Calame Dylan, Lester Evan, Chiu Phil, Seeberger Lauren
Department of Neurology, University of California Los Angeles, Los Angeles, CA, USA.
Department of Medicine, Weill Cornell, New York City, NY, USA.
J Neurosci Methods. 2025 Mar;415:110349. doi: 10.1016/j.jneumeth.2024.110349. Epub 2024 Dec 14.
21st century neurology will require scalable and quantitative tools that can improve neurologic evaluations over telehealth and expand access to care. Commercially available mixed-reality headsets allow for simultaneous presentation of stimuli via holograms projected into the real world and objective and quantitative measurement of hand movement, eye movement, and phonation.
We created 6 tasks designed to mimic standard neurologic assessments and administered them to a single participant via the Microsoft HoloLens 2 mixed-reality headset. The tasks assessed postural hand tremor, finger tapping, pronation and supination of hands, hand and eye tracking of a center-out task, hand and eye tracking of a random motion task, and vocal assessment.
We show the utility of the HoloLens for commonly used neurological exams. First, we demonstrate that headset-derived holograms can project hand movements and objects in 3D space, providing a method to accurately and reproducibly present test stimuli to reduce test-test variability. Second, we found that participant hand movements closely matched holographic stimuli using a variety of metrics calculated on recorded movement data. Third, we showed that the HoloLens can record and playback exam tasks for visual inspection, sharing with other medical providers, and future analysis. Fourth, we showed that vocal recordings and analysis could be used to profile vocal characteristics over time. Together, this demonstrates the versatility of mixed reality headsets and possible applications for neurological assessment.
Administering components of the neurologic exam via a self-contained and commercially available mixed-reality headset has numerous benefits including detailed kinematic quantification, reproducible stimuli presentation from test to test, and can be self-administered expanding access to neurological care and saving hospital time and money.
21世纪的神经病学将需要可扩展的定量工具，以改善远程医疗中的神经学评估，并扩大医疗服务的可及性。市售的混合现实头显允许通过投射到现实世界中的全息图同时呈现刺激，并对手部运动、眼球运动和发声进行客观定量测量。
我们创建了6项旨在模拟标准神经学评估的任务，并通过Microsoft HoloLens 2混合现实头显将其应用于一名参与者。这些任务评估了姿势性手部震颤、手指敲击、手部的旋前和旋后、中心向外任务的手部和眼球追踪、随机运动任务的手部和眼球追踪以及发声评估。
我们展示了HoloLens在常用神经学检查中的实用性。首先，我们证明了头显生成的全息图可以在三维空间中投射手部运动和物体，提供了一种准确且可重复地呈现测试刺激以减少测试间变异性的方法。其次，我们发现，使用根据记录的运动数据计算出的各种指标，参与者的手部运动与全息刺激密切匹配。第三，我们表明，HoloLens可以记录和回放检查任务，用于目视检查、与其他医疗提供者共享以及未来分析。第四，我们表明，语音记录和分析可用于描绘随时间变化的语音特征。总之，这证明了混合现实头显的多功能性以及在神经学评估中的可能应用。
通过独立的市售混合现实头显进行神经学检查的各个组成部分有诸多益处，包括详细的运动学量化、每次测试可重复的刺激呈现，并且可以自行进行，从而扩大神经学护理的可及性，节省医院的时间和金钱。
