clinicalneuroengineering

Blog

  • Hello world!

    Welcome to WordPress. This is your first post. Edit or delete it, then start writing!

  • Differentiating between Paediatric Ataxia and Developmental Coordination Disorder using video- based movement quantification with deep neural networks

    Researcher: Wei Tang, MSc (PhD student)

    Expected thesis defense: 2025

    Other promotors: Dr. Peter van Ooijen (DASH, Radiotherapy, UMCG), Dr. D.A. Sival (Pediatric Neurology, UMCG)

    Funding: Chinese Scholarship Council

    “Ataxia” refers to the impairment of the expected smooth performance of targeted directional movements, leading to impaired coordination, such as instability when walking, limbs shaking, slow response and poor accuracy. The recognition of ataxia with onset in early life (EOA) is difficult because children with Developmental Coordination Disorder (DCD) present with phenotypically impaired coordination that resembles ataxia, exhibiting slow motor behavior in the absence of mental retardation and visual impairment. Children with DCD often avoid social interaction and physical activity and suffer from many secondary psychosocial problems such as inferiority and depression. Thus, the diagnosis of DCD and EOA is very important for current and future management and health. Currently, clinicians usually use the Scale for the Assessment and Rating of Ataxia (SARA) to measure the severity of ataxia. But researchers found that phenotypic discrimination between EOA and DCD is incomplete. Therefore, the use of inertial measurement units, (IMUs) attached to the body with elastic straps including accelerometers and gyroscopes obtained during movements for automatic classification, has been studied for their use as an aid in the differential diagnosis of EOA and DCD. Mannini et al (2017) found that automatic classification based on quantitative gait features performs better than classification based on the phenotypic diagnosis, which suggests that quantification of movement and subsequent automatic classification could provide a support tool for consistent and repeatable diagnostic evaluation. Besides, Martinez- Manzanera et al. (2018) found that the variation within finger to nose trajectories was also different between EOA and DCD. Yet, the different studies into this matter have shown that DCD remains poorly recognizable, with overlap between ataxia and DCD coordination disorders, as well as between physiologically immature coordination and DCD, both phenotypically and when classifying on the basis of quantified movements using inertial measurement units (IMUs). In the study proposed here, the aim is to achieve further improvement in the differentiation between DCD and EOA in a clinical setting using video-based movement quantification with deep neural networks.

  • Use it or Lose it? An interdisciplinary approach to understanding the adaptation of the ageing brain to a fast-changing world

    Researcher: Celina Putz, MSc (PhD student)

    Expected thesis defense: 2023

    Other promotors: Prof. dr. Monicque Lorist (first promotor), Prof. dr. Martien Kas (second promotor)

    Funding: UMCG

    The past two decades have been marked by a major growth in technology being incorporated into society and public services. At the same time, we are faced with an increasingly aging society. Older adults in particular often might encounter difficulties adapting to these technological advancements, as it is known that deficits in behavioural flexibility occur with aging. Based on limited empirical evidence from recordings of electrical brain activity in humans, it has been suggested that especially neural mechanisms underlying reward-based learning are vulnerable to ageing. On a cortical level in humans, feedback-based learning involves a fast cascade of processes implicated in the detection and processing of feedback information and the recruitment of cognitive control necessary to update the information processing system in order to optimize future performance. Additionally, at the subcortical level, human fMRI data and local field potentials measured in rodents suggest a role for the brain’s reward regions to enable flexible behavioural responses under learning conditions. Given the differences in temporal and spatial resolution of the methods used, and the different study groups, the link between these two sets of findings remains elusive, as well as the impact of age on these mechanisms underlying reward-based learning. The proposed project aims at gaining insights into changes in mechanisms involved in learning in the aging brain.


  • Near-infrared spectroscopy (NIRS) for monitoring cerebral autoregulation: fundamental insights and clinical applications

    Researcher: Nick Eleveld, MSc (PhD student)

    Expected thesis defense: 2023

    Other promotors: Dr. Jan Willem Elting, MD, PhD (Neurology, UMCG), Dr. Gea Drost, MD, PhD (Neurology, UMCG), Prof. dr. Tony Absalom (Anesthesiology, UMCG)

    Funding: UMCG

    Maintenance of adequate cerebral perfusion is crucial for normal brain function. One of the main mechanisms securing adequate cerebral perfusion is cerebral autoregulation (CA), which comprises the contraction and dilation of cerebral arterioles in response to changes in systemic blood pressure to keep a relatively constant cerebral blood flow (CBF). It is known that CA can be impaired in (cerebral) diseases such as stroke, traumatic brain injury, and carotid artery disease. Yet, clinical usage of CA measurements remains limited, because accuracy and reproducibility are often low, analysis techniques are variable and data interpretation is subject to debate. Recently, near-infrared spectroscopy (NIRS) was shown to provide CA estimates similar to common techniques. Moreover, NIRS measurements are easy to perform, relatively comfortable to the patient, and allow long-term monitoring. Therefore, NIRS holds the promise of being a clinically applicable CA technique. However, several issues need to be investigated to allow clinical NIRS-based CA measurements. 1) The NIRS-based CA method needs improvements and elaborate artefact handling is necessary. 2) Increased fundamental understanding of NIRS-derived perfusion dynamics is necessary via controlled challenges of the cerebral circulation. 3) The clinical applicability of NIRS-based CA in several cerebral pathologies needs to be investigated.

