Posts Tagged neurological conditions

[WEB PAGE] What Does Chocolate and Peanut Butter Have to Do with Stroke? Find Out Here

Posted by Debbie Overman | Jan 16, 2020   

What Does Chocolate and Peanut Butter Have to Do with Stroke? Find Out Here

Calling it his “chocolate and peanut butter moment,” a University at Buffalo researcher has developed a brain model designed to offer insights into damage caused by stroke and other injuries that represents a combination of two existing approaches that seems obvious.

The model is designed to create a digital simulation environment that can serve as a testing ground for hypotheses about specific damage caused by neurological issues. The researcher’s background in computer modeling made his advancement of combining existing approaches seem obvious–hence, the “chocolate and peanut butter moment,” a media release from University at Buffalo explains.

“This model is tied accurately to the functional connectivity of the brain and is able to demonstrate realistic patterns of cognitive impairment,” says Christopher McNorgan, an assistant professor of psychology in UB’s College of Arts and Sciences, in the release. “Since the model reflects how the brain is connected, we can manipulate it in ways that provide insights, for example, into the areas of a patient’s brain that might be damaged.

“This recent work doesn’t prove that we have a digital facsimile of the human brain, but the findings indicate that the model is performing in a way that is consistent with how the brain performs, and that at least suggests that the model is taking on properties that are moving in the direction of possibly one day creating a facsimile.”

The findings, published in NeuroImage, provide a powerful means of identifying and understanding brain networks and how they function, which could lead to what once were unrealized possibilities for discovery and understanding.

Explaining McNorgan’s model starts with a look at the two fundamental components of its design: functional connectivity and multivariate pattern analyses (MVPA).

For many years, traditional brain-based models have relied on a general linear approach. This method looks at every spot in the brain and how those areas respond to stimuli. This approach is used in traditional studies of functional connectivity, which rely on functional magnetic resonance imaging (fMRI) to explore how the brain is wired. A linear model assumes a direct relationship between two things, such as the visual region of the brain becoming more or less active when a light flickers on or off.

While linear models excel at identifying which areas are active under certain conditions, they often fail to detect complicated relationships potentially existing among multiple areas. That’s the domain of more recent advances, like MVPA, a “teachable” machine-learning technique that operates on a more holistic level to evaluate how activity is patterned across brain regions.

MVPA is non-linear. Assume for instance that there’s a set of neurons dedicated to recognizing the meaning of a stop sign. These neurons are not active when we see something red or something octagonal because there’s not a one-to-one linear mapping between being red and being a stop sign (an apple isn’t a stop sign), nor between being octagonal and being a stop sign (a board room table isn’t a stop sign).

“A non-linear response ensures that they do light up when we see an object that is both red and octagonal,” McNorgan explains, the release continues.

“For this reason, non-linear methods like MVPA have been at the core of so-called ‘Deep Learning’ approaches behind technologies, such as the computer vision software required for self-driving cars.”

But MVPA uses brute force machine-learning techniques. The process is opportunistic, sometimes confusing coincidence with correlation. Even ideal models require researchers to provide evidence that activity in the theoretical model would also be present under the same conditions in the brain.

On their own, both traditional functional connectivity and MVPA approaches have limitations, and integrating results generated by each of these approaches requires considerable effort and expertise for brain researchers to puzzle out the evidence.

When combined, however, the limitations are mutually constrained —  and McNorgan is the first researcher to successfully integrate functional connectivity and MVPA to develop a machine-learning model that’s explicitly grounded in real-world functional connections among brain regions. In other words, the mutually constrained results are a self-assembling puzzle.

“It was my chocolate and peanut butter moment,” says McNorgan, an expert in neuroimaging and computational modeling.

“I’ve had a particular career trajectory that has allowed me to work extensively with different theoretical models. That background provided a particular set of experiences that made the combination seem obvious in hindsight,” he comments.

To build his models, McNorgan begins by gathering the brain data that will teach them the patterns of brain activity that are associated with each of three categories – in this case, tools, musical instruments and fruits. These data came from 11 participants who imagined the appearance and sound of familiar category examples, like hammers, guitars and apples, while undergoing an MRI scan. These scans indicate which areas are more or less active based on blood oxygen levels.

“There are certain patterns of activity across the brain that are consistent with thinking about one category versus another,” says McNorgan. “We might think of this as a neural fingerprint.”

These MRI patterns were then digitized and used to train a series of computer models to recognize which activity patterns were associated with each category.

“After training, models are given previously unseen activity patterns,” he explains. “Significantly above-chance classification accuracy indicates that the models have learned a generalizable relationship between specific brain activity patterns and thinking about a specific category.”

To test whether the digital brain models produced by this new method were more realistic, McNorgan gave them “virtual lesions” by disrupting activations in regions known to be important for each of the categories.

