Non-invasive optical monitoring of free and bound oxygen in humans

Background: Possibilities of detecting oxygen - both in its free form, as gas in the lungs, and in its bound form, as oxygenated hemoglobin - have been explored in this thesis. Perfusion and oxygenation of vital organs (e.g., heart, brain and kidneys) may be severely compromised in critical illness or major trauma, which is why blood is rapidly diverted to those organs to improve chances of survival. Blood vessels in less important organs (e.g., skin, skeletal muscles and intestines) are constricted, leading to reduced regional perfusion and oxygenation in these organs. Non-invasive measurements of changes in tissue perfusion and oxygenation, in e.g., the forearm, might give an early indication of clinical deterioration. Preterm infants are very vulnerable patients. Their organs, in particular the lungs, are not fully developed, and the respiratory distress syndrome (RDS) frequently occurs. The intestines may be affected by necrotizing enterocolitis (NEC). Complementary diagnostic and surveillance methods of RDS and NEC are desirable. Aims: The overall aim of this thesis, which includes Studies I-IV, was to develop and evaluate non-invasive optical techniques, based on light at different wavelengths, to complement future bedside surveillance in critically illness or severe injury, for adults as well as for infants. Methods: Changes in tissue oxygenation by near-infrared spectroscopy (I-II), blood perfusion by laser Doppler imaging (I) and blood volume by tissue viability imaging (I) in skeletal muscle and skin were studied, and continuous-wave and timeresolved near-infrared spectroscopy were compared (II) in healthy volunteers subjected to various defined regional physiological perturbations. For the first time, gas in scattering media absorption spectroscopy (GASMAS) was used to detect alveolar water vapor (III-IV) and oxygen gas (IV), as well as intestinal water vapor (III) in newborn infants. Main results: Near-infrared spectroscopy, laser Doppler imaging and tissue viability imaging provided valuable information on physiological changes in the microcirculation (I). Continuous-wave and time-resolved near-infrared spectroscopy techniques were both able to determine changes in tissue oxygenation, but the time-resolved technique provided more realistic values with smaller inter-individual differences (II). Alveolar (III-IV) and intestinal signals of water vapor (III), were readily detected, together with alveolar signals of oxygen gas (IV), non-invasively in newborn infants. Conclusions: Optical techniques, being non-invasive and providing data in real-time, are attractive as potential tools for surveillance in critical illness or severe injury, in particular concerning the oxygenation. As an overall conclusion, we believe, that fully developed time-resolved near-infrared techniques have the potential to become an additional monitoring method of choice for surveillance of critically ill or severely injured patients. Likewise, GASMAS has great potential for future monitoring of critically ill preterm or full-term infants, and might, ultimately, reduce the current use of X-ray imaging in these most vulnerable patients

Investigating the Effects of Custom Made Orthotics on Brain Forms: A Pilot Study

OBJECTIVES: To determine (1) the feasibility of this novel approach and technique of recording brain activity, wirelessly and continuously, during human gait, and (2) if custom made orthotics will alter the brain activity patterns recorded. METHODS: Gait trials were performed on 16 participants walking with and without orthotic devices in their shoes while simultaneously collecting EEG data through the Emotiv wireless neuroheadset. RESULTS: The Emotiv neuroheadset was capable of detecting changes in brain activity between the two gait trials. The differences in brain activity identified between conditions were not statistically significant. CONCLUSION: The findings suggest the Emotiv EEG device is sensitive enough to detect changes in brain activation patterns during human gait. Further research is required before definite conclusions can be made about this novel device, or about what effects, if any, orthotics have on brain activation patterns during gait

Perfusive and diffusive oxygen transport in skeletal muscle during incremental handgrip exercise