    References

    • Nick Eleveld, Cornelia Hoedemaekers, Ruud van Kaam, Guus Leijte, Judith van den Brule, Peter Pickkers, Marcel Aries, Natasha Maurits, Jan Willem Elting (2021), Near-infrared spectroscopy derived Dynamic Cerebral Autoregulation in Experimental Human Endotoxemia, Frontiers in Neurology.

  • The role of arm swing in human gait: a study in healthy participants and Parkinson patients

    Researcher: Joyce Weersink, MSc (MD/PhD student)

    Expected thesis defense: 2021

    Copromotor: Dr. Bauke de Jong, MD, PhD (Neurology, UMCG)

    Collaborators: Prof. dr. Teus van Laar, MD, PhD (Neurology, UMCG)

    Funding: UMCG

    Locomotion of quadrupeds, with abrupt switches between e.g. trot and gallop, obviously requires coordinated action of four limbs. Bipedal gait in human similarly exhibits a characteristic four-limb pattern with anti-phase arm swing in a frequency identical to that of the lower limb oscillations. The onset of locomotion or gait initiation, is defined as the phase between standing motionless and steady-state locomotion. Patients with Parkinson’s Disease (PD) typically exhibit short shuffling steps and reduced arm swing, while they often suffer from difficulties in both onset and continuation of gait, including freezing of gait. Decreased supplementary motor area (SMA) activation, which is a strong finding in PD patients, has been associated with both initiation failures and gait abnormalities characterized by an impaired anti-phase cyclic movement organization underlying reduced arm swing. Cerebral circuitry, including the SMA, controlling the onset and continuation of human locomotion and its pathophysiology remains to be further identified. Neuroimaging techniques that explore functioning of and connectivity within these circuits can be used to understand how these gait disturbances develop as well as identify potential targets for medical and surgical interventions.
    The objective of this project is to examine how arm swing contributes to the onset and continuation of locomotion in healthy participants and PD patients and to study its underlying functional brain networks by using EEG-EMG-IMU recordings.

    References

    • Weersink, J. B., de Jong, B. M., Halliday, D. M. & Maurits, N. M. (2021). Intermuscular coherence analysis in older adults reveals that gait-related arm swing drives lower limb muscles via subcortical and cortical pathways. Journal of Physiology. https://physoc.onlinelibrary.wiley.com/doi/10.1113/JP281094
    • Weersink, J. B., Gefferie, S. R., van Laar, T., Maurits, N. M. & de Jong, B. M. (2020). Pre-Movement Cortico-Muscular Dynamics Underlying Improved Parkinson Gait Initiation after Instructed Arm Swing. Journal of Parkinson’s Disease, 10, 4, p. 1675-1693 https://content.iospress.com/articles/journal-of-parkinsons-disease/jpd202112
    • Weersink, J. B., Maurits, N. M., & de Jong, B. M. (2019). EEG time-frequency analysis provides arguments for arm swing support in human gait control. Gait & Posture, 70, 71-78. https://doi.org/(…)gaitpost.2019.02.017
    • Weersink, J. B., Eikelboom, C., Dominguez Vega, Z. T., Maurits, N. M., & de Jong, B. M. (2018). Forward arm extension as a cue for gait initiation in Parkinson’s patients. Movement Disorders, 33(11), 1826-1827. https://doi.org/10.1002/mds.27510

  • Long-term outcome after mild Traumatic Brain Injury in elderly (ReCONNECT study)

    Researcher: Mayra Bittencourt Villalpando, MSc (PhD student)

    Expected thesis defense: 2022

    Second promotor: Prof. dr. Joukje van der Naalt

    Funding: BCN-BRAIN

    Traumatic brain injury (TBI) is one of the most important causes of morbidity and mortality in adults. Mild TBI (mTBI) accounts for 85% of cases and 15-20% of those patients suffer from persistent complaints that interfere with resumption of daily activities. The number of elderly sustaining a TBI is increasing due to growing life expectancy and now comprises 20% of all TBI hospital admissions. The majority of TBI in the elderly is caused by a fall and related to high health care costs. Concomitant brain injury is often not reported, although repetitive head injury is related to worsening of symptoms, cognitive decline and dementia. Yet, the effect of mild TBI on cognitive and physical functioning and its relation with long-term psychosocial functioning and quality of life in elderly patients who are more vulnerable to develop persistent complaints in view of age-related cognitive decline has scarcely been investigated.

