Abstract
The implementation of wearable and wireless systems for deep brain stimulation offers the opportunity to substantially advance the treatment of progressive neurodegenerative movement disorders, such as Parkinson’s disease and Essential tremor. Deep brain stimulation offers an efficacious alternative regarding scenarios for which the intervention by medication has become intractable while avoiding the permanency of ablative neurosurgery. Even subsequent to the expert surgical application of the deep brain stimulation system, the acquisition of the optimal parameter configuration is inherently resource intensive and challenging in nature. With the advent of wearable and wireless systems, the response to therapy intervention for movement disorder status can be objectively quantified through the inertial sensor signal, such as an accelerometer and gyroscope. Furthermore, wireless connectivity to the Internet enables experimental and post-processing resources to be remotely situated effectively anywhere in the world. With machine learning amended to the post-processing capability, clinical diagnostic acuity is substantially advanced. Foundational subjects are elucidated, such a general perspective regarding Parkinson’s disease and Essential tremor, traditional ordinal methodologies for diagnosing severity, and the development of deep brain stimulation including surgical techniques for installation. The role of wearable and wireless systems, such as the smartphone, for quantifying the status of neurodegenerative movement disorders, such as Parkinson’s disease and Essential tremor, is presented. The utility of applying machine learning for augmenting diagnostic acuity of movement disorder status is addressed. The integration of wearable and wireless systems, such as the smartphone, with machine learning is discussed for the ability to distinctively classify between deep brain stimulation set to “On” and “Off” status for Parkinson’s disease and Essential tremor. The amalgamation of wearable and wireless systems with deep brain stimulation using machine learning as an augmented post-processing application implicate the evolutionary trends for the ability to achieve closed-loop optimization of parameter configurations with the development of Network Centric Therapy for a quantum leap in the treatment intervention for neurodegenerative movement disorders, such as Parkinson’s disease and Essential tremor.
Keywords
- Wearable and wireless system
- Smartphone
- Wireless inertial sensor
- Accelerometer
- Gyroscope
- Deep brain stimulation system
- Movement disorders
- Parkinson’s disease
- Essential tremor
- Parameter configuration
- Optimization
- Closed-loop tuning
- Network Centric Therapy
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References
Parkinson J (1817) An essay on the shaking palsy. Whittingham and Rowland, London
Louis ED (2005) Essential tremor. Lancet Neurol 4(2):100–110
Louis ED (2000) Essential tremor. Arch Neurol (JAMA Neurology) 57(10):1522–1524
Kandel ER, Schwartz JH, Jessell TM (2000) Principles of neural science. McGraw-Hill, New York, Ch 43
Essential tremor: [http://www.essentialtremor.org/about-et/]
Seeley RR, Stephens TD, Tate P (2003) Anatomy and physiology. McGraw-Hill, Boston, Ch 14
Deuschl G, Raethjen J, Hellriegel H, Elble R (2011) Treatment of patients with essential tremor. Lancet Neurol 10(2):148–161
Habib-ur-Rehman (2000) Diagnosis and management of tremor. Arch Intern Med 160(16):2438–2444
LeMoyne R (2013) Wearable and wireless accelerometer systems for monitoring Parkinson’s disease patients—a perspective review. Adv Park Dis 2(4):113–115
Nolte J, Sundsten JW (2002) The human brain: an introduction to its functional anatomy. Mosby, St. Louis, Ch 19
Williams R (2010) Alim-Louis Benabid: stimulation and serendipity. Lancet Neurol 9(12):1152
Amon A, Alesch F (2017) Systems for deep brain stimulation: review of technical features. J Neural Transm 124(9):1083–1091
Isaias IU, Tagliati M (2008) Deep brain stimulation programming for movement disorders. In: Deep brain stimulation in neurological and psychiatric disorders. Springer, New York, pp 361–397
Volkmann J, Moro E, Pahwa R (2006) Basic algorithms for the programming of deep brain stimulation in Parkinson’s disease. Mov Disord 21(S14):S284–S289
Ramaker C, Marinus J, Stiggelbout AM, Van Hilten BJ (2002) Systematic evaluation of rating scales for impairment and disability in Parkinson’s disease. Mov Disord 17(5):867–876
Fahn S, Elton RL, UPDRS Program Members (1987) Unified Parkinson’s Disease Rating Scale. In: Recent developments in Parkinson’s disease, Vol. 2. Macmillan Healthcare Information, Florham Park, pp 153–163, 293–304.
