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Abstract
Parkinson's disease (PD) is a brain disorder with distinct molecular, functional and structural features, causing tremors in elderly-matured-people, which is, differentiated by the convolution of cardinal motoric-symptoms: tremor, Bradykinesia/akinesia rigidity and postural-instability. Though clinical-diagnosis and benefits of deep-brain-stimulation (DBS) in subthalamic-nuclei (STN) have been established, albeit, how its mechanisms augment motoric-symptoms not been fully elucidated. We present a principal component (PC) based tracking method to quantify the efficacy-of-DBS predict UPDRS score objectively. Twelve PD patients were included in this study. Our hypothesis is that whether DBS and innocuous-microelectrodes save STN-neurons and restores-motor-function. In our long study, high-frequency stimulation in PD brain did not dent STN-neurons. Further, it is risk-free to stimulate-STN much prior than it was accepted far so. Intraoperative microelectrode-recording (iMER) for targeting during DBS procedures has been evaluated in 46 successive-patients with advanced idiopathic PD, who received DBS. We extrapolated MER-signals of STN-features with PCs for computing the effects of DBS in PD. The signal-parameters were transformed into a lower dimensional-feature space. In our computation, we obtained 75% variation. We find that MER gives proof of correct-positioning of microelectrode, ensures accurate-detection of STN confines and establishes its exact coordinates in a more objective way. MER boosts safety, accuracy and efficacy of DBS-electrode implementation. Thus, MER confirms the presence of abnormal-STN-neurons. Certainly tranquil MER can confirm clear position-of-electrodes and strengthen the confidence of the neurosurgeons that they are in the right-target. Availability-of-MER results in a vast data vis-á-vis functioning on neurons positioned deep in the brain may further help in untying arcane-of-brain.
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Venkateshwarla Rama Raju
Venkateshwarla Rama Raju received the BSc (Hons) degree in electronics from Osmania University in 1984, a post BTech (Hons) degree in computer science & engineering (CSE) with artificial intelligence – robotics & biomedical engineering (AI&R, BME) specialization from the University of Hyderabad (UoH), Central University (HCU) in 1988, a MTech degree in computer science & technology with AI/NLP specialization from JNU New Delhi in 1992, and a PhD degree in transdiscipline biomedical engineering & neurology from Nizam's Inst. of Medical-Sciences (NIMS) 2009 all in India. He also pursued an advanced master's degree through advanced research in cognitive science (AI/Medical-Neuroscience, Natural Language-and-Speech Processing, Speech-Technology & Auditory-Processing) at ILASH-Research Centre, Computer Science Department, University of Sheffield (England, 1994–1995), a MPhil/DSc degree in biomedical-signal-processing from the Bioengineering-Transducers-Signal-Processing (BTSP) Research Group of the University of Leicester (UoL), Department of Engineering (England, 1995–1997). He worked as scientist/engineer at Planning Commission (New Delhi) through Indian Engineering Services (IES), and Research Fellow at UOS-and-UoL. He has worked on a DST Project at NIMHANS Psychiatry and Neurology Departments in association with Indian Institute of Science (IISc)-TATA Institute, Bangalore (1997–1998). Later he worked as a Reader in the Departments of BME & ECE, Osmania University (1997–1999). Presently, he is a full professor at CMRCET-JNTU (UGC Autonomous) Hyderabad involved in developing and applying new estimation, systems and control tools in order to build computational simulation and statistical models of electrical-activity in neural circuits affected by Parkinson's disease (PD), understand electro-physiological-dynamics of neural circuits in health/disease-states during DBS treatment, design more effective, adaptive, and safer DBS-strategies for neurological-neurodegenerative disorders; design new clinical/clinico-statistical experiments, develop/apply systems-level mathematical frameworks for modeling-and-controlling neuronal network activity in the brain with DBS using AI machine and deep learning techniques, create a more intelligent system for both placing-and-controlling the electrodes; implant an intelligent chip that continuously measures/monitors neural activity, and finally build an effective new cadre-of-researchers who bridge the training and thinking gaps toward major-advances in transdiscipline neuroscience. He has over 180 papers published in national and international journals and over 12 chapters in IFMBE Springer Nature proceedings. He is a professional member of different scientific societies of engineering medicine biology and computing: Life member of ISTE, senior member of IEEE (USA), British Computing Society (BCS, UK), LAM of Indian Academy of Neurology (IAN), Life Member of Indian Academy of Neurosciences (IANs) Member of International Parkinson Disease and Movement Disorders Society (WI, USA), Neurological Society of India (NSI), Member of Andhra Pradesh Neurology Society and Neuroscientists Association, etc. Corresponding author. Email: [email protected]
Rukmini Kandadai Mridula
Rukmini Kandadai Mridula is currently working as an assistant professor in the Department of Neurology, Nizam's Institute of Medical Sciences, Hyderabad. She studied MBBS at Kasturba Medical College, Manipal and completed her DNB (General Medicine) and DM (Neurology) from Nizam's Institute of Medical Sciences, Hyderabad. She is interested in movement disorders, cognitive neurology and neuroimaging. Her special areas of interest include non-motor aspects of Parkinson's disease, atypical Parkinsonian syndromes and mild cognitive impairment. She is part of the specialized movement disorder team running the STN-DBS programme in NIMS. She has over 40 papers published in national and international journals and over 10 chapters in various text books. Email: [email protected]
Rupam Borgohain
Rupam Borgohain did his MBBS (Assam Medical College, Dibrugarh) in 1983, Internship from Safdarjung Hospital, New Delhi (in 1985), DM (Neurology) from a National Institute of Mental Health and Neurosciences (NIMHANS) Bangalore in 1991. He joined as assistant professor in NIMS and became professor of Neurology in 2005. Since then, he has been actively involved in the movement disorder which is his specialization. He has international authority on movement disorders and published more than 135 articles in various journals (both national and international). He has proposed and implemented a number of clinical research projects in movement disorders and undertaken number of trials. He is a Professional member of medical scientific societies: Life member of the Indian Neurological Society, Life member of Andhra Pradesh Neurology Society, Movement Disorder Society, Life member of Indian Academy of Neurology, etc. Email: [email protected]