Severity scoring approach using modified optical flow method and lesion identification for facial nerve paralysis assessment

The facial nerve controls facial movement and expression. Hence, a patient with facial nerve paralysis will experience affected social interactions, psychological distress, and low self-esteem. Upon the first presentation, it is crucial to determine the severity level of the paralysis and take out the possibility of stroke or any other serious causes by recognising the type of lesion in preventing any mistreatment of the patient. Clinically, the facial nerve is assessed subjectively by observing voluntary facial movement and assigning a score based on the deductions made by the clinician. However, the results are not uniform among different examiners evaluating the same patients. This is extremely undesirable for both medical diagnostic and treatment considerations. Acknowledging the importance of this assessment, this research was conducted to develop a facial nerve assessment that can classify both the severity level of facial nerve function and also the types of facial lesion, Upper Motor Neuron (UMN) and Lower Motor Neuron (LMN), in facial regional assessment and lesion assessment, respectively. For regional assessment, two optical flow techniques, Kanade-Lucas-Tomasi (KLT) and Horn-Schunck (HS) were used in this study to determine the local and global motion information of facial features. Nevertheless, there is a problem with the original KLT which is the inability of the Eigen features to distinguish the normal and patient subjects. Thus, the KLT method was modified by introducing polygonal measurements and the landmarks were placed on each facial region. Similar to the HS method, the multiple frames evaluation was proposed rather than a single frame evaluation of the original HS method to avoid the differences between frames becoming too small. The features of these modified methods, Modified Local Sparse (MLS) and Modified Global Dense (MGD), were combined, namely the Combined Modified Local-Global (CMLG), to discover both local (certain region) and global (entire image) flow features. This served as the input into the k-NN classifier to assess the performance of each of them in determining the severity level of paralysis. For the lesion assessment, the Gabor filter method was used to extract the wrinkle forehead features. Thereafter, the Gabor features combined with the previous features of CMLG, by focusing only on the forehead region to evaluate both the wrinkle and motion information of the facial features. This is because, in an LMN lesion, the patient will not be able to move the forehead symmetrically during the rising eyebrows movement and unable to wrinkle the forehead due to the damaged frontalis muscle. However, the patient with a UMN lesion exhibits the same criteria as a normal subject, where the forehead is spared and can be lifted symmetrically. The CMLG technique in regional assessment showed the best performance in distinguishing between patient and normal subjects with an accuracy of 92.26% compared to that of MLS and MGD, which were 88.38% and 90.32%, respectively. From the results, some assessment tools were developed in this study namely individual score, total score and paralysis score chart which were correlated with the House-Brackmann score and validated by a medical professional with 91.30% of accuracy. In lesion assessment, the combined features of Gabor and CMLG on the forehead region depicted a greater performance in distinguishing the UMN and LMN lesion of the patient with an accuracy of 89.03% compared to Gabor alone, which was 78.07%. In conclusion, the proposed facial nerve assessment approach consisting of both regional assessment and lesion assessment is capable of determining the level of facial paralysis severity and recognising the type of facial lesion, whether it is a UMN or LMN lesion

