BM402: Engineering in Medicine PDF

BM402: ENGINEERING IN MEDICINE 14th Nov 2024 M 2170 – South Campus Neurofeedback Rehab Engineering Case Study Physiology, emotions and brain Emotions can have a significant impact on our physiological responses, including our heart rate and respiratory rate....

BM402: ENGINEERING IN MEDICINE 14th Nov 2024 M 2170 – South Campus Neurofeedback Rehab Engineering Case Study Physiology, emotions and brain Emotions can have a significant impact on our physiological responses, including our heart rate and respiratory rate. Fear, anger, anxiety - release of adrenaline and other stress hormones - increase in heart rate - rapid breathing. Happiness - releases endorphins - decrease in heart rate Brain structures involved in dealing with stress and fear. - shallower breathing Happiness and fMRI - The studies found that recalling happy events activates various areas including the anterior cingulate cortex, prefrontal cortex, and insula. - These areas are also associated with other basic emotions such as sadness and anger. Suardi et al. 2016 Happiness and fMRI fMRI - Neurofeedback Real-time fMRI (rtfMRI): - fMRI data processing and display are performed at a speed that makes them consequent with image acquisition. - enabled real-time neurofeedback - allows a person to watch and regulate the fMRI signal from his or her own brain. fMRI - Neurofeedback - provides real-time feedback about brain activity to a person, with the goal of helping them learn to regulate their brain function. - a person undergoing neurofeedback training may be monitored with fMRI to identify which brain regions are involved in the process of learning to regulate brain activity. Reading – 15 minutes Neurofeedback - A type of biofeedback that teaches self-regulation of brain activity. - Focused on enhancing cognitive functions or managing conditions (e.g., ADHD, anxiety). - Provides real-time brain activity data to help users adjust their mental state. Brain-Computer Interface (BCI) - A system that enables direct communication between the brain and external devices. - Allows users to control devices (e.g., prosthetics, computers) using thought. - Translates brain signals into commands for devices, without a primary focus on self-regulation. Common Tools: Both use EEG and signal processing techniques. Relationship: Neurofeedback is a specialized application of BCI technology, but their intents and interactions differ. Neurofeedback (NFB) NFB is an operant conditioning technique for learning how to control one’s brain activity to improve cognitive performance, regulate stress levels, emotional functioning and behavior. Neurofeedback (NFB) NFB is an operant conditioning technique for learning how to control one’s brain activity to improve cognitive performance, regulate stress levels, emotional functioning and behavior. Neurofeedback (NFB) NFB is an operant conditioning technique for learning how to control one’s brain activity to improve cognitive performance, regulate stress levels, emotional functioning and behavior. Happiness and fMRI fMRI - Neurofeedback & Happiness Happy Memories condition: - the word ‘‘Happy’’, two color bars, and a number indicating the neurofeedback fMRI signal level were displayed on the screen. - participants were instructed to evoke happy autobiographical memories to make themselves feel happy while trying to increase the level of the red bar to a given target level (indicated by the fixed height blue bar). Happiness and fMRI Fronto-temporo-limbic network - Important for the regulation of emotions, decision-making, and social cognition. - The fronto-temporo-limbic network is a functional network of brain regions that are involved in emotional processing, memory, and attention. - It includes the prefrontal cortex, anterior cingulate cortex, amygdala, hippocampus, insula. - Dysregulation of this network has been Activation Network for Happy Memories and Count Conditions. The implicated in various psychiatric group activation analysis for Happy>Count contrast revealed disorders, such as depression, anxiety, significant BOLD signal changes in a fronto-temporo-limbic network, and post-traumatic stress disorder. while the Count>Happy contrast revealed activations in a parietal network. EEG & Neurofeedback (NFB) EEG & Neurofeedback Neurofeedback as a Rehabilitation Tool Neurofeedback, e.g., EEG biofeedback, is a technique that uses real-time monitoring of brain activity (usually through EEG - Electroencephalography) to help individuals learn to self-regulate their brain function. This process can be valuable in rehabilitation, particularly for patients recovering from neurological conditions, injuries, or disorders that affect brain function. - - a non-invasive method of promoting neural plasticity - - important for people recovering from neurological injuries (e.g., stroke, traumatic brain injury, spinal cord injury) or neurological conditions (e.g., ADHD, anxiety, depression, epilepsy). Neurofeedback as a Rehabilitation Tool Neurofeedback as a Rehabilitation Tool - Stroke Rehabilitation - Traumatic Brain Injury (TBI) Recovery - Cognitive Rehabilitation (memory, attention) - Pain Management and Stress Reduction - - Integration with VR, Robotics Neurofeedback as a Rehabilitation Tool - Memory Training: Specific neurofeedback protocols can be designed to improve working memory or long-term memory. For example, theta/beta ratio training has been shown to be effective in conditions like ADHD, which often coexists with cognitive dysfunction. - Attention and Focus: In conditions like ADHD or after brain injuries (where attention and focus are often impaired), neurofeedback can train the brain to increase focus and attention by increasing the power of specific brainwave frequencies (like beta waves). Reading – 15 mins Rehabilitation Engineering  Case Study: Engineering Solutions for Traumatic Brain Injury (TBI) Rehabilitation – Focus on Brainstem Damage Recovery Traumatic Brain Injury (TBI) is a major cause of long-term Patient Profile: disability, particularly when damage occurs to the brainstem. Age: 35 Cause of Injury: Motor vehicle accident We know that brainstem is responsible for regulating Symptoms: Severe motor impairment, respiratory essential life functions such as breathing, heart rate, and difficulties, and swallowing problems. Initially, the patient consciousness. was in a coma and then progressed to a minimally conscious state. The patient suffered significant Injuries to this critical area can lead to profound impairments, brainstem damage, resulting in partial paralysis (locked-in including motor dysfunction, respiratory problems, and syndrome) and difficulty with vital functions like difficulty swallowing. breathing and swallowing.  