Master of ScienceDepartment of KinesiologyThomas J. BarstowLimb blood flow increases linearly with exercise intensity; however, invasive measurements of microvascular muscle blood flow during incremental exercise have demonstrated submaximal plateaus. Diffuse correlation spectroscopy (DCS) noninvasively quantifies relative changes in microvascular blood flow at rest via a blood flow index (BFI). The purpose of this study was to quantify relative changes in tissue blood flow during exercise using DCS, compare the BFI of the flexor digitorum superficialis (BFI[subscript]FDS) muscle to brachial artery blood flow (Q̇[subscript]BA) measured via Doppler ultrasound, and employ near infrared spectroscopy (NIRS) alongside DCS to simultaneously measure perfusive and diffusive oxygen transport within a single volume of exercising skeletal muscle tissue. We hypothesized Q̇[subscript]BA would increase with increasing exercise intensity until task failure, BFI[subscript]FDS would plateau at a submaximal work rate, and muscle oxygenation characteristics (total-[heme], deoxy-[heme], and % saturation) measured with NIRS would demonstrate a plateau at a similar work rate as BFI[subscript]FDS. Sixteen subjects (23.3 ± 3.9 yrs; 170.8 ± 1.9 cm; 72.8 ± 3.4 kg) participated in this study. Peak power (P[subscript]peak) was determined for each subject (6.2 ± 1.4W) via an incremental handgrip exercise test to task failure. Measurements of Q̇[subscript]BA, BFI[subscript]FDS, total-[heme], deoxy-[heme], and % saturation were made during each stage of the incremental exercise test. Q̇[subscript]BA increased with exercise intensity until the final work rate transition (p < 0.05). No increases in BFI[subscript]FDS or muscle oxygenation characteristics were observed at exercise intensities greater than 51.5 ± 22.9% of P[subscript]peak and were measured simultaneously in a single volume of exercising skeletal muscle tissue. Differences in muscle recruitment amongst muscles of the whole limb may explain the discrepancies observed in Q̇[subscript]BA and BFI[subscript]FDS responses during incremental exercise and should be further investigated

Rehabilitation of gait after stroke: a review towards a top-down approach

This document provides a review of the techniques and therapies used in gait rehabilitation after stroke. It also examines the possible benefits of including assistive robotic devices and brain-computer interfaces in this field, according to a top-down approach, in which rehabilitation is driven by neural plasticity

EEG During Pedaling: Evidence for Cortical Control of Locomotor Tasks

Objective: This study characterized the brain electrical activity during pedaling, a locomotor-like task, in humans. We postulated that phasic brain activity would be associated with active pedaling, consistent with a cortical role in locomotor tasks. Methods: Sixty four channels of electroencephalogram (EEG) and 10 channels of electromyogram (EMG) data were recorded from 10 neurologically-intact volunteers while they performed active and passive (no effort) pedaling on a custom-designed stationary bicycle. Ensemble averaged waveforms, 2 dimensional topographic maps and amplitude of the β (13–35 Hz) frequency band were analyzed and compared between active and passive trials. Results: The peak-to-peak amplitude (peak positive–peak negative) of the EEG waveform recorded at the Cz electrode was higher in the passive than the active trials (p \u3c 0.01). β-band oscillations in electrodes overlying the leg representation area of the cortex were significantly desynchronized during active compared to the passive pedaling (p \u3c 0.01). A significant negative correlation was observed between the average EEG waveform for active trials and the composite EMG (summated EMG from both limbs for each muscle) of the rectus femoris (r = −0.77, p \u3c 0.01) the medial hamstrings (r = −0.85, p \u3c 0.01) and the tibialis anterior (r = −0.70, p \u3c 0.01) muscles. Conclusions: These results demonstrated that substantial sensorimotor processing occurs in the brain during pedaling in humans. Further, cortical activity seemed to be greatest during recruitment of the muscles critical for transitioning the legs from flexion to extension and vice versa. Significance: This is the first study demonstrating the feasibility of EEG recording during pedaling, and owing to similarities between pedaling and bipedal walking, may provide valuable insight into brain activity during locomotion in humans

Hybrid Sensing and Adaptive Control for Direct Brain Actuation of Artificial Limbs

Developing a non-invasive direct brain control of artificial limbs is both challenging and desirable. Such a sensory and control system, if successful, will have a profound impact on the disabled. In this dissertation, we present the design and development of a non-invasive, hybrid sensory system, which uses near-infrared spectroscopy (NIRS) and electroencephalography (EEG) to measure brain activity with simultaneous electromyography (EMG) to provide feedback data in a healthy limb. Through the combination of these sensory techniques, we have successfully trained a control system capable of mapping brain activity onto muscle actuation. The design of a control algorithm capable of automatic reconfiguration to account for changing sensor conditions, selection of an appropriate pre-trained network based on input characteristics, and adaptation to adjust output based on the user\u27s activity are investigated. The selection of an appropriate algorithm and its initial performance using our sensory system are presented and discussed. The sensory and control system are designed for application in artificial limb control for persons who have undergone amputation of an upper-extremity. Actuation of the elbow and wrist are the primary focus of the study, with the intent to expand to forearm torsion and hand grasping in subsequent studies. During the course of the investigation, the additional function of treating phantom limb pain was incorporated into the design, which has also lead to increased sensor resolution requirements