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Neurologist consistency in interpreting information provided by an interactive visualization software for deep brain

Srivatsan Pallavaram¹, Fenna T Phibbs, Christopher Tolleson

¹Department of Electrical Engineering & Computer Science, Vanderbilt University, Nashville, TN, USA.

Neuromodulation : Journal of the International Neuromodulation Society

|May 8, 2013

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Neurologists showed high consistency using the CRAVE software for deep brain stimulation (DBS) programming. The software assists in visualizing electrode placement and tissue activation, simplifying complex postoperative therapy for movement disorders.

Area of Science:

Neurosurgery
Neurology
Medical Imaging

Background:

Deep brain stimulation (DBS) programming for movement disorders is complex and time-consuming.
Neurologists benefit from tools visualizing electrode location, tissue activation, and statistical data.
This study assesses the consistency of DBS programming using specialized software.

Purpose of the Study:

To evaluate the consistency of neurologists in interpreting and utilizing data from a DBS programming assistance software.
To determine the software's effectiveness in aiding postoperative DBS therapy.

Main Methods:

Five neurologists used the CRAnialVault Explorer (CRAVE) software with datasets from 17 patients (29 leads).
Data included probabilistic stimulation response maps, anatomical images, tissue activation models, and electrode positions.

Keywords:

3D anatomical structures computer-assisted postoperative programming assistance deep brain stimulation electrophysiological statistical atlases nonrigid image registration

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Consistency in optimal contact selection was measured.

Main Results:

High inter-neurologist consistency was observed: 97% (mode) and 95% (mean) with efficacy maps alone.
Consistency slightly decreased to 93% (mode) and 89% (mean) when using efficacy and adverse effect maps.
Fleiss' kappa statistic indicated very strong agreement (0.87 to 0.72).

Conclusions:

Neurologists demonstrated high consistency using CRAVE software for DBS programming assistance.
The software features a short learning curve, as three neurologists had no prior experience.
Contact selection was not dependent on software familiarity.