    The objectives of the ReCONNECT study are twofold:

    1) To study the relation between cognitive and physical recovery after mTBI in elderly and long-term psychosocial functioning and quality of life.

    2) To study the effect of mTBI in elderly as external stressor on the course of age-related cognitive decline and the development of persistent complaints in relation to acute and long-term brain network connectivity changes.

    References

    • Bittencourt-Villalpando, M., van der Horn, H. J., Maurits, N. M. & van der Naalt, J. (2021). Disentangling the effects of age and mild traumatic brain injury on brain network connectivity: A resting state fMRI study. NeuroImage. Clinical. 29, 14 p., 102534. https://www.sciencedirect.com/science/article/pii/S2213158220303715
    • Balart-Sánchez, S. A., Bittencourt-Villalpando, M., van der Naalt, J. & Maurits, N. M. (2021). Electroencephalography, Magnetoencephalography, and Cognitive Reserve: A Systematic Review. Archives of Clinical Neuropsychology. https://pubmed.ncbi.nlm.nih.gov/33522563/
    • Bittencourt-Villalpando, M., van der Horn, H., Liemburg, E., Maurits, N. & van der Naalt, J. (2019). Age and Gender Effects on Resting State Networks after Mild Traumatic Brain Injury, Brain Injury. 33, p. 169.
    • Bittencourt Villalpando, M. & Maurits, N. M. (2019). Linear SVM algorithm optimization for an EEG-based Brain-Computer Interface used by high functioning autism spectrum disorder participants. XV Mediterranean Conference on Medical and Biological Engineering and Computing – Medicon 2019. Springer Nature, p. 1875-1884. https://link.springer.com/chapter/10.1007/978-3-030-31635-8_228
    • Bittencourt-Villalpando, M. & Maurits, N. M. (2018). Stimuli and Feature Extraction Algorithms for Brain-Computer Interfaces: a systematic comparison.  IEEE Transactions on Neural Systems and Rehabilitation Engineering. 26, 9, p. 1669-1679. https://ieeexplore.ieee.org/document/8410884

  • Quantification of symptoms of movement disorders – towards home-based assessments

    Researcher: Zeus Tlaltecutli Dominguez Vega, MSc (PhD student) Expected thesis defense: 2021

    Copromotor: Dr. Jan Willem Elting

    Funding: Conacyt

    Topics of interest in this project are the automatic detection of tremor and myoclonus in inertial measurement unit recordings, as well as the use of machine learning methods to classify different movement disorders on the basis of features derived from such recordings.

    References

    • Dominguez-Vega, Z. T., Kramer, G., Elting, J. W. J., Tijssen, M. A. J. & Maurits, N. M. (2021). Three Days of Measurement Provide Reliable Estimates of Daily Tremor Characteristics: A Pilot Study in Organic and Functional Tremor Patients. Tremor and other hyperkinetic movements. 11(1):13. http://doi.org/10.5334/tohm.603
    • Kramer, G., Dominguez-Vega, Z. T., Laarhoven, H. S. A., Brandsma, R., Smit, M., van der Stouwe, A. M. M., Elting, J. W. J., Maurits, N. M., Rosmalen, J. G. M. & Tijssen, M. A. J. (2019) Similar association between objective and subjective symptoms in functional and organic tremor, Parkinsonism & Related Disorders. 64, p. 2-7.  https://www.sciencedirect.com/science/article/abs/pii/S1353802019302470
    • Weersink, J. B., Eikelboom, C., Dominguez Vega, Z. T., Maurits, N. M. & de Jong, B. M. (2018). Forward arm extension as a cue for gait initiation in Parkinson’s patients, Movement Disorders. 33, 11, p. 1826-1827.  https://pubmed.ncbi.nlm.nih.gov/30329182/

  • Long-term outcome after mild traumatic brain injury in elderly and its relation with changes in brain network connectivity and cognitive ageing (ReCONNECT study)

    Researcher: Sebastian Balart Sanchez, MSc (PhD student)

    Expected thesis defense: 2022

    Second promotor: Prof. dr. Joukje van der Naalt

    Funding: Conacyt – Baha Sur

    Traumatic brain injury (TBI) is one of the most important causes of morbidity and mortality in adults. Mild TBI (mTBI) accounts for 85% of cases and 15-20% of those patients suffer from persistent complaints that interfere with resumption of daily activities. The number of elderly sustaining a TBI is increasing due to growing life expectancy and now comprises 20% of all TBI hospital admissions. The majority of TBI in the elderly is caused by a fall and related to high health care costs. Concomitant brain injury is often not reported, although repetitive head injury is related to worsening of symptoms, cognitive decline and dementia. Yet, the effect of mild TBI on cognitive and physical functioning and its relation with long-term psychosocial functioning and quality of life in elderly patients who are more vulnerable to develop persistent complaints in view of age-related cognitive decline has scarcely been investigated.