Goetz CG, Stebbins GT, Chmura TA, Fahn S, Poewe W, Tanner CM (2010) Teaching program for the Movement Disorder Society-sponsored revision of the Unified Parkinson’s Disease Rating Scale: (MDS-UPDRS). Mov Disord 25(9):1190–1194
Movement Disorder Society Task Force on Rating Scales for Parkinson’s Disease (2003) The Unified Parkinson’s Disease Rating Scale (UPDRS): status and recommendations. Mov Disord 18(7):738–750
Goetz CG, Tilley BC, Shaftman SR, Stebbins GT, Fahn S, Martinez-Martin P, Poewe W, Sampaio C, Stern MB, Dodel R, Dubois B, Holloway R, Jankovic J, Kulisevsky J, Lang AE, Lees A, Leurgans S, LeWitt PA, Nyenhuis D, Olanow CW, Rascol O, Schrag A, Teresi JA, van Hilten JJ, LaPelle N (2008) Movement Disorder Society-sponsored revision of the Unified Parkinson’s Disease Rating Scale (MDS-UPDRS): scale presentation and clinimetric testing results. Mov Disord 23(15):2129–2170
Fahn S, Tolosa E, Marin C (1988) Clinical rating scale for tremor. In: Parkinson’s disease and movement disorders. Urban & Schwarzenberg, Baltimore, pp 225–234
Elble RJ (2016) The essential tremor rating assessment scale. J Neurol Neuromed 1(4):34–38
Siderowf A, McDermott M, Kieburtz K, Blindauer K, Plumb S, Shoulson I (2002) Test–retest reliability of the unified Parkinson’s disease rating scale in patients with early Parkinson’s disease: results from a multicenter clinical trial. Mov Disord 17(4):758–763
Metman LV, Myre B, Verwey N, Hassin-Baer S, Arzbaecher J, Sierens D, Bakay R (2004) Test–retest reliability of UPDRS-III, dyskinesia scales, and timed motor tests in patients with advanced Parkinson’s disease: an argument against multiple baseline assessments. Mov Disord 19(9):1079–1084
Richards M, Marder K, Cote L, Mayeux R (1994) Interrater reliability of the Unified Parkinson’s Disease Rating Scale motor examination. Mov Disord 9(1):89–91
Post B, Merkus MP, de Bie RM, de Haan RJ, Speelman JD (2005) Unified Parkinson’s Disease Rating Scale motor examination: are ratings of nurses, residents in neurology, and movement disorders specialists interchangeable? Mov Disord 20(12):1577–1584
LeMoyne R, Coroian C, Cozza M, Opalinski P, Mastroianni T, Grundfest W (2009) The merits of artificial proprioception, with applications in biofeedback gait rehabilitation concepts and movement disorder characterization. In: Biomedical engineering. InTech, Vienna, pp 165–198
LeMoyne R, Mastroianni T (2018) Wearable and wireless systems for healthcare I: gait and reflex response quantification. Springer, Singapore
LeMoyne R, Mastroianni T (2017) Smartphone and portable media device: a novel pathway toward the diagnostic characterization of human movement. In: Smartphones from an applied research perspective. InTech, Rijeka, Croatia, pp 1–24
LeMoyne R, Mastroianni T (2017) Wearable and wireless gait analysis platforms: smartphones and portable media devices. In: Wireless MEMS networks and applications. Elsevier, New York, pp 129–152
LeMoyne R, Mastroianni T (2016) Telemedicine perspectives for wearable and wireless applications serving the domain of neurorehabilitation and movement disorder treatment. In: Telemedicine, SMGroup, Dover, Delaware, pp 1–10
LeMoyne R, Mastroianni T (2015) Use of smartphones and portable media devices for quantifying human movement characteristics of gait, tendon reflex response, and Parkinson’s disease hand tremor. In: Mobile health technologies, methods and protocols. Springer, New York, pp 335–358
LeMoyne R, Coroian C, Mastroianni T, Grundfest W (2008) Accelerometers for quantification of gait and movement disorders: a perspective review. J Mech Med Biol 8(2):137–152
Diamond MC, Scheibel AB, Elson LM (1985) The human brain coloring book. Harper Perennial, New York, Ch 5
