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Advances in Portable Neuroimaging and Their Effect on Novel Therapies
Published in Yu Chen, Babak Kateb, Neurophotonics and Brain Mapping, 2017
Eric M. Bailey, Ibrahim Bechwati, Sonal Ambwani, Matthew Dickman, Joseph Fonte, Geethika Weliwitigoda
Many millions of people in the world are afflicted with a variety of neurological diseases and the costs are approximated to be greater than $500B annually (Brain Institute). If one looks worldwide, these numbers become almost astronomical. Because the brain is such a complex organ, it is also quite difficult and costly just to diagnose these disorders. As for treatment, many of these disorders such as dementia and amyotrophic lateral sclerosis (ALS) lack any form of treatment. Medicine has made some progress in treatment; however, these treatments require time, urgent diagnoses, and/or precise surgical deliveries. Organ complexity requires neuroimaging to be used for diagnosis, and precision delivery generally requires neuroimaging to guide such therapy accurately. This presents a dilemma because complex neuroimaging, until this previous decade, could only be performed in a fixed radiology suite. The advent of portable neuroimaging has broken the paradigm shift whereas a patient must be brought to a scanner. Now it is possible to bring the scanner to the patient. This is a great concept particularly for patients unable to go near a scanner due to some obstacles such as being in ICU in an unstable condition while tethered to other life support machinery, an example being a patient undergoing neurosurgery. Other examples include any patient undergoing surgery, including neurosurgery where rapid imaging of the neuraxis is needed to guide the surgeon appropriately. Therefore, this section will explore what we know today to be these areas and instances whereby portable imaging has not only made sense but may also be the only choice.
Eye-controlled augmentative and alternative communication system to improve communication quality between dysarthria patients and foreign caregivers in Taiwan
Published in Artde D.K.T. Lam, Stephen D. Prior, Siu-Tsen Shen, Sheng-Joue Young, Liang-Wen Ji, Smart Science, Design & Technology, 2019
Amyotrophic lateral sclerosis (ALS), also referred to as motor neuron disease (MND), is a critical neurodegenerative disease. The postonset course of ALS is characterized by gradual difficulty in speaking and swallowing in patients. The disease also compromises limb movement. Eventually, the respiratory muscles are weakened, leading to breathing failure; thus, sustaining life is a difficult task (Murray, 2006). Because patients with ALS have complete mental and sensory functions, they suffer during the course of the disease. In Taiwan, the average annual incidence of ALS was 1.05 per 100,000, with the average age of onset being 52.5 years and the most common age of onset being between 65 and 69 years (Lai and Tseng, 2008). The average survival period after onset is 5.6 years (Lee, et al., 2013). Many studies have indicated that the quality of life of ALS patients is considerably affected by psychological factors (Felgoise, et al., 2016). Approximately 80% of patients with ALS progress to dysarthria, a speech disorder (Tomik and Guiloff, 2010). Most patients experience dysarthria and tetraplegia in the middle and late stages of the diseases. Patients who have lost oral communication ability might feel marginalized and ignored, leading to depression. In addition to experiencing communication problems in the normal course of the disease, many ALS patients receive tracheostomy procedures, which also cause difficulties in oral communication. Accordingly, ALS patients need caregivers’ help on all aspects of daily life. They require help in tasks such as drinking water, adjusting their postures, or ameliorating physical discomfort.
Microbial Biotechnology
Published in Nwadiuto (Diuto) Esiobu, James Chukwuma Ogbonna, Charles Oluwaseun Adetunji, Olawole O. Obembe, Ifeoma Maureen Ezeonu, Abdulrazak B. Ibrahim, Benjamin Ewa Ubi, Microbiomes and Emerging Applications, 2022
Olawole O. Obembe, Nwadiuto (Diuto) Esiobu, O. S. Aworunse, Nneka R. Agbakoba
ALS, also called Lou Gehrig’s disease, is a neuromuscular disease characterized by progressive death of motor neurons and muscle atrophy. The condition is accompanied by de-regulated energy metabolism as well as systemic and CNS-specific inflammation. These are potential pathogenic factors found to interact with gut microbiota (Brenner et al., 2017). ALS is a neurodegenerative disease with a pathophysiology that may be related to the gastro-intestinal tract. Gut microbiota, therefore, may have an impact on brain activity through the gut-microbiota-brain axis under both physiological and pathological conditions.
Inertial sensing of step kinematics in ambulatory patients with ALS and related motor neuron diseases
Published in Journal of Medical Engineering & Technology, 2021
Andrew Geronimo, Anne E. Martin, Zachary Simmons
This was a single-session, prospective study using body-worn inertial sensors to measure gait of adult patients attending a tertiary care ALS clinic. This study included patients with a diagnosis of definite, probable, probable laboratory-supported possible ALS [24], primary lateral sclerosis (PLS) or progressive muscular atrophy (PMA). PLS patients experience isolated upper motor neuron dysfunction, leading to spasticity and incoordination, while PMA patients have isolated lower motor neuron dysfunction, producing muscle weakness. Those with ALS exhibit signs of both upper and lower motor neuron dysfunction. Clinical parameters of age, gender, height, walking sub-score of the ALSFRS-R (FRSw) and mobility assistance were collected for each subject. FRSw was either 2 (walks with assistance), 3 (early ambulation difficulties) or 4 (normal walking). Mobility assistance was either “no assistance”, “cane” or “rolling walker” based on the type of aid using during the recording. The study was approved by the Institutional Review Board of the Penn State Health Hershey Medical Centre and all subjects provided written informed consent.
TeleBCI: remote user training, monitoring, and communication with an evoked-potential brain-computer interface
Published in Brain-Computer Interfaces, 2020
Andrew Geronimo, Zachary Simmons
Three participant groups were enrolled in this study: AAC-BCI users, their BCI facilitators (together referred to as ‘participant teams’), and clinician nurses. Clinician nurses were members of a multidisciplinary ALS care team. Potential patient participants were recruited from the clinical population and through use of a regional mailer. Patients were required to have a diagnosis of definite, probable, probable laboratory-supported, or possible ALS by revised El Escorial research criteria [24], primary lateral sclerosis (PLS, upper motor neuron involvement only), or progressive muscular atrophy (PMA, lower motor neuron involvement only). Eligible subjects were also required to have limitations in their capacity for useful speech, upper extremity function, or both, have a facilitator able to perform the study procedures, and have access to a reliable in-home internet connection. Consent procedures were performed in the home of the participant, following the research protocol approved by our Institutional Review Board (IRB).
A novel EOG-based wireless rapid communication device for people with motor neuron diseases
Published in Journal of Medical Engineering & Technology, 2018
Ali Bulent Usakli, Serkan Gurkan, Guray Gurkan, Alper Kaya
As an example for MND, amyotrophic lateral sclerosis (ALS) (or “Lou Gehrig’s Disease”) is a progressive neurodegenerative disease. ALS is the most common MND and it affects both upper and lower motor neurons. In other words, it affects the brain and the spinal cord nerve cells. Motor neurons reach from the brain to the spinal cord and from the spinal cord to the muscles throughout the body through different paths. The progressive degeneration of the motor neurons in ALS eventually causes to their death. When the motor neurons die, the ability of the brain to initiate and control muscle movement is lost. Even breathing, for example, cannot be possible without any supporting device. With voluntary muscle action progressively affected, patients in the later stages of the disease may become totally paralysed. ALS is usually fatal within 2–5 years of diagnosis. For the present, unfortunately, there is no known cure for ALS.