Posts Tagged health

[NEWS] Wireless ‘pacemaker for the brain’ could be new standard treatment for neurological disorders

A grey-colored sits on an illustration of a brain

A new neurostimulator developed by engineers at UC Berkeley can listen to and stimulate electric current in the brain at the same time, potentially delivering fine-tuned treatments to patients with diseases like epilepsy and Parkinson’s.

The device, named the WAND, works like a “pacemaker for the brain,” monitoring the brain’s electrical activity and delivering electrical stimulation if it detects something amiss.

These devices can be extremely effective at preventing debilitating tremors or seizures in patients with a variety of neurological conditions. But the electrical signatures that precede a seizure or tremor can be extremely subtle, and the frequency and strength of electrical stimulation required to prevent them is equally touchy. It can take years of small adjustments by doctors before the devices provide optimal treatment.

WAND, which stands for wireless artifact-free neuromodulation device, is both wireless and autonomous, meaning that once it learns to recognize the signs of tremor or seizure, it can adjust the stimulation parameters on its own to prevent the unwanted movements. And because it is closed-loop — meaning it can stimulate and record simultaneously — it can adjust these parameters in real-time.

“The process of finding the right therapy for a patient is extremely costly and can take years. Significant reduction in both cost and duration can potentially lead to greatly improved outcomes and accessibility,” said Rikky Muller, an assistant professor of electrical engineering and computer sciences at Berkeley. “We want to enable the device to figure out what is the best way to stimulate for a given patient to give the best outcomes. And you can only do that by listening and recording the neural signatures.”

WAND can record electrical activity over 128 channels, or from 128 points in the brain, compared to eight channels in other closed-loop systems. To demonstrate the device, the team used WAND to recognize and delay specific arm movements in rhesus macaques. The device is described in a study that appeared today (Dec. 31) in Nature Biomedical Engineering.

A WAND chip in a hand

Ripples in a pond

Simultaneously stimulating and recording electrical signals in the brain is much like trying to see small ripples in a pond while also splashing your feet — the electrical signals from the brain are overwhelmed by the large pulses of electricity delivered by the stimulation.

Currently, deep brain stimulators either stop recording while delivering the electrical stimulation, or record at a different part of the brain from where the stimulation is applied — essentially measuring the small ripples at a different point in the pond from the splashing.

“In order to deliver closed-loop stimulation-based therapies, which is a big goal for people treating Parkinson’s and epilepsy and a variety of neurological disorders, it is very important to both perform neural recordings and stimulation simultaneously, which currently no single commercial device does,” said former UC Berkeley postdoctoral associate Samantha Santacruz, who is now an assistant professor at the University of Texas in Austin.

Researchers at Cortera Neurotechnologies, Inc., led by Muller, designed the WAND custom integrated circuits that can record the full signal from both the subtle brain waves and the strong electrical pulses. This chip design allows WAND to subtract the signal from the electrical pulses, resulting in a clean signal from the brain waves.

A close up picture of an integrated circuit

Existing devices are tuned to record signals only from the smaller brain waves and are overwhelmed by the large stimulation pulses, making this type of signal reconstruction impossible.

“Because we can actually stimulate and record in the same brain region, we know exactly what is happening when we are providing a therapy,” Muller said.

In collaboration with the lab of electrical engineering and computer science professor Jan Rabaey, the team built a platform device with wireless and closed-loop computational capabilities that can be programmed for use in a variety of research and clinical applications.

In experiments lead by Santacruz while a postdoc at UC Berkeley, and by electrical engineering and computer science professor Jose Carmena, subjects were taught to use a joystick to move a cursor to a specific location. After a training period, the WAND device was capable of detecting the neural signatures that arose as the subjects prepared to perform the motion, and then deliver electrical stimulation that delayed the motion.

“While delaying reaction time is something that has been demonstrated before, this is, to our knowledge, the first time that it has been demonstrated in a closed-loop system based on a neurological recording only,” Muller said.

“In the future we aim to incorporate learning into our closed-loop platform to build intelligent devices that can figure out how to best treat you, and remove the doctor from having to constantly intervene in this process,” she said.

Andy Zhou and Benjamin C. Johnson of UC Berkeley join Santacruz as co-lead authors on the paper. Other contributing authors include George Alexandrov, Ali Moin and Fred L. Burghardt of UC Berkeley. This work was supported in part by the Defense Advanced Research Projects Agency (W911NF-14- 2- 0043) and the National Science Foundation Graduate Research Fellowship Program (Grant No. 1106400). Authors Benjamin C. Johnson, Jan M. Rabaey, Jose M. Carmena and Rikky Muller have financial interest in Cortera Neurotechnologies, Inc., which has filed a patent application on the integrated circuit used in this work.

