1. Quantitative Detection of Parkinson's Disease Symptoms Advisor: Dr. Chris Kao Project Team: Kylen Bares Eddie Cao

2. Dr. Changquing (Chris) Kao, M.D., Ph.D. Research Associate Professor in Department of Neurosurgery at Vanderbilt University Clinical interest: –Microelectrode brain mapping for target localization of deep brain stimulation treatment of movement disorders Research focus: –Electrophysiology in nerve stimulation, epilepsy, pain control and head injury

3. What is Parkinson’s Disease? Neurodegenerative disorder caused by damaged or dead dopamine-releasing neurons in the substantia nigra Dopamine: neurotransmitter that carries information from neuron to neuron and eventually to the muscles Brain no longer able to direct or control muscle movement in a normal manner. Half a million people every year are affected by Parkinson’s

4. Symptoms Tremor or trembling in hands, arms, legs, jaw, and face Rigidity or stiffness of the limbs and trunk Slowness of motor movements Postural instability or impaired balance and coordination Reduction in blinking rate of eyes

6. Treatment Drugs: Levodopa/ L-Dopa Drugs designed to mimic dopamine effects or counteract acetylcholine effects Pallidotomy: Section of globus pallidus removed Deep Brain Stimulation (DBS) : Implants stimulators that block brain signals causing rigidity, tremors and other symptoms http://www.pdmdcenter.com/articles/HopkinsWeb/index.html

7. Deep Brain Stimulation 3 parts: lead electrode, extension wire, neurostimulator Lead electrode: thin, insulated wire inserted through the skull within the tip placed inside predetermined target area (located by MRI or CT scan) Extension: thin, insulated wire connecting lead and neurostimulator, passing under the skin Neurostimulator (NS): “battery” pack implanted under the skin near neck or torso Electrical stimulation is delivered from NS to affected target area in the brain, blocking abnormal nerve signals

8. Problem Quantifiable measurement of the symptoms of Parkinson’s disease is needed to maximize therapy. Unfortunately, there currently does not exist a method known to be reliable.

9. Our Device A pneumatic-actuated frame that fits around the right arm - uses air pressure for individual flexion of the fingers and forearm - measures the pressure exerted on the actuator piston - this pressure corresponds to the force needed to move the arm and, therefore, the rigidity of the arm muscles Each patient will be their own control since we only need to measure effectiveness of treatment

10. Our Device Composed of two main parts –Control Box Contains the pneumatic valves and pressure manifold –Arm frame Encloses the arm and translates motion of pneumatic cylinders into motion of the arm

12. Pneumatic Circuit Diagram

16. Current Status Acquired materials for control box and pneumatic actuators for arm frame Control box is complete, pending a minor change in tube layout. Acquired access to a life-size dummy to design our frame around ProE model has been completed Planning the construction of the prototype

17. Some answered questions Anesthesia does affect rigidity, but cannot be eliminated, so administration is localized. Some patients do have tremors, which, however, don’t affect the effectiveness of measurement. Stimulation mapping will quantitatively detect efficacy more objectively about muscle function improvement.

18. Ultimate Goals To create and test the viability of a fully controllable pneumatic device that forces movement in the arms of actual Parkinson’s patients and accurately displays the required pressure to induce movement. To enable the device to adjust in order to comfortably fit multiple patients.