Ultrasound technology uses sound waves with a frequency beyond the threshold of human hearing (>20,000 Hz). The purpose of this article is to provide a background on fundamental ultrasound concepts, review various devices on the market, and discuss the potential uses for POCUS in outpatient neurology. In neurology, there are abundant potential indications, including but not limited to evaluation of extracranial vascular disease, musculoskeletal (MSK) diseases, neuromuscular disorders (NMD), neuro-ophthalmologic conditions, and procedural guidance. 1-4 Many different handheld devices are available, and emerging evidence suggests the accuracy of these devices often rivals or surpasses cart-based ultrasound devices and other modalities. POCUS is used primarily to complement the physical exam and is of considerable interest, because it can enable disease screening, accelerate definitive diagnosis, guide clinical decision-making, and decrease overall healthcare costs. Ultrasound has evolved from large immobile machines to portable devices on wheeled carts, and now, handheld devices that can fit in a clinician’s pocket, making them continuously available at the point of care. Ultrasound technology is used in many areas of medicine, including obstetrics, cardiology, critical care, emergency medicine, pediatrics, and primary care. Point-of-care ultrasound (POCUS) has become an increasingly popular diagnostic tool to meet this need. Listeners will hear, feel and see the brain activity either in the normal state or a seizure state, and all in its natural time course and with its awesome rhythms and severity.Healthcare delivery is rapidly evolving in the US, and significant efforts have been made to expedite the speed and accuracy of diagnostic testing across a variety of healthcare settings. The final product of this unique collaboration will be a device that creates audio and 3D visualizations directly from arrays of intracranial brain signals in patients with epilepsy. While the PI will contribute with his unique expertise in intracranial electrophysiological recordings and signal processing, the co-PI will contribute with his internationally known and ground-breaking method of “musification” of biological, medical, and environmental sources. In this collaborative project, the PI is the Director of Medication-Resistant Epilepsy Program at Stanford and the Co-PI is the Director of Center of Computer Research in Music and Acoustics. At a higher level of abstraction, advanced sonification and visualization software can track patterns over time in the data, uncovering the individual regularities, which may then lead to larger patterns to be found in common among many patients with epilepsy. You can move through the 3D visual and auditory space to pinpoint the origin of specific patterns, the entrainment of neighboring areas and so on. Couple this with visualizations of the same flowing data in 3D projections, and the workings of the brain become navigable. For example, by “sonifying” the data patterns - turning them into a kind of music - the human ear can follow the nuances and shifts of brain states with a surprising deftness. It is here that collaboration between School of Humanities and Sciences and School of Medicine holds great promise, certain to advance the possibilities of representing brain signals in a novel and illuminating way. Recordings from inside the brain yield unprecedentedly rich data-sets of electrical signals both in normal and in seizure states. Interdisciplinary Initiatives Program Round 6 - 2012
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