Brain Computer Interfaces and Emotional Involvement: Theory, Research, and Applications

This reprint is dedicated to the study of brain activity related to emotional and attentional involvement as measured by Brain–computer interface (BCI) systems designed for different purposes. A BCI system can translate brain signals (e.g., electric or hemodynamic brain activity indicators) into a command to execute an action in the BCI application (e.g., a wheelchair, the cursor on the screen, a spelling device or a game). These tools have the advantage of having real-time access to the ongoing brain activity of the individual, which can provide insight into the user’s emotional and attentional states by training a classification algorithm to recognize mental states. The success of BCI systems in contemporary neuroscientific research relies on the fact that they allow one to “think outside the lab”. The integration of technological solutions, artificial intelligence and cognitive science allowed and will allow researchers to envision more and more applications for the future. The clinical and everyday uses are described with the aim to invite readers to open their minds to imagine potential further developments

Applications of EMG in Clinical and Sports Medicine

This second of two volumes on EMG (Electromyography) covers a wide range of clinical applications, as a complement to the methods discussed in volume 1. Topics range from gait and vibration analysis, through posture and falls prevention, to biofeedback in the treatment of neurologic swallowing impairment. The volume includes sections on back care, sports and performance medicine, gynecology/urology and orofacial function. Authors describe the procedures for their experimental studies with detailed and clear illustrations and references to the literature. The limitations of SEMG measures and methods for careful analysis are discussed. This broad compilation of articles discussing the use of EMG in both clinical and research applications demonstrates the utility of the method as a tool in a wide variety of disciplines and clinical fields

Miller Fisher Syndrome: The Localisation of Pathology

The syndrome described by Miller Fisher (1956) comprises an acute ophthalmoplegia (or ophthalmoparesis) associated with severe ataxia, predominantly of gait and trunk, and a mild to moderate increase in the cerebrospinal fluid protein level unassociated with pleocytosis. As in the Guillain-Barre syndrome, there is usually an antecedent infection commonly of the upper respiratory tract. The illness has a benign course with rapid and usually complete recovery. The precise nature, aetiology and main site of pathological changes in the Miller Fisher syndrome are not well understood and have been the subject of some controversy. Since neuropathological evidence from typical cases of the syndrome is lacking, due to the benign nature of the illness, hypotheses have been based on clinical observations. Opinions have suggested either that the syndrome is related to acute inflammatory demyelinating polyradiculoneuropathy, or, that it is due to a brainstem inflammatory lesion, or, that both such types of component are present. This thesis is an attempt to address the question of identification of the main site of action of the pathological process in the Miller Fisher syndrome. Comprehensive multimodal and serial neurophysiological investigations, testing both the peripheral and central nervous system, have been applied to a group of seven typical patients with the syndrome at standardised intervals from onset of the illness up to and after full recovery. The results are compared with those from 20 patients with classical Guillain-Barre syndrome systematically investigated in a similar way, and with those previously reported in the literature. The findings are then discussed in the context of peripheral versus central nervous system dysfunction. In the first chapter, a review is presented of a small number of reports of similar cases described incompletely prior to Fisher's original 1956 account, followed by an analysis of 84 patients with the syndrome reported in the literature and by an outline of some of the controversies concerning the underlying pathology. Chapter 2 describes the clinical findings together with the course, laboratory investigations and case analysis of 7 patients with typical Miller Fisher syndrome. In chapter 3, the neurophysiological methods and the timing of their application are detailed, together with a critical appraisal of their reliability. The investigations used included: 1. electromyography. 2. nerve conduction studies. 3. late response (H-reflex and F-wave) studies. 4. estimation of motor unit numbers and motor unit potentials analysis. 5. peripheral facial nerve and blink reflex studies. 6. computerised quantitative sensory (thermal and vibration) threshold measurements. 7. muscle silent period studies. 8. multimodal evoked potentials (somatosensory, brainstem auditory and visual) studies. 9. electroencephalography. 10. Quantitative pupillometric and pharmacological observations on the pupils. The results of the neurophysiological investigations and their evolution with time are presented in chapter 4. The findings indicated the presence of a significant dysfunction in the peripheral nerves of the limbs, the facial nerves and in the postganglionic parasympathetic fibres subserving the pupils. They also provided support for a peripheral disturbance as the underlying mechanism for the ataxia observed in patients with the Miller Fisher syndrome. The results of comparably timed, similar comprehensive neurophysiological investigation in 20 patients with the Guillain-Barre syndrome for a total period of 18 months are described in chapter 5. The results are compared with those of other studies from the literature. In chapter 6, the lack of any significant neurophysiological or brain imaging evidence for central nervous system involvement in the group of patients with the Miller Fisher syndrome is outlined. In the main discussion in chapter 7, the neurophysiological findings in the patients with the Miller Fisher syndrome are critically assessed and compared with those from the patients with the Guillain-Barre syndrome in the present study and in reports from the literature. This discussion is set in the context of concepts of peripheral and of central nervous system involvement. Clinical similarities between the Miller Fisher and the Guillain-Barre syndromes are outlined and 20 patients who appear to have overlapping features which suggest a link or continuum between the two syndromes, are reviewed from the literature. (Abstract shortened by ProQuest.)