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via Wireless ‘pacemaker for the brain’ could be new standard treatment for neurological disorders | Berkeley News

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[WEB SITE] UK hospital to explore VR for stroke patient rehabilitation

The debilitating impact of a stroke can last long after the event has taken place. Sufferers are often left with a range of problems, which make include poor balance, loss of coordination, partial paralysis, impaired spatial awareness and speech, and a lengthy recovery timeline.

At the extreme end of the scale, patients have to spend time in rehab learning to walk again. But just as damaging to those seeking a return to normality is the challenge of performing everyday tasks with the ease they were able to in the past. Just putting the kettle on or operating a toaster, for example, are skills that require confidence to be rebuilt alongside no small amount of cognitive rehabilitation.

Using VR to aid stroke recovery

Traditionally, that process involves hours of supervised – and often tediously repetitive – physiotherapy. Although the majority of people survive their first stroke, one-third are left with significant cognitive impairment that impedes their ability to function. Often this translates into needing social and financial support, in many cases for the rest of their lives.

In an effort to cut lengthy hospital stays, ease the burden on nursing staff, clinicians and therapists, and improve patient outcomes, the University of Chester’s Medical Graphics team has partnered with the Stroke Department at the Countess of Chester Hospital to see where Virtual Reality (VR) technology might fit in.

The concept behind the project is to help patients gain confidence and cognitive support in the relatively risk-free virtual world first, before carrying out tasks in the real world. The experimental project has been awarded a £453,000 grant from Innovate UK and will be assisted by local 3D imaging company, CadScan.

Using off-the-shelf VR headsets, the aim is to make intensive rehabilitation more accessible and immediate. In turn, the VR solution could reduce the duration and cost of long-term care while making rehab programmes more adaptable.

The devices can be operated with minimal supervision, and it goes without saying that practising physical processes in the virtual world carries less risk to patients who are vulnerable both physically and psychologically.

It’s also easier to track their recovery progress and pinpoint areas that require closer attention. “Patients will be able to measure how well their cognitive abilities are improving, building confidence in their ability to perform everyday tasks and reducing the psychological trauma often associated with the condition,” said Professor Nigel John from the University of Chester.

The UK spends around £9 billion every year caring for stroke sufferers. Fifty percent of that goes toward direct formal care. An influx of VR systems may sound like an expensive solution beyond the budget of most hospitals, but it could turn out to be a viable alternative for the future.

“The purpose of rehabilitation is to stimulate brain recovery through the stimulus of new areas that compensate for the area of damage. It can be tedious for many patients and expensive to provide. As a result, some of them may not receive the amount of specialist therapy time they actually need,” said Professor Kausik Chatterjee, consultant physician at the Countess of Chester Hospital.

“This is a problem not only for the NHS, but also for most of the healthcare system across the globe. This project is exciting in its ambition – both in terms of the benefit to the patient, and potential financial savings too.”

Plus: Researchers unveil ‘smart sticker’ for remote health monitoring

In related IoT health news, a research team at Purdue University, Indiana, have developed a smart sticker capable of remotely monitoring the health of heart patients.

The smart stickers’ largely cellulose structure means they are biocompatible and relatively inexpensive, explains the team’s research paper, published in ACS Applied Materials and Interfaces.

The smart stickers could be used internally, implanted onto internal organs to transmit data without causing adverse reactions. The researchers also suggest that athletes could use the technology to monitor health while exercising to provide alerts in real time.

To begin with, though, most applications are external. Ramses Martinez, Purdue University assistant professor of Industrial Engineering and Biomedical Engineering, said, “For the first time, we have created wearable electronic devices that someone can easily attach to their skin and are made out of paper to lower the cost of personalised medicine.

“The low cost of these wearable devices and their compatibility with large-scale manufacturing techniques will enable the quick adoption of these new fully disposable, wearable sensors in a variety of healthcare applications requiring single-use diagnostic systems,” he added.

Internet of Business says

The exploratory use of connected technologies in healthcare, including AI, wearables, and augmented and virtual reality, is booming and holds out great promise for the future, especially when it comes to the treatment of serious and debilitating conditions.