Hariz GM, Lindberg M, Bergenheim AT (2002) Impact of thalamic deep brain stimulation on disability and health-related quality of life in patients with essential tremor. J Neurol Neurosurg Psychiatry 72(1):47–52
LeMoyne R, Tomycz N, Mastroianni T, McCandless C, Cozza M, Peduto D (2015) Implementation of a smartphone wireless accelerometer platform for establishing deep brain stimulation treatment efficacy of essential tremor with machine learning. In: 37th Annual international conference of the IEEE, Engineering in Medicine and Biology Society (EMBS), pp 6772–6775
LeMoyne R, Mastroianni T, Tomycz N, Whiting D, Oh M, McCandless C, Currivan C, Peduto D (2017) Implementation of a multilayer perceptron neural network for classifying deep brain stimulation in ‘On’ and ‘Off’ modes through a smartphone representing a wearable and wireless sensor application. In: 47th Society for Neuroscience annual meeting (featured in Hot Topics; top 1% of abstracts)
LeMoyne R, Mastroianni T, McCandless C, Currivan C, Whiting D, Tomycz N (2018) Implementation of a smartphone as a wearable and wireless accelerometer and gyroscope platform for ascertaining deep brain stimulation treatment efficacy of Parkinson’s disease through machine learning classification. Adv Park Dis 7(2):19–30
LeMoyne RC (2010) Wireless quantified reflex device. Ph.D. Dissertation UCLA
LeMoyne R, Mastroianni T, Coroian C, Grundfest W (2011) Tendon reflex and strategies for quantification, with novel methods incorporating wireless accelerometer reflex quantification devices, a perspective review. J Mech Med Biol 11(3):471–513
LeMoyne R, Mastroianni T, Kale H, Luna J, Stewart J, Elliot S, Bryan F, Coroian C, Grundfest W (2011) Fourth generation wireless reflex quantification system for acquiring tendon reflex response and latency. J Mech Med Biol 11(1):31–54
LeMoyne R, Coroian C, Mastroianni T, Grundfest W (2008) Quantified deep tendon reflex device for response and latency, third generation. J Mech Med Biol 8(4):491–506
LeMoyne R, Dabiri F, Jafari R (2008) Quantified deep tendon reflex device, second generation. J Mech Med Biol 8(1):75–85
LeMoyne R, Dabiri F, Coroian C, Mastroianni T, Grundfest W (2007) Quantified deep tendon reflex device for assessing response and latency. In: 37th Society for Neuroscience annual meeting
LeMoyne R, Jafari R, Jea D (2005) Fully quantified evaluation of myotatic stretch reflex. In: 35th Society for Neuroscience annual meeting
LeMoyne R, Mastroianni T (2017) Implementation of a smartphone wireless gyroscope platform with machine learning for classifying disparity of a hemiplegic patellar tendon reflex pair. J Mech Med Biol 17(6):1750083
LeMoyne R, Kerr W, Zanjani K, Mastroianni T (2014) Implementation of an iPod wireless accelerometer application using machine learning to classify disparity of hemiplegic and healthy patellar tendon reflex pair. J Med Imaging Health Inform 4(1):21–28
LeMoyne R, Mastroianni T (2016) Smartphone wireless gyroscope platform for machine learning classification of hemiplegic patellar tendon reflex pair disparity through a multilayer perceptron neural network. In: Wireless Health (WH) of IEEE, pp 103–108
LeMoyne R, Mastroianni T (2015) Machine learning classification of a hemiplegic and healthy patellar tendon reflex pair through an iPod wireless gyroscope platform. In: 45th Society for Neuroscience annual meeting
LeMoyne R, Mastroianni T, Grundfest W, Nishikawa K (2013) Implementation of an iPhone wireless accelerometer application for the quantification of reflex response. In: 35th Annual international conference of the IEEE, Engineering in Medicine and Biology Society (EMBS), pp 4658–4661
