Neurology Model

What is it?

This is a computer program written in Java, to help medical students (and perhaps neurology trainees) to understand neuroanatomy and how it relates to normal neurological function, abnormal neurological function, and examination findings in patients. It is a physical and physiological interactive model of the central and peripheral nervous system, which allows you to create lesions and dynamically see the clinical signs.
The program has three parts.

Images are on the left hand side of the screen, and are organised into groups. There are coronal, axial and sagittal MRI images, axial CT images, Visible Human project slices, microscopic stained sections, photos of prosections, and diagrams (7 groups).
You can select a group of images by clicking on the tabs at the top left. The master image will then appear in the far left column. A slice or image can be selected by clicking on here, or by scrolling with the mouse wheel when the mouse is in the main image region. Zoom in on any image by dragging up & down with the right mouse button. Pan around by dragging with the left mouse button. The images are neuroanatomically labelled, and by hovering over a region with the mouse, the area is outlined in colour, and the name of the region appears above the image. Clicking on a region selects it.
Examination is shown on the right hand side of the screen, and comprises a series of interactive images/tables. The current neurological examination findings can be seen by scrolling down. In particular there are models of
- Visual fields
- Pupillary reflexes
- Saccades, smooth pursuit and eye muscles
- Facial, tongue and palate muscles
- Power and deep tendon reflexes in the limbs
- Dermatomes and sensory nerves
- Upper limb movement incoordination, focal weakness, and bradykinesia
- Posture and balance
Model of the connections between areas and how they cause each of the clinical signs. Each named region can be quantitatively lesioned by selecting it and using the slider at the bottom of the screen. Any number of regions can be lesioned at a time, and the combination of lesions is fed into the simulation. Each examination finding is calculated from whether signals can pass through each region necessary for the given function.
Lesioned regions are shown in green, and in the sensory and motor examinations, green is used to show a deficit.
By right-clicking in the images on the left, you can select 'lesion mode', where a lesion can be 'painted' on the image. Depending on how much each subregion is affected by your lesion, the constellation of clinical signs is calculated. Of course, multiple lesions can be explored too. To restore to healthy state, select 'Clear all lesions'.

Advanced users can also view the connectivity diagram that is used to calculate the signs, and edit the connections. There is also a facility to edit the anatomical hotspots by painting on the slices, and creating more detailed physiologically relevant region maps.