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Description
The efficacy of deep brain stimulation (DBS) in Parkinson's disease (PD) has been convincingly demonstrated in studies that compare motor performance with and without stimulation, but characterization of performance at intermediate stimulation amplitudes has been limited. This study investigated the effects of changing DBS amplitude in order to assess dose-response characteristics, inter-subject variability, consistency of effect across outcome measures, and day-to-day variability. Eight subjects with PD and bilateral DBS systems were evaluated at their clinically determined stimulation (CDS) and at three reduced amplitude conditions: approximately 70%, 30%, and 0% of the CDS (MOD, LOW, and OFF, respectively). Overall symptom severity and performance on a battery of motor tasks - gait, postural control, single-joint flexion-extension, postural tremor, and tapping - were assessed at each condition using the motor section of the Unified Parkinson's Disease Rating Scale (UPDRS-III) and quantitative measures. Data were analyzed to determine whether subjects demonstrated a threshold response (one decrement in stimulation resulted in ≥ 70% of the maximum change) or a graded response to reduced stimulation. Day-to-day variability was assessed using the CDS data from the three testing sessions. Although the cohort as a whole demonstrated a graded response on several measures, there was high variability across subjects, with subsets exhibiting graded, threshold, or minimal responses. Some subjects experienced greater variability in their CDS performance across the three days than the change induced by reducing stimulation. For several tasks, a subset of subjects exhibited improved performance at one or more of the reduced conditions. Reducing stimulation did not affect all subjects equally, nor did it uniformly affect each subject's performance across tasks. These results indicate that altered recruitment of neural structures can differentially affect motor capabilities and demonstrate the need for clinical consideration of the effects on multiple symptoms across several days when selecting DBS parameters.
ContributorsConovaloff, Alison (Author) / Abbas, James (Thesis advisor) / Krishnamurthi, Narayanan (Committee member) / Mahant, Padma (Committee member) / Jung, Ranu (Committee member) / Helms Tillery, Stephen (Committee member) / Arizona State University (Publisher)
Created2013
ContributorsShi, Ge (Performer) / ASU Library. Music Library (Publisher)
Created2018-03-25
ContributorsShatuho, Kristina (Performer) / ASU Library. Music Library (Publisher)
Created2018-03-27
Description
Parkinson's disease (PD) is a neurodegenerative disorder that produces a characteristic set of neuromotor deficits that sometimes includes reduced amplitude and velocity of movement. Several studies have shown that people with PD improved their motor performance when presented with external cues. Other work has demonstrated that high velocity and large amplitude exercises can increase the amplitude and velocity of movement in simple carryover tasks in the upper and lower extremities. Although the cause for these effects is not known, improvements due to cueing suggest that part of the neuromotor deficit in PD is in the integration of sensory feedback to produce motor commands. Previous studies have documented some somatosensory deficits, but only limited information is available regarding the nature and magnitude of sensorimotor deficits in the shoulder of people with PD. The goals of this research were to characterize the sensorimotor impairment in the shoulder joint of people with PD and to investigate the use of visual feedback and large amplitude/high velocity exercises to target PD-related motor deficits. Two systems were designed and developed to use visual feedback to assess the ability of participants to accurately adjust limb placement or limb movement velocity and to encourage improvements in performance of these tasks. Each system was tested on participants with PD, age-matched control subjects and young control subjects to characterize and compare limb placement and velocity control capabilities. Results demonstrated that participants with PD were less accurate at placing their limbs than age-matched or young control subjects, but that their performance improved over the course of the test session such that by the end, the participants with PD performed as well as controls. For the limb velocity feedback task, participants with PD and age-matched control subjects were less accurate than young control subjects, but at the end of the session, participants with PD and age-matched control subjects were as accurate as the young control subjects. This study demonstrates that people with PD were able to improve their movement patterns based on visual feedback of performance and suggests that this feedback paradigm may be useful in exercise programs for people with PD.
ContributorsSmith, Catherine (Author) / Abbas, James J (Thesis advisor) / Ingalls, Todd (Thesis advisor) / Krishnamurthi, Narayanan (Committee member) / Buneo, Christopher (Committee member) / Rikakis, Thanassis (Committee member) / Arizona State University (Publisher)
Created2015
Description
Parkinson's disease is a neurodegenerative condition diagnosed on patients with
clinical history and motor signs of tremor, rigidity and bradykinesia, and the estimated
number of patients living with Parkinson's disease around the world is seven
to ten million. Deep brain stimulation (DBS) provides substantial relief of the motor
signs of Parkinson's disease patients. It is an advanced surgical technique that is used
when drug therapy is no longer sufficient for Parkinson's disease patients. DBS alleviates the motor symptoms of Parkinson's disease by targeting the subthalamic nucleus using high-frequency electrical stimulation.