He found that the mutually constrained models showed classification errors consistent with the lesion location. For example, lesions to areas thought to be important for representing tools disrupted accuracy for tool patterns, but not the other two categories. By comparison, other versions of models not trained using the new method did not show this behavior.

“The model now suggests how brain areas that might not appear to be important for encoding information when considered individually may be important when it’s functioning as part of a larger configuration or network,” he says. “Knowing these areas may help us understand why someone who suffered a stroke or other injury is having trouble making these distinctions.”

[Source(s): University at Buffalo, Newswise]

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[ARTICLE] A Systematic Review of International Clinical Guidelines for Rehabilitation of People With Neurological Conditions: What Recommendations Are Made for Upper Limb Assessment? – Full Text

Background: Upper limb impairment is a common problem for people with neurological disabilities, affecting activity, performance, quality of life, and independence. Accurate, timely assessments are required for effective rehabilitation, and development of novel interventions. International consensus on upper limb assessment is needed to make research findings more meaningful, provide a benchmark for quality in clinical practice, more cost-effective neurorehabilitation and improved outcomes for neurological patients undergoing rehabilitation.

Aim: To conduct a systematic review, as part of the output of a European COST Action, to identify what recommendations are made for upper limb assessment.

Methods: We systematically reviewed published guidance on measures and protocols for assessment of upper limb function in neurological rehabilitation via electronic databases from January 2007–December 2017. Additional records were then identified through other sources. Records were selected for inclusion based on scanning of titles, abstracts and full text by two authors working independently, and a third author if there was disagreement. Records were included if they referred to “rehabilitation” and “assessment” or “measurement”. Reasons for exclusion were documented.

Results: From the initial 552 records identified (after duplicates were removed), 34 satisfied our criteria for inclusion, and only six recommended specific outcome measures and /or protocols. Records were divided into National Guidelines and other practice guidelines published in peer reviewed Journals. There was agreement that assessment is critical, should be conducted early and at regular intervals and that there is a need for standardized measures. Assessments should be conducted by a healthcare professional trained in using the measure and should encompass body function and structure, activity and participation.

Conclusions: We present a comprehensive, critical, and original summary of current recommendations. Defining a core set of measures and agreed protocols requires international consensus between experts representing the diverse and multi-disciplinary field of neurorehabilitation including clinical researchers and practitioners, rehabilitation technology researchers, and commercial developers. Current lack of guidance may hold-back progress in understanding function and recovery. Together with a Delphi consensus study and an overview of systematic reviews of outcome measures it will contribute to the development of international guidelines for upper limb assessment in neurological conditions.

Introduction

Worldwide prevalence of stroke in 2010 was 33 million, with 16.9 million people having a first stroke, of which 795,000 were American and 1.1 million European (1). It has been estimated that approximately one third of people fail to regain upper limb capacity, despite receiving therapy (2). This has important implications for both individuals and the wider society as reduced upper limb function is associated with dependence and poor quality of life for both patients and carers (35) and impacts on national economies (6).

While stroke has the highest prevalence, other neurological conditions such as Multiple Sclerosis (MS), Spinal Cord Injury (SCI), and Traumatic Brian Injury, have a significant incidence and there are often similarities in presentation, and treatment and therefore assessment. The worldwide incidence of SCI is 40–80 cases per million population and the estimated European mean annual rate of MS incidence is 4.3 cases per 100,000 (7). Recently, Kister et al. (8) reported that 60% of people with MS have impaired hand function. The impact of upper limb dysfunction on ADL is higher than in stroke, as both sides are often affected (9). Although dysfunction after SCI depends on level of injury, upper limb function is consistently cited as a health priority. The incidence rate of TBI in Europe is about 235 per 100,000 population (10). Outcome data among European countries are very heterogeneous. From the US however, it is known that about 1.1% of the population suffer a TBI resulting in long term disability (11).

 

Continue —>  Frontiers | A Systematic Review of International Clinical Guidelines for Rehabilitation of People With Neurological Conditions: What Recommendations Are Made for Upper Limb Assessment? | Neurology

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[REVIEW] A review of international clinical guidelines for rehabilitation of people with neurological conditions: what recommendations are made for upper limb assessment?

Background: Upper limb impairment is a common problem for people with neurological disabilities, affecting activity, performance, quality of life and independence. Accurate, timely assessments are required for effective rehabilitation, and development of novel interventions. International consensus on upper limb assessment is needed to make research findings be more meaningful, provide a benchmark for quality in clinical practice, more cost-effective neurorehabilitation and improved outcomes for neurological patients undergoing rehabilitation.

Aim: To conduct a systematic review, as part of the output of a European COST Action, to identify what recommendations are made for upper limb assessment.

