The Voice of Reason

I have reviewed this iPhone medical application for iMedicalApps.com.

The full review can be read below on this site or here at iMedicalApps: http://www.imedicalapps.com/2010/11/brain-tutor-hd-makes-learning-brain-anatomy-approachable-by-combining-3-dimensional-and-cross-sectional-views-of-the-brain-ipad/

Brain Tutor HD for the Apple iPad

By Brian Wells, MS-3, MSM, MPH

Few areas of medical science remain as wondrous and mysterious as that of neurology. Indeed, I remember not so long ago sitting in a study hall with a book on neuroanatomy and a collection of class notes and pages printed from various sites on the Internet, often staring off into the field outside the study hall as I tried to visualize in three dimensions the two dimensional diagrams about which I was learning. Of course, there were models of the brain and numerous MRIs and CTs to examine but nothing which elegantly combined the information with the images, transforming 2D slice to 3D realism. This is the goal which Brain Tutor HD seeks to achieve.

The program information divided into five atlases, namely Lobes, Gyri, Sulci, Brodman Areas and Functional Areas. Each atlas contains numerous structures appropriate to its parent category. As the structures in the atlas are selected, the corresponding areas in the 3D brain representation are highlighted. Each entry also provides an arrow which loads the description and displays information such as the nomenclature, location, function and connectivity.

In addition to computer-generated models of the neuroanatomy, the program also provides MRI imaging in the form of a 3D rotatable head created with the BrainVoyager software package. In this depiction, the same rules as earlier apply. As each structure is selected, the corresponding area in the MRI lights up showing the appropriate anatomy. Coronal, transverse and sagittal views are all available.

However, for all the great attributes of this program, it is likely just the beginning. The program often hints at function without providing full explanation. For example, when referencing Brodmann area 4, the user is informed that it contains the motor homunculus yet the user is not given information about the homunculus or even a link to an external website. If the developer were to begin adding hyperlinks between descriptions and expanded reference materials, this program would truly start to become the benchmark for neuroanatomy learning.

A few additional items that would add tremendous value and make this a truly world-class software package are:

• Add subcortical structures and vascular structures
• Add a quiz function, where a structure is highlighted and user selects the answer from a multiple choice form
• Add attached labels similar to those seen in 3D Brain (seen below)
• Add animations or information about various neurals tracts, such as DC/ML and corticospinal
• Add information about various neuropathologies and show sample MRIs of each pathology. For example, epidural hematoma or central pontine myelinolysis.

For comparison, since 3D Brain was previously reviewed by iMedicalApps, a screenshot of the two programs is provided.

As one can see in the above pictures, 3D Brain uses an attached labeling system rather than a strict color coding. Unlike Brain Tutor HD, this enables the user to view multiples structures at the same time without having to reference structures one by one to find the corresponding color coding.

However, as was noted in the previous 3D brain review

“When trying to explain to a family member why their loved one is having difficulty with speech after a stroke you could quickly show Broca’s area in a three dimensional fashion.  Your point would get across a lot better this way than to exclusively show CT or MRI images.”

This statement applies equally well to Brain Tutor HD. Both applications have definite bedside application in addition to their roles in facilitating learning.

Brain Tutor HD does address one drawback to 3D Brain noted in the previous review

“In the future I’d love to see them incorporate cross sectional images of the brain with detailed labeling.  This would help with learning more anatomy and it would also help you explain more complex diseases, such as Parkinsons.”

in that it does provide real-world MRI images of the brain in a moving cross section. Flipping through the cross sections of the brain feels a lot like viewing the images on a computer in the hospital and really helps with learning the anatomy as it exists in three dimensions.

Overall, Brain Tutor HD is an excellent program that sells for $1.99 in Apple’s App Store. By providing structure selection integrated with MRI images, computer-rendered mockups of the brain, and information about each structure, Brain Tutor HD is able to deliver a unique and valuable experience for the neuroanatomy student. Clinicians will also find the program helpful in explaining conditions to patients when the patients actual images are unavailable or difficult to show at the bedside. In any case, it’s hard to go wrong with this program at only $1.99, especially if the developer begins integrating some of the improvements outlined in this article. If the user has access to an iPhone or iPod Touch, the free Brain Tutor 3D can be used to evaluate the software before purchasing the iPad version.

Video demonstration of Brain Tutor HD: http://www.youtube.com/watch?v=hpQNSROMl_g

Brain Tutor HD: http://www.brainvoyager.com/iOS/BrainTutorHD.html

Brain Tutor HD in iTunes: http://itunes.apple.com/app/brain-tutor-hd/id392586830?mt=8

Brain Tutor 3D (iPhone): http://www.brainvoyager.com/iOS/iphonebraintutor3d.html

Brain Tutor 3D in iTunes (free): http://itunes.apple.com/app/brain-tutor-3d/id301362928?mt=8

Testing Platform: This application was tested on a 32 GB iPad 3G running iOS 3.2.2 jailbroken with limera1n (http://limera1n.com). Data access was provided over 802.11n Wi-Fi on a 10.21 Mbps/0.57 Mbps connection with a 24 ms ping as measured by Speedtest.net (http://www.speedtest.net).

Filed under: Medicine, Reviews, Technology | Tagged: apple, brain tutor hd, ios, ipad, neuroanatomy |