LeMoyne R, Coroian C, Mastroianni T (2009) Quantification of Parkinson’s disease characteristics using wireless accelerometers. In: ICME International conference on IEEE Complex Medical Engineering (CME), pp 1–5
LeMoyne R, Mastroianni T, Cozza M, Coroian C, Grundfest W (2010) Implementation of an iPhone for characterizing Parkinson’s disease tremor through a wireless accelerometer application. In: 32nd Annual international conference of the IEEE, Engineering in Medicine and Biology Society (EMBS), pp 4954–4958
LeMoyne R, Mastroianni T (2016) Implementation of a multilayer perceptron neural network for classifying a hemiplegic and healthy reflex pair using an iPod wireless gyroscope platform. In: 46th Society for Neuroscience annual meeting
LeMoyne R, Mastroianni T, Grundfest W (2013) Wireless accelerometer configuration for monitoring Parkinson’s disease hand tremor. Adv Park Dis 2(2):62–67
LeMoyne R, Coroian C, Mastroianni T, Grundfest W (2008) Virtual proprioception. J Mech Med Biol 8(3):317–338
Benabid AL, Pollak P, Louveau A, Henry S, de Rougemont J (1987) Combined (thalamotomy and stimulation) stereotactic surgery of the VIM thalamic nucleus for bilateral Parkinson’s disease. Appl Neurophysiol 50(1–6):344–346
Rehncrona S, Johnels B, Widner H, Törnqvist AL, Hariz M, Sydow O (2003) Long-term efficacy of thalamic deep brain stimulation for tremor: double-blind assessments. Mov Disord 18(2):163–170
Sydow O, Thobois S, Alesch F, Speelman JD (2003) Multicentre European study of thalamic stimulation in essential tremor: a six year follow up. J Neurol Neurosurg Psychiatry 74(10):1387–1391
Krack P, Batir A, Van Blercom N, Chabardes S, Fraix V, Ardouin C, Koudsie A, Limousin PD, Benazzouz A, LeBas JF, Benabid AL, Pollak P (2003) Five-year follow-up of bilateral stimulation of the subthalamic nucleus in advanced Parkinson’s disease. N Engl J Med 349(20):1925–1934
Lyons KE, Koller WC, Wilkinson SB, Pahwa R (2001) Long term safety and efficacy of unilateral deep brain stimulation of the thalamus for parkinsonian tremor. J Neurol Neurosurg Psychiatry 71(5):682–684
Benabid AL, Benazzous A, Pollak P (2002) Mechanisms of deep brain stimulation. Mov Disord 17(S3):S73–S74
Yu H, Neimat JS (2008) The treatment of movement disorders by deep brain stimulation. Neurotherapeutics 5(1):26–36
Pretto T (2007) Deep brain stimulation. Neurologist 13(2):103–104
Panisset M, Picillo M, Jodoin N, Poon YY, Valencia-Mizrachi A, Fasano A, Munhoz R, Honey CR (2017) Establishing a standard of care for deep brain stimulation centers in Canada. Can J Neurol Sci 44(2):132–138
Schwalb JM, Hamani C (2008) The history and future of deep brain stimulation. Neurotherapeutics 5(1):3–13
Hariz M (2017) My 25 stimulating years with DBS in Parkinson’s disease. J Park Dis 7(s1):S33–S41
Fang JY, Tolleson C (2017) The role of deep brain stimulation in Parkinson’s disease: an overview and update on new developments. Neuropsychiatr Dis Treat 13:723–732
Sun FT, Morrell MJ (2014) Closed-loop neurostimulation: the clinical experience. Neurotherapeutics 11(3):553–563
Priori A, Foffani G, Rossi L, Marceglia S (2013) Adaptive deep brain stimulation (aDBS) controlled by local field potential oscillations. Exp Neurol 245:77–86
Okun MS (2012) Deep-brain stimulation for Parkinson’s disease. N Engl J Med 367(16):1529–1538
Hariz MI (2002) Complications of deep brain stimulation surgery. Mov Disord 17(S3):S162–S166
Constantoyannis C, Berk C, Honey CR, Mendez I, Brownstone RM (2005) Reducing hardware-related complications of deep brain stimulation. Can J Neurol Sci 32(2):194–200
Patterson T, Stecker MM, Netherton BL (2007) Mechanisms of electrode induced injury. Part 2: clinical experience. Am J Electroneurodiagnostic Technol 47(2):93–113