Methods: We systematically reviewed published guidance on measures and protocols for assessing upper limb function in neurological rehabilitation via electronic databases from January 2007 – December 2017. Additional records were then identified through other sources. Records were selected for inclusion based on scanning of titles, abstracts and full text by two authors working independently, and a third author if there was disagreement. Records were included if they referred to ‘rehabilitation’ and ‘assessment’ or ‘measurement’. Reasons for exclusion were documented.
Results: From the initial 552 records identified (after duplicates were removed), 34 satisfied our criteria for inclusion and only six recommended specific outcome measures and /or protocols. Records were divided into National Guidelines and other practice guidelines published in peer reviewed Journals. There was agreement that assessment is critical, should be conducted early and at regular intervals and that there is a need for standardised measures. Assessments should be conducted by a healthcare professional trained in using the measure and should encompass body function and structure, activity and participation.
Conclusions: We present a comprehensive, critical and original summary of current recommendations. Defining a core set of measures and agreed protocols requires international consensus between experts representing the diverse and multi-disciplinary field of neurorehabilitation including clinical researchers and practitioners, rehabilitation technology researchers and commercial developers. Current lack of guidance may hold-back progress in understanding function and recovery. Together with a Delphi consensus study and an overview of systematic reviews of outcome measures it will contribute to the development of international guidelines for upper limb assessment in neurological conditions.

 

via Frontiers | A review of international clinical guidelines for rehabilitation of people with neurological conditions: what recommendations are made for upper limb assessment? | Neurology

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[WEB SITE] BIONIK Labs Debuts Its Updated InMotion System at APTA CSM

Word new written in ash, dust, dirt as a irony, oxymoron, parado

BIONIK Laboratories Corp launches its newest generation InMotion ARM/HAND robotic system for clinical rehabilitation of stroke survivors and those with mobility impairments due to neurological conditions.

The new technology, which made its official debut recently at the American Physical Therapy Association Combined Sections Meeting (APTA CSM) in Washington, DC, includes the following new features, according to the Toronto-based company:

    • Enhanced hand-rehabilitation technology: provides therapy focused on hand opening and grasping for patients ready to retrain reach and grasp functional tasks.
    • InMotion EVAL: assesses hand movements precisely and objectively, allowing clinicians to better measure and quantify patient progress.
    • Improved, comprehensive reporting: improved documentation of patient outcomes, easier use and enhanced interpretation of evaluation results, allowing clearer progress indications over the complete rehabilitation journey, all on one screen.

“The goal of our new generation InMotion ARM/HAND is to enable rehabilitation facilities to enhance their treatment programs for patients recovering from stroke or other neurological injury who are ready to retrain reach and grasp functionality. Along with the improved reporting capabilities, we believe our innovative technology will enable clinicians to improve the patient rehabilitation process and achieve greater recovery for stroke survivors,” says Dr Eric Dusseux, CEO, BIONIK Laboratories, in a media release.

“We’re pleased to unveil the new generation InMotion ARM/HAND at APTA CSM and to showcase its functionality to some of the leading minds in physical therapy,” he adds.

[Source(s): BIONIK Laboratories Corp, Business Wire]

 

via BIONIK Labs Debuts Its Updated InMotion System at APTA CSM – Rehab Managment

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[BOOK] Occupational Therapy and Neurological Conditions – Google Books

An introductory, comprehensive textbook covering all aspects of the occupational needs of clients with neurological conditions. Written from an occupational perspective and for the needs of occupational therapists and their clients Ideal for students and newly qualified practitioners to provide them with an overview of this key area of practice Includes case studies to place material within the context of practice Officially endorsed by the College of Occupational Therapists

Source: Occupational Therapy and Neurological Conditions – Judi Edmans, Jenny Preston – Google Books

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[ARTICLE] Robotics in the Rehabilitation of Neurological Conditions – Full Text PDF

Introduction

The research of robotics for the rehabilitation of neurological conditions has increased in the last decade. The technological advances of the 21st century are bringing robotics to all domains of our society (Morone et al., 2014).

Our research site has been focusing upon the application of robotic technology for neurological conditions. Our current robotic research is on the upper and lower motor function in patients with stroke (CVA), spinal cord injury (SCI), and brain injury (BI). The research of robotics in the rehabilitation of neurological conditions has been constrained by cost and lack of insurance coverage. In the United States the use of robotics in health care has the potential to deliver highly intensive activity-based therapy (Scott and Dukelow, 2011). Loss of motor function is a result and consequence of neurological disorders (Moreno et al., 2011). The stroke prevalence is estimated at 2.9%, or a new stroke occurs every 40 seconds. While spinal cord injury has an incidence rate of traumatic SCI from 12.1 to 57.8 per million (Moreno et al., 2011). Additionally, other neurological diseases such as, Parkinson’s, cerebral palsy…

Continue —> Robotics in the Rehabilitation of Neurological Conditions (PDF Download Available).

Full Text PDF

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