Development and validation of a murine model for long-term intravital imaging of peripheral nerve regeneration

INTRODUCTION: Injury to the facial nerve can lead to functional and aesthetic sequelae in patients. Though surgical interventions are available to restore lost motor and sensory function, outcomes are often suboptimal due to inadequate or disorganized axonal regeneration. While engineering improvements to the standard of care are underway, gaps remain in our molecular understanding of peripheral nerve injury to translate these efforts clinically. Over the last few decades, advancements in intravital imaging such as the development of fluorescent reporter mice and use of multiphoton excitation techniques have allowed for markedly enhanced characterization of biological phenomena at higher resolutions, at greater depths, and for longer timescales. Challenges in reliably and serially imaging in vivo within murine models have been overcome through the development of chronic imaging windows in various settings of the body. However, there are very few techniques available presently for imaging the peripheral nerve microenvironment and no prior work detailing use in the facial nerve setting. OBJECTIVE: Longitudinal studies employing intravital imaging techniques carry potential to improve understanding of peripheral nerve regeneration and function. Using multiphoton microscopy and fluorescent reporter mice, we propose a prototype, surgical protocol of implantation, and initial safety and efficacy testing of a facial nerve window to enable chronic imaging for enhanced characterization of the peripheral nerve microenvironment. METHODS: A stainless-steel implant with an affixed glass coverslip and aluminum external fixation component was developed for implantation in a transgenic reporter mouse model to enable chronic intravital imaging of the facial nerve buccal and marginal mandibular branches. A qualitative observational study and clinical assessment scoring study was performed post-surgical implantation to monitor behavior, physical appearance, weight loss, and reactivity to animal handling over the typical time-course of nerve regeneration. Segments of facial nerve branches were harvested from control and window-implanted mice and imaged using widefield epifluorescence microscopy for axon quantification to determine any adverse effects from window compression onto axonal fibers. Two-photon microscopy (2PM) and Simulated Raman Scattering (SRS) were also performed through the window to visualize axon tracts, myelin sheaths, and surrounding collagen matrix in wild-type and transgenic mice models. RESULTS: Qualitative serial observational studies and assessment scoring indicated no obvious functional deficits over the time-course of typical nerve regeneration and normal scores for weight, behavior, physical appearance, and reactivity. Neural histomorphometric analysis indicated no significant difference in mean myelinated axon count of buccal (mean ± SD; control buccal, 947.6 ± 129.9; window-implanted buccal, 799.3 ± 128.6; p = .136) and marginal mandibular branches (control marginal mandibular, 801.3 ± 145.1; window-implanted marginal mandibular, 738.0 ± 197.2; p = .599) between control and window-implanted mice, suggesting that neuropathy was not induced from the window itself. High-resolution images of nerve morphology in healthy and injured transgenic and wild-type mice were obtained using 2PM and SRS. CONCLUSION: Herein, we describe a novel and replicable platform for longitudinal intravital imaging of murine facial nerve. Future studies will evaluate viability of this model for imaging the facial nerve microenvironment, particularly Schwann cell-axon interactions, in the setting of severe nerve injury over a period of several weeks to months. Improved understanding gained through such studies of the structural peripheral nerve microenvironment may allow for advancements in viral vector therapeutics, nerve graft scaffold design, as well as advanced injury diagnostics and tracking.2022-06-02T00:00:00