This work proposes a behavior recognition model for patients with Parkinson's
disease. In particular, an adaptive learning method is proposed to classify behavioral
tasks of Parkinson's disease patients using local field potential and electrocorticography
signals that are collected during DBS implantation surgeries. Unique patterns
exhibited between these signals in a matched feature space would lead to distinction
between motor and language behavioral tasks. Unique features are first extracted
from deep brain signals in the time-frequency space using the matching pursuit decomposition
algorithm. The Dirichlet process Gaussian mixture model uses the extracted
features to cluster the different behavioral signal patterns, without training or
any prior information. The performance of the method is then compared with other
machine learning methods and the advantages of each method is discussed under
different conditions.
clinical history and motor signs of tremor, rigidity and bradykinesia, and the estimated
number of patients living with Parkinson's disease around the world is seven
to ten million. Deep brain stimulation (DBS) provides substantial relief of the motor
signs of Parkinson's disease patients. It is an advanced surgical technique that is used
when drug therapy is no longer sufficient for Parkinson's disease patients. DBS alleviates the motor symptoms of Parkinson's disease by targeting the subthalamic nucleus using high-frequency electrical stimulation.
This work proposes a behavior recognition model for patients with Parkinson's
disease. In particular, an adaptive learning method is proposed to classify behavioral
tasks of Parkinson's disease patients using local field potential and electrocorticography
signals that are collected during DBS implantation surgeries. Unique patterns
exhibited between these signals in a matched feature space would lead to distinction
between motor and language behavioral tasks. Unique features are first extracted
from deep brain signals in the time-frequency space using the matching pursuit decomposition
algorithm. The Dirichlet process Gaussian mixture model uses the extracted
features to cluster the different behavioral signal patterns, without training or
any prior information. The performance of the method is then compared with other
machine learning methods and the advantages of each method is discussed under
different conditions.
ContributorsDutta, Arindam (Author) / Papandreou-Suppappola, Antonia (Thesis advisor) / Holbert, Keith E. (Committee member) / Bliss, Daniel W. (Committee member) / Arizona State University (Publisher)
Created2015
Description
Although tremor, rigidity, and bradykinesia are cardinal symptoms of Parkinson's disease (PD), impairments of gait and balance significantly affect quality of life, especially as the disease progresses, and do not respond well to anti-parkinsonism medications. Many studies have shown that people with PD can walk better when appropriate cues are presented but, to the best of our knowledge, the effects of real-time feedback of step length and uprightness of posture on gait and posture have not been specifically investigated. If it can be demonstrated that real-time feedback can improve posture and gait, the resultant knowledge could be used to design effective rehabilitation strategies to improve quality of life in this population.
In this feasibility study, we have developed a treadmill-based experimental paradigm to provide feedback of step length and upright posture in real-time. Ten subjects (mean age 65.9 ± 7.6 years) with mild to moderate PD (Hoehn and Yahr stage III or below) were evaluated in their ability to successfully utilize real-time feedback presented during quiet standing and treadmill walking tasks during a single data collection session in their medication-on state. During quiet standing tasks in which back angle feedback was provided, subjects were asked to utilize the feedback to maintain upright posture. During treadmill walking tasks, subjects walked at their self-selected speed for five minutes without feedback, with feedback of back angle, or with feedback of step length. During walking tasks with back angle feedback, subjects were asked to utilize the feedback to maintain upright posture. During walking tasks with step length feedback, subjects were asked to utilize the feedback to walk with increased step length. During quiet standing tasks, measurements of back angle were obtained; during walking tasks, measurements of back angle, step length, and step time were obtained.
Subjects stood and walked with significantly increased upright posture during the tasks with real-time back angle feedback compared to tasks without feedback. Similarly, subjects walked with significantly increased step length during tasks with real-time step length feedback compared to tasks without feedback. These results demonstrate that people with PD can utilize real-time feedback to improve upright posture and gait.
In this feasibility study, we have developed a treadmill-based experimental paradigm to provide feedback of step length and upright posture in real-time. Ten subjects (mean age 65.9 ± 7.6 years) with mild to moderate PD (Hoehn and Yahr stage III or below) were evaluated in their ability to successfully utilize real-time feedback presented during quiet standing and treadmill walking tasks during a single data collection session in their medication-on state. During quiet standing tasks in which back angle feedback was provided, subjects were asked to utilize the feedback to maintain upright posture. During treadmill walking tasks, subjects walked at their self-selected speed for five minutes without feedback, with feedback of back angle, or with feedback of step length. During walking tasks with back angle feedback, subjects were asked to utilize the feedback to maintain upright posture. During walking tasks with step length feedback, subjects were asked to utilize the feedback to walk with increased step length. During quiet standing tasks, measurements of back angle were obtained; during walking tasks, measurements of back angle, step length, and step time were obtained.
Subjects stood and walked with significantly increased upright posture during the tasks with real-time back angle feedback compared to tasks without feedback. Similarly, subjects walked with significantly increased step length during tasks with real-time step length feedback compared to tasks without feedback. These results demonstrate that people with PD can utilize real-time feedback to improve upright posture and gait.
ContributorsJellish, Jeremy (Author) / Abbas, James (Thesis advisor) / Krishnamurthi, Narayanan (Thesis advisor) / Ingalls, Todd (Committee member) / Arizona State University (Publisher)
Created2014
ContributorsCarlisi, Daniel (Performer) / ASU Library. Music Library (Publisher)
Created2018-04-07
Description
Yannis Constantinidis was the last of the handful of composers referred to collectively as the Greek National School. The members of this group strove to create a distinctive national style for Greece, founded upon a synthesis of Western compositional idioms with melodic, rhyhmic, and modal features of their local folk traditions. Constantinidis