Facial Paralysis Grading Based on Dynamic and Static Features

Peripheral facial nerve palsy, also known as facial paralysis (FP), is a common clinical disease, which requires subjective judgment and scoring based on the FP scale. There exists some automatic facial paralysis grading methods, but the current methods mostly only consider either static or dynamic features, resulting in a low accuracy rate of FP grading. This thesis proposes an automatic facial paralysis assessment method including both static and dynamic characteristics. The first step of the method performs preprocessing on the collected facial expression videos of the subjects, including rough video interception, video stabilization, keyframe extraction, image geometric normalization and gray-scale normalization. Next, the method selects as keyframes no facial expression state and maximum facial expression state in the image data to build the the research data set. Data preprocessing reduces errors, noise, redundancy and even errors in the original data. The basis for extracting static and dynamic features of an image is to use Ensemble of Regression Trees algorithm to determine 68 facial landmarks. Based on landmark points, image regions of image are formed. According to the Horn-Schunck optical flow method, the optical flow information of parts of the face are extracted, and the dynamic characteristics of the optical flow difference between the left and right parts are calculated. Finally, the results of dynamic and static feature classification are weighted and analyzed to obtain FP ratings of subjects. A 32-dimensional static feature is fed into the support vector machine for classification. A 60-dimensional feature vector of dynamical aspects is fed into a long and short-term memory network for classification. Videos of 30 subjects are used to extract 1419 keyframes to test the algorithm. The accuracy, precision, recall and f1 of the best classifier reach 93.33%, 94.29%, 91.33% and 91.87%, respectively.Perifeerinen kasvojen hermohalvaus, joka tunnetaan myös nimellä kasvojen halvaus (FP), on yleinen kliininen sairaus, joka vaatii subjektiivista arviointia ja FP -asteikon pisteytystä. Joitakin automaattisia kasvohalvauksen luokittelumenetelmiä on olemassa, mutta yleensä ottaen ne punnitsevat vain joko staattisia tai dynaamisia piirteitä. Tässä tutkielmassa ehdotetaan automaattista kasvojen halvaantumisen arviointimenetelmää, joka kattaa sekä staattiset että dynaamiset ominaisuudet. Menetelmän ensimmäinen vaihe suorittaa ensin esikäsittelyn kohteiden kerätyille kasvojen ilmevideoille, mukaan lukien karkea videon sieppaus, videon vakautus, avainruudun poiminta, kuvan geometrinen normalisointi ja harmaasävyjen normalisointi. Seuraavaksi menetelmä valitsee avainruuduiksi ilmeettömän tilan ja kasvojen ilmeiden maksimitilan kuvadatasta kerryttäen tutkimuksen data-aineiston. Tietojen esikäsittely vähentää virheitä, kohinaa, redundanssia ja jopa virheitä alkuperäisestä datasta. Kuvan staattisten ja dynaamisten piirteiden poimimisen perusta on käyttää Ensemble of Regression Trees -algoritmia 68 kasvojen merkkipisteiden määrittämiseen. Merkkipisteiden perusteella määritellään kuvan kiinnostavat alueet. Horn-Schunckin optisen virtausmenetelmän mukaisesti poimitaan optisen virtauksen tiedot joistakin kasvojen osista, ja dynaaminen luonnehdinta lasketaan vasempien ja oikeiden osien välille. Lopuksi dynaamisen ja staattisen piirteiden luokittelun tulokset painotetaan ja analysoidaan kattavasti koehenkilöiden FP-luokitusten saamiseksi. 32- ulotteinen staattisten piirteiden vektori syötetään tukivektorikoneeseen luokittelua varten. 60-ulotteinen dynaamisten piirteiden ominaisuusvektori syötetään pitkän ja lyhyen aikavälin muistiverkkoon luokittelua varten. Parhaan luokittelijan tarkkuus, täsmällisyys, palautustaso ja f1 saavuttavat arvot 93,33%, 94,29%, 91,33% ja 91,87%

Die zentrale Fazialisparese: eine Analyse der mimischen Funktion und der von Patienten empfundenen Schwere der Erkrankung

Die zentrale Fazialisparese ist eines der häufigsten Symptome bei Patienten mit akuten Hirnschädigungen, wie beispielsweise dem Schlaganfall. Die Lähmung ist nicht nur aus ästhetischen und funktionellen Gründen einschränkend, sondern auch emotional und psychisch belastend. Für die Patienten ergeben sich daraus häufig soziale Stigmatisierungen, die einen großen Einfluss auf die Eigenwahrnehmung der Erkrankung haben. ..