Nutt JG, Anderson VC, Peacock JH, Hammerstad JP, Burchiel KJ (2001) DBS and diathermy interaction induces severe CNS damage. Neurology 56(10):1384–1386
Rezai AR, Phillips M, Baker KB, Sharan AD, Nyenhuis J, Tkach J, Henderson J, Shellock FG (2004) Neurostimulation system used for deep brain stimulation (DBS): MR safety issues and implications of failing to follow safety recommendations. Investig Radiol 39(5):300–303
Tagliati M, Jankovic J, Pagan F, Susatia F, Isaias IU, Okun MS (2009) Safety of MRI in patients with implanted deep brain stimulation devices. NeuroImage 47(S2):T53–T57
Temel Y (2010) Limbic effects of high-frequency stimulation of the subthalamic nucleus. Vitam Horm 82:47–63
Tomycz ND, Whiting DM (2018) Deep brain stimulation: indications, operative technique, and programming. Internal Publication Allegheny General Hospital
Saunders JB, Inman VT, Eberhart HD (1953) The major determinants in normal and pathological gait. J Bone Joint Surg 35A(3):543–558
Culhane KM, O’Connor M, Lyons D, Lyons GM (2005) Accelerometers in rehabilitation medicine for older adults. Age Ageing 34(6):556–560
Patel S, Park H, Bonato P, Chan L, Rodgers M (2012) A review of wearable sensors and systems with application in rehabilitation. J Neuroeng Rehabil 9(1):21
LeMoyne R (2007) Gradient optimized neuromodulation for Parkinson’s disease. In: 12th Annual UCLA research conference on aging
LeMoyne R, Coroian C, Mastroianni T (2008) 3D wireless accelerometer characterization of Parkinson’s disease status. In: Plasticity and repair in neurodegenerative disorders (Conference)
LeMoyne R, Mastroianni T (2018) Bluetooth inertial sensors for gait and reflex response quantification with perspectives regarding cloud computing and the Internet of Things. In: Wearable and wireless systems for healthcare I: gait and reflex response quantification. Springer, Singapore, pp 95–103
LeMoyne R, Mastroianni T (2018) Role of machine learning for gait and reflex response classification. In: Wearable and wireless systems for healthcare I: gait and reflex response quantification. Springer, Singapore, pp 111–120
LeMoyne R, Mastroianni T, Tomycz N, Whiting D, McCandless C, Peduto D, Cozza M (2015) I-Phone wireless accelerometer quantification of extremity tremor in essential tremor patient undergoing activated and inactivated deep brain stimulation. In: International Neuromodulation Society’s 12th World Congress
Hall M, Frank E, Holmes G, Pfahringer B, Reutemann P, Witten IH (2009) The WEKA data mining software: an update. ACM SIGKDD Explor Newsl 11(1):10–18
Witten IH, Frank E, Hall MA (2011) Data mining: practical machine learning tools and techniques. Morgan Kaufmann, Burlington, MA
LeMoyne R, Kerr W, Mastroianni T, Hessel A (2014) Implementation of machine learning for classifying hemiplegic gait disparity through use of a force plate. In: 13th International Conference on Machine Learning and Applications (ICMLA), IEEE, pp 379–382
LeMoyne R, Mastroianni T, McCandless C, Currivan C, Whiting D, Tomycz N (2018) Implementation of a smartphone as a wearable and wireless inertial sensor platform for determining efficacy of deep brain stimulation for Parkinson’s disease tremor through machine learning. In: 48th Society for Neuroscience annual meeting (Nanosymposium)
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LeMoyne, R., Mastroianni, T., Whiting, D., Tomycz, N. (2019). Wearable and Wireless Systems for Movement Disorder Evaluation and Deep Brain Stimulation Systems. In: Wearable and Wireless Systems for Healthcare II. Smart Sensors, Measurement and Instrumentation, vol 31. Springer, Singapore. https://doi.org/10.1007/978-981-13-5808-1_1
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