Equine clinics

The present final report concluding the degree of the Integrated Master in Veterinary Medicine at the University of Évora is based on the curricular externship in an outpatient clinic with Dr. An Sleeckx in the Greater Lisbon / Ribatejo area. This report is divided into two parts. The first part presents the casuistic of the externship and describes clinical cases like abdominal pain, lameness, pre-purchase exam, intoxication with monensin, insect bite hypersensitivity and castration which were followed during the externship. As painful events like lameness and colic are very common in equine clinics, a literature research on pain assessment in horses was made and presented in the second part as a monography. The focus was on new composite pain scales including behavior and facial expressions which seem to be the most reliable to detect pain according to the newest publications; Resumo: Clínica e Cirurgia de Equinos O presente relatório de conclusão do curso de Mestrado Integrado em Medicina Veterinária da Universidade de Évora é baseado no estágio curricular realizado em clínica ambulatória com a Dra. An Sleeckx na zona da Grande Lisboa/ Ribatejo. O relatório é dividido em duas partes. A primeira parte apresenta a casuística do estágio e descreve casos clínicos como dor abdominal, claudicações, acto de compra, intoxicação com monensina, hipersensibilidade à picada de insectos e castração, que foram acompanhados durante o estágio. Uma vez que eventos dolorosos como as claudicações e as cólicas são muito comuns nas clínicas equinas, foi feita uma pesquisa bibliográfica sobre avaliação da dor em cavalos, que foi apresentada na segunda parte como uma monografia. O foco foi em novas escalas composta de dor, incluindo comportamento e expressões faciais que parecem ser as mais fiáveis para detectar a dor de acordo com as mais recentes publicações

Peripheral Neuropathy

Over the last two decades we have seen extensive progress within the practice of neurology. We have refined our understanding of the etiology and pathogenesis for both peripheral and central nervous system diseases, and developed new therapeutic approaches towards these diseases. Peripheral neuropathy is a common disorder seen by many specialists and can pose a diagnostic dilemma. Many etiologies, including drugs that are used to treat other diseases, can cause peripheral neuropathy. However, the most common cause is Diabetes Mellitus, a disease all physicians encounter. Disability due to peripheral neuropathy can be severe, as the patients suffer from symptoms daily. This book addresses the advances in the diagnosis and therapies of peripheral neuropathy over the last decade. The basics of different peripheral neuropathies is briefly discussed, however, the book focuses on topics that address new approaches to peripheral neuropathies

Deep human face analysis and modelling

Human face appearance and motion play a significant role in creating the complex social environments of human civilisation. Humans possess the capacity to perform facial analysis and come to conclusion such as the identity of individuals, understanding emotional state and diagnosing diseases. The capacity though is not universal for the entire population, where there are medical conditions such prosopagnosia and autism which can directly affect facial analysis capabilities of individuals, while other facial analysis tasks require specific traits and training to perform well. This has lead to the research of facial analysis systems within the computer vision and machine learning fields over the previous decades, where the aim is to automate many facial analysis tasks to a level similar or surpassing humans. While breakthroughs have been made in certain tasks with the emergence of deep learning methods in the recent years, new state-of-the-art results have been achieved in many computer vision and machine learning tasks. Within this thesis an investigation into the use of deep learning based methods for facial analysis systems takes place, following a review of the literature specific facial analysis tasks, methods and challenges are found which form the basis for the research findings presented. The research presented within this thesis focuses on the tasks of face detection and facial symmetry analysis specifically for the medical condition facial palsy. Firstly an initial approach to face detection and symmetry analysis is proposed using a unified multi-task Faster R-CNN framework, this method presents good accuracy on the test data sets for both tasks but also demonstrates limitations from which the remaining chapters take their inspiration. Next the Integrated Deep Model is proposed for the tasks of face detection and landmark localisation, with specific focus on false positive face detection reduction which is crucial for accurate facial feature extraction in the medical applications studied within this thesis. Evaluation of the method on the Face Detection Dataset and Benchmark and Annotated Faces in-the-Wild benchmark data sets shows a significant increase of over 50% in precision against other state-of-the-art face detection methods, while retaining a high level of recall. The task of facial symmetry and facial palsy grading are the focus of the finals chapters where both geometry-based symmetry features and 3D CNNs are applied. It is found through evaluation that both methods have validity in the grading of facial palsy. The 3D CNNs are the most accurate with an F1 score of 0.88. 3D CNNs are also capable of recognising mouth motion for both those with and without facial palsy with an F1 score of 0.82