The wearables market in particular is seeing extensive innovation. For example, earlier this year we reported on how researchers have developed a smart sticking plaster that can monitor a patient’s blood pressure. Made of silicon elastomer, the postage-stamp sized wearable works by sending ultrasonic waves into the skin, which reflect off the wearer’s bodily tissues and blood.

In theory, the patch could be used to monitor patients at home, with the data collected over time and analysed on a laptop. As well as avoiding the need for multiple appointments, uncomfortable pressure tests, and invasive procedures, the wearable may help cut costs and reduce the risk of infection.

The system is being developed at the University of California, San Diego.

 

via UK hospital to explore VR for stroke patient rehabilitation | Internet of Business

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[WEB SITE] Lightweight Robotic Exoskeleton Approved By FDA | Popular Science

POWER WALKING INTO THE FUTURE

The Indego exoskeleton, which was approved by the FDA today

The Indego exoskeleton, which was approved by the FDA today

The Indego robotic exoskeleton has received approval from the FDA. The device, which is 26 pounds and designed to be easy to put on and take off from a wheelchair, was tested in an extensive clinical trial, assessing its safety on a variety of indoor and outdoor surfaces.

“It is particularly gratifying because it is the first thing that has come out of my lab that has become a product that people can purchase, which hopefully will make a significant improvement in their quality of life,” Vanderbilt engineering professor Michael Goldfarb said in a statement.

Indego is strapped tightly around the torso, with rigid supports attaching to the hip, knee, and foot. Battery-powered, computer-controlled electric motors drive the joints, and the wearer navigates the device similar to a Segway, according to the engineers. Lean forward and the exoskeleton walks forward, lean back for a while and it will sit down.

Indego, which has been available in Europe since November, is the second exoskeleton to gain FDA approval in the U.S. The first, ReWalk was approved in 2014. Indego’s selling point is its weight–almost 20 pounds lighter than ReWalk–and its functional electrical stimulation, which sends little electrical pulses to the paralyzed muscles. Those pulses could help lessen muscle atrophy and improve circulation. Now, Parker Hannifin, the manufacturer, needs to show that the device can reduce the secondary medical conditions often caused by lower-body paralysis, in order to convince insurance companies to cover the $80,000 device. According to the Wall Street Journal, the company plans a commercial launch for Indego in the U.S. “in the coming months.”

Source: Lightweight Robotic Exoskeleton Approved By FDA | Popular Science

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[ARTICLE] Energy Expenditure and Exercise Intensity of Interactive Video Gaming in Individuals Poststroke

Abstract

Background. Off-the-shelf activity-promoting video games (AVGs) are proposed as a tool for promoting regular physical activity among individuals poststroke.

Objective. To characterize the energy expenditure (EE), exercise intensity, and energy metabolism of individuals poststroke, while playing AVGs in different positions, from different consoles, and to compare the performance with comfortable walking and with able-bodied individuals.

Methods. Eleven poststroke and 8 able-bodied participants played in standing Wii-Boxing Xbox-Boxing, Wii-Run and Penguin, and also Wii-Boxing in sitting. EE (expressed as metabolic equivalents [METs]); exercise intensity (expressed as %predicted maximal heart rate [HR]), rate of perceived exertion (RPE), and respiratory exchange ratio (RER) were used to characterize the games. Results. Participants’ poststroke EE ranged from 1.81 ± 0.74 to 3.46 ± 1.3 METs and was lower compared with able-bodied participants for Xbox-Boxing (P = .001), Wii-Boxing in standing (P = .01), Run (P < .001), and Penguin (P = .001). Participants’ poststroke exercise intensity ranged from 49.8 ± 9.3 to 64.7 ± 9.3 %predicted maximal HR and was lower compared with able-bodied participants for Xbox-Boxing (P = .007) and Run (P = .005). For participants poststroke, EE of walking at a comfortable did not differ from boxing games in standing or Run. For able-bodied participants only, the EE for Xbox-Boxing was higher than Wii-Boxing (6.5 ± 2.6 vs 4.4 ± 1.1, P = .02). EE was higher in standing versus sitting for poststroke (P = .04) and able-bodied (P = .03) participants. There were no significant group differences for RPEs. RER of playing in sitting approached anaerobic metabolism.

Conclusions. Playing upper extremity (ie, Boxing) or mobility (ie, Run) AVGs in standing resulted in moderate EE and intensity for participants poststroke. EE was lower for poststroke than for able-bodied participants.

via Energy Expenditure and Exercise Intensity of Interactive Video Gaming in Individuals Poststroke.

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