    The objectives of the ReCONNECT study are twofold:

    1) To study the relation between cognitive and physical recovery after mTBI in elderly and long-term psychosocial functioning and quality of life.

    2) To study the effect of mTBI in elderly as external stressor on the course of age-related cognitive decline and the development of persistent complaints in relation to acute and long-term brain network connectivity changes.

    References

    • Balart-Sánchez, S. A., Bittencourt-Villalpando, M., van der Naalt, J. & Maurits, N. M. (2021). Electroencephalography, Magnetoencephalography, and Cognitive Reserve: A Systematic Review. Archives of Clinical Neuropsychology. https://pubmed.ncbi.nlm.nih.gov/33522563/

  • Anosognosia and neuroimaging predictors of cognitive decline in dementia

    Researcher: Jaime Mondragon Uribe, MSc (PhD student)
    Thesis defense date: September 15, 2021

    First promotor: Prof. dr. Peter-Paul De Deyn

    Funding: Conacyt

    This Ph.D. thesis titled, Anosognosia of memory deficits in dementia: biomarkers, connectivity, and clinical aspects, is an effort to shed light on a neuropsychiatric phenomenon that has both academic research, as well as clinical practice implications. Anosognosia or unawareness of memory deficits is the main topic of this Ph.D. thesis that explores the implications of this neuropsychiatric phenomenon with neuroimaging measures, specifically functional brain connectivity, as well as clinical neurology and biomarker analysis. First, the current research definitions associated with the Alzheimer’s disease (AD) continuum (i.e., the National Institute on Aging and Alzheimer’s Association 2018 AT(N) research framework classification) are put into context, followed by an introduction of brain connectivity as a biomarker of AD progression and the neural correlates of anosognosia reported in the literature as obtained from different neuroimaging techniques. After introducing the biological and neuroimaging implications of anosognosia in the AD continuum, the neural correlates of anosognosia based on the AT(N) classification are reported using data from the Alzheimer’s Disease Neuroimaging Initiative (ADNI) cohort. Finally, this thesis touches upon the clinical implications of anosognosia in end-of-life decision-making

    References

    • Mondragón, J. D., Maurits, N. M., & De Deyn, P. P. (2019). Functional Neural Correlates of Anosognosia in Mild Cognitive Impairment and Alzheimer’s Disease: a Systematic Review. Neuropsychology Review. https://doi.org/(…)7/s11065-019-09410-x

    • Alzheimer’s Disease Neuroimaging Initiative, Mondragón, J. D., Maurits, N. M. & De Deyn, P. P. (2021). Functional connectivity differences in Alzheimer’s disease and amnestic mild cognitive impairment associated with AT(N) classification and anosognosia. Neurobiology of Aging. 101, p. 22-39. https://doi.org/10.1016/j.neurobiolaging.2020.12.021

  • Specific neurophysiological markers and the use of serious gaming for diagnosing SLI and dyslexia

    Researcher: Camila Martinez Rebolledo, former PhD student

    Thesis defense: December 10, 2020

    First promotor: Prof. Ben Maassen, PhD

    Funding: Conicyt

    Children with developmental language disorder (DLD) have an increased risk of developing reading difficulties. However, the DLD group is a heterogeneous group and individual children with DLD may be present with different challenges depending on particular weaknesses. This dissertation explores the effect of comprehension difficulties on reading development in children with DLD. By using different approaches, the dissertation studies the language and reading difficulties from a behavioural perspective by testing reading and general language skills, as well as from a neurophysiological point of view, by using event-related potential recordings. Moreover, the dissertation explores the possibility to use serious video-gaming as an intervention, as well as an early diagnostic tool. The results suggest that rapid automatized naming is a suitable predictor of reading skills in second grade. Additionally, the data suggest that brain responses in kindergarten and first grade are indicators of reading skills in second grade. Finally, the results suggest that GraphoGame, a serious-videogame designed to train phonological awareness and letter-sound association, may be beneficial for training early reading skills. Also, in-game data and game progress correlate with reading fluency in second grade, which suggests that GraphoGame can be used to not only support but also diagnose, at an early stage, children who become struggling readers later on. The results add to the field of reading and special educational needs, as well as suggest possible approaches to investigate reading training and diagnosis in children, from a distance.