Case Study: Engineering Solutions for Traumatic Brain Injury (TBI) Rehabilitation – Focus on Brainstem Damage Recovery Rehabilitation Strategies and Engineering Treatment Timeline: Solutions: Acute Phase (0-6 weeks): Immediate medical In class assignment based on 3 rehabs (1 given) intervention to stabilize the brain injury. The patient patient needs: was placed on a ventilator to assist with breathing, - Brainstorm on challenge, solution, outcome and a feeding tube was used for nutrition. - Work in groups (2-3 p.) Rehabilitation Phase (6 weeks - 6 months): - 30 minutes Introduction of physical, occupational, and speech therapy to address motor, respiratory, and swallowing 1. Speech and Swallowing Rehabilitation difficulties. Use of engineering solutions to promote 2. XX Rehabilitation neuroplasticity and recovery of lost functions. 3. YY Rehabilitation - Group presentations X-ray An X-ray, also called a radiograph, sends radiation through the body. Areas with high levels of calcium (bones and teeth) block the radiation, causing them to appear white on the image. Soft tissues allow the radiation to pass through. They appear gray or black on the image. Fractures Dislocations Misalignments Narrowed joint spaces X-ray An X-ray won’t show subtle bone injuries, soft tissue injuries or inflammation. Portrait of Wilhelm Conrad Röntgen. The electromagnetic spectrum. X-rays have higher energy than visible light. What injuries require an X-ray? An X-ray won’t show soft tissue injuries or inflammation. Broken arm The electromagnetic spectrum. X-rays have higher energy than visible light. What injuries require an X-ray? An X-ray won’t show soft tissue injuries or inflammation. Broken arm Detects bone fractures, certain tumors and other abnormal masses, pneumonia, some types of injuries, calcifications, foreign objects, or dental problems. The electromagnetic spectrum. X-rays have higher energy than visible light. What injuries require an X-ray? An X-ray won’t show soft tissue injuries or inflammation. Broken arm For example, our bones contain calcium, which has a higher atomic number than most other tissues. Because of this property, bones readily absorb x-rays and therefore produce high contrast on the x-ray detector. As a result, bony structures appear whiter than other tissues against the black background of a radiograph. Detects bone fractures, certain tumors and other abnormal masses, pneumonia, some types of injuries, Conversely, x-rays travel more easily through less radiologically dense calcifications, foreign objects, or dental problems. tissues, such as air-filled cavities such as the lungs. These structures are displayed in shades of gray on a radiograph When are medical x-rays used? Detects bone fractures, certain tumors and other abnormal masses, Broken arm X-ray radiography pneumonia, some types of injuries, calcifications, foreign objects, or dental problems. A mammogram is a radiograph of the breast Mammography used to detect and diagnose breast cancer. Tumors typically appear as masses, either regular or irregular in shape, and are brighter than the surrounding tissue on the image (whiter on a black background or blacker on a white background). Mammograms can also identify small calcium deposits, called microcalcifications, which appear as bright specks on the image When are medical x-rays used? Computed tomography (CT): Combines traditional x-ray technology with computer processing to generate a series of cross-sectional images of the body that can later be combined to form a three- dimensional x-ray image. CT images are more detailed than plain radiographs and give doctors the ability to view structures within the body from different angles. When are medical x-rays used? Here are the steps for CT image formation: 1. X-ray Source and Detector Rotation: The X-ray tube and detectors rotate around the patient. 2. X-ray Attenuation: Different tissues absorb X-rays at varying degrees. 3.Data Collection Detectors capture X-rays passing through the body from multiple angles. 4. Reconstruction: The computer processes the data and reconstructs cross-sectional slices using algorithms, such as filtered back projection, and iterative recon. 5. Image Display: The reconstructed images are displayed on a monitor, with contrast and brightness adjusted. When are medical x-rays used? Basal ganglia calcification Here are the steps for CT image formation: 1. X-ray Source and Detector Rotation: The X-ray tube and detectors rotate around the patient. 2. X-ray Attenuation: Different tissues absorb X-rays at varying degrees. 3.Data Collection Detectors capture X-rays passing through the body from multiple angles. 4. Reconstruction: The computer processes the data and reconstructs cross-sectional slices using algorithms, such as filtered back projection, and iterative recon. Normal intracranial calcifications can be defined as all age-related physiologic and neurodegenerative 5. Image Display: The reconstructed images are calcifications that are unaccompanied by any evidence of displayed on a monitor, with contrast and disease and have no demonstrable pathological cause. brightness adjusted. CT recon steps Basal ganglia calcification 1. The Basics of CT Scanning 2. Raw Data Collection 3. Back Projection (The Basic Idea) 4. Filtered Back Projection 5. Iterative Reconstruction (A More Advanced Method) 6. Converting Slices into a 3D Image Normal intracranial calcifications can be defined as all age-related physiologic and neurodegenerative calcifications that are unaccompanied by any evidence of disease and have no demonstrable pathological cause. CT recon steps Basal ganglia calcification Filtered Back Projection (FBP) is based on two main mathematical operations: Fourier transforms and convolution. - A Fourier transform is a mathematical operation that converts data from the spatial domain (like an image) into the frequency domain. In the frequency domain, data is represented as a combination of different frequencies. - For FBP, the Fourier transform is applied to each Normal intracranial calcifications can be defined as all projection to decompose it into its frequency age-related physiologic and neurodegenerative components. This helps us see which frequencies are calcifications that are unaccompanied by any evidence of disease and have no demonstrable pathological cause. present in the data and is useful for filtering out unwanted noise and enhancing edges.