater than less thanbrgreater thanResults: At the follow-up after a mean of 18.1 months stimulation in the off-medication state improved the contralateral UPDRS III score by 47.7%. Contralateral tremor, rigidity, and bradykinesia were improved by 82.2%, 34.3%, and 26.7%, respectively. Stimulation alone abolished tremor at rest in 10 (66.7%) and action tremor in 8 (533%) of the patients. less thanbrgreater than less thanbrgreater thanConclusion: Unilateral cZi DBS seems to be safe and effective for patients with severe Parkinsonian tremor. The effects on rigidity and bradykinesia were, however, not as profound as in previous reports of DBS in this area.

When laser light illuminates a diffuse object, it produces a random interference effect known as a speckle pattern. If there is movement in the object, the speckles fluctuate in intensity. These fluctuations can provide information about the movement. A simple way of accessing this information is to image the speckle pattern with an exposure time longer than the shortest speckle fluctuation time scale-the fluctuations cause a blurring of the speckle, leading to a reduction in the local speckle contrast. Thus, velocity distributions are coded as speckle contrast variations. The same information can be obtained by using the Doppler effect, but producing a two-dimensional Doppler map requires either scanning of the laser beam or imaging with a high-speed camera: laser speckle contrast imaging (LSCI) avoids the need to scan and can be performed with a normal CCD- or CMOS-camera. LSCI is used primarily to map flow systems, especially blood flow. The development of LSCI is reviewed and its limitations and problems are investigated. (C) The Authors. Published by SPIE under a Creative Commons Attribution 3.0 Unported License. Distribution or reproduction of this work in whole or in part requires full attribution of the original publication, including its DOI.

In this paper, we investigate the possibility of using accurate prediction models for the prediction of protoporphyrin bleaching dynamics to achieve photobleaching-insensitive methods to improve the evaluation of data in an existing clinical fluorescence-guided resection technique. To simulate the scenario, measurements were carried out in vivo on skin of healthy volunteers using a compact fiber-based fluorescence spectroscopy system. We have developed an effective method for the parameterization of sequences of bleaching spectra. We analyze convergence and decay rates with respect to initial conditions and excitation irradiance. We also discuss the consequences and the potential for bleaching-insensitive measurements and their applicability in a few examples from in vivo open brain surgery.