Study and development of sensorimotor interfaces for robotic human augmentation

This thesis presents my research contribution to robotics and haptics in the context of human augmentation. In particular, in this document, we are interested in bodily or sensorimotor augmentation, thus the augmentation of humans by supernumerary robotic limbs (SRL). The field of sensorimotor augmentation is new in robotics and thanks to the combination with neuroscience, great leaps forward have already been made in the past 10 years. All of the research work I produced during my Ph.D. focused on the development and study of fundamental technology for human augmentation by robotics: the sensorimotor interface. This new concept is born to indicate a wearable device which has two main purposes, the first is to extract the input generated by the movement of the user's body, and the second to provide the somatosensory system of the user with an haptic feedback. This thesis starts with an exploratory study of integration between robotic and haptic devices, intending to combine state-of-the-art devices. This allowed us to realize that we still need to understand how to improve the interface that will allow us to feel the agency when using an augmentative robot. At this point, the path of this thesis forks into two alternative ways that have been adopted to improve the interaction between the human and the robot. In this regard, the first path we presented tackles two aspects conerning the haptic feedback of sensorimotor interfaces, which are the choice of the positioning and the effectiveness of the discrete haptic feedback. In the second way we attempted to lighten a supernumerary finger, focusing on the agility of use and the lightness of the device. One of the main findings of this thesis is that haptic feedback is considered to be helpful by stroke patients, but this does not mitigate the fact that the cumbersomeness of the devices is a deterrent to their use. Preliminary results here presented show that both the path we chose to improve sensorimotor augmentation worked: the presence of the haptic feedback improves the performance of sensorimotor interfaces, the co-positioning of haptic feedback and the input taken from the human body can improve the effectiveness of these interfaces, and creating a lightweight version of a SRL is a viable solution for recovering the grasping function

Epilepsy

With the vision of including authors from different parts of the world, different educational backgrounds, and offering open-access to their published work, InTech proudly presents the latest edited book in epilepsy research, Epilepsy: Histological, electroencephalographic, and psychological aspects. Here are twelve interesting and inspiring chapters dealing with basic molecular and cellular mechanisms underlying epileptic seizures, electroencephalographic findings, and neuropsychological, psychological, and psychiatric aspects of epileptic seizures, but non-epileptic as well

PRELIMINARY FINDINGS OF A POTENZIATED PIEZOSURGERGICAL DEVICE AT THE RABBIT SKULL

The number of available ultrasonic osteotomes has remarkably increased. In vitro and in vivo studies have revealed differences between conventional osteotomes, such as rotating or sawing devices, and ultrasound-supported osteotomes (Piezosurgery®) regarding the micromorphology and roughness values of osteotomized bone surfaces. Objective: the present study compares the micro-morphologies and roughness values of osteotomized bone surfaces after the application of rotating and sawing devices, Piezosurgery Medical® and Piezosurgery Medical New Generation Powerful Handpiece. Methods: Fresh, standard-sized bony samples were taken from a rabbit skull using the following osteotomes: rotating and sawing devices, Piezosurgery Medical® and a Piezosurgery Medical New Generation Powerful Handpiece. The required duration of time for each osteotomy was recorded. Micromorphologies and roughness values to characterize the bone surfaces following the different osteotomy methods were described. The prepared surfaces were examined via light microscopy, environmental surface electron microscopy (ESEM), transmission electron microscopy (TEM), confocal laser scanning microscopy (CLSM) and atomic force microscopy. The selective cutting of mineralized tissues while preserving adjacent soft tissue (dura mater and nervous tissue) was studied. Bone necrosis of the osteotomy sites and the vitality of the osteocytes near the sectional plane were investigated, as well as the proportion of apoptosis or cell degeneration. Results and Conclusions: The potential positive effects on bone healing and reossification associated with different devices were evaluated and the comparative analysis among the different devices used was performed, in order to determine the best osteotomes to be employed during cranio-facial surgery

The role of phonology in visual word recognition: evidence from Chinese

Posters - Letter/Word Processing V: abstract no. 5024The hypothesis of bidirectional coupling of orthography and phonology predicts that phonology plays a role in visual word recognition, as observed in the effects of feedforward and feedback spelling to sound consistency on lexical decision. However, because orthography and phonology are closely related in alphabetic languages (homophones in alphabetic languages are usually orthographically similar), it is difficult to exclude an influence of orthography on phonological effects in visual word recognition. Chinese languages contain many written homophones that are orthographically dissimilar, allowing a test of the claim that phonological effects can be independent of orthographic similarity. We report a study of visual word recognition in Chinese based on a mega-analysis of lexical decision performance with 500 characters. The results from multiple regression analyses, after controlling for orthographic frequency, stroke number, and radical frequency, showed main effects of feedforward and feedback consistency, as well as interactions between these variables and phonological frequency and number of homophones. Implications of these results for resonance models of visual word recognition are discussed.postprin

Automatisierte Erkennung und Evaluation von therapeutischen Übungen für Patienten mit Mimikdysfunktionen

In dieser Arbeit wird ein flexibles, kamerabasiertes Trainingssystem zur Rehabilitation von Gesichtslähmungen (Fazialisparesen) und anderen Mimikdysfunktionen vorgestellt. Das System unterstützt das selbstständige Training des Patienten, indem es die Durchführung von insgesamt zwölf Fazialisübungen automatisch bewertet und mehrstufiges Feedback an den Anwender vermittelt. Es eignet sich somit für einen begleitenden Einsatz zu den regulären Übungseinheiten, welche von einem Logopäden oder Sprechwissenschaftler angeleitet werden. Während Ansätze zur automatisierten Diagnose und Gradierung von Fazialisparesen in der Literatur vergleichsweise verbreitet sind, finden sich gegenwärtig nur vereinzelt Konzepte für therapiebegleitende Trainingsanwendungen. Die diesen Anwendungen zu Grunde liegenden Algorithmen sind zudem auf einzelne Fazialisübungen spezialisiert und daher, anders als das in dieser Arbeit vorgestellte System, nicht ohne Mehraufwand auf weitere Übungen übertragbar. Die Beiträge der vorliegenden Arbeit umfassen die wesentlichen Komponenten der technischen Gesamtarchitektur des Trainingssystems. Der methodische und experimentelle Fokus der Ausarbeitung liegt dabei vor allem auf der Merkmalsextraktion, sowie der Ableitung des Feedbacks aus den extrahierten Merkmalsdeskriptoren. Eine wesentliche Neuheit gegenüber dem Stand der Technik besteht in der Möglichkeit, das Trainingssystem flexibel um zusätzliche Fazialisübungen zu ergänzen und sowohl globales als auch regionenbezogenes Feedback bereitzustellen. Die dafür ausgewählten Verfahren basieren vorwiegend auf der Verarbeitung von 3D-Kameradaten und umfassen die Extraktion von Punktsignaturen, Histogrammen orientierter Normalenvektoren, sowie von Krümmungs-, Distanz- und Winkelmerkmalsdeskriptoren. Die Feedbackermittlung stützt sich auf den Einsatz von Random-Forests und den aus diesen ableitbaren paarweisen Ähnlichkeiten. Letztere stellen Schätzwerte für die merkmalsbezogene Übereinstimmung zwischen der vom Patienten ausgeführten Übung und den Modelldurchführungen in den Trainingsdaten dar.This thesis presents an automated, camera-based training system employable for the therapy of facial paralysis and related muscle dysfunctions. The proposed system aims to support patients in conducting twelve different facial exercises by providing automatically generated feedback. Thus, it is suited to supplement individual exercise sessions that are not supervised by a therapist. Automated grading and diagnosis systems for facial paralysis are a prominent topic in the literature on clinical image processing. In contrast, only few papers deal with the development of automated training systems for facial muscle re-education. Furthermore, the underlying algorithms are typically specialized for particular facial exercises and difficult to adapt to additional requirements. The contributions of this thesis comprise the main components of the system architecture with a methodical and technical emphasis on feature extraction algorithms and feedback estimation methods. Regarding the state-of-the-art, the major novelty is embodied in the possibility to easily extend the system to additional exercises and in the derivation of global and local feedback. The selected approaches rely on processing of 3D-camera data and include the extraction of point signatures, histograms of oriented normal vectors, curvatures, distance, and angle features. The feedback generation is based on random forest classifiers and proximities derived from trained forests. These proximities provide an estimate of similarity between the patient sample and training data samples

Interactive effects of orthography and semantics in Chinese picture naming

Posters - Language Production/Writing: abstract no. 4035Picture-naming performance in English and Dutch is enhanced by presentation of a word that is similar in form to the picture name. However, it is unclear whether facilitation has an orthographic or a phonological locus. We investigated the loci of the facilitation effect in Cantonese Chinese speakers by manipulating—at three SOAs (2100, 0, and 1100 msec)—semantic, orthographic, and phonological similarity. We identified an effect of orthographic facilitation that was independent of and larger than phonological facilitation across all SOAs. Semantic interference was also found at SOAs of 2100 and 0 msec. Critically, an interaction of semantics and orthography was observed at an SOA of 1100 msec. This interaction suggests that independent effects of orthographic facilitation on picture naming are located either at the level of semantic processing or at the lemma level and are not due to the activation of picture name segments at the level of phonological retrieval.postprin