ANN-based nerve damage preservation system for neurosurgical operation

The neurophysiologic intraoperative monitoring system (NIOM) is used for assessing the nerve function during operation. The free running electromyography (EMG) and the compound muscle action potential (CMAP) are monitored by the neurophysiologist for surgical intervention to avoid neurophysiologic deficit. However, there is a variation of surgical intervention in different neurophysiologist. 50% decrease in amplitude of CMAP response is considered as nerve damage compared with the baseline which may vary in particular case. These would make the nerve function estimation qualitative evaluated by neurophysiologist. This study aimed to investigate the quantitative method of nerve function prediction. Instead of applying one pulse stimulus, the varied current amplitude pulse train was applied to the nerve to obtain the variation of the CMAP responses. The varied CMAP responses were used as an input of artificial neuron network (ANN) for estimating the remaining nerve function. The results revealed that the estimated nerve damage level was linearly correlated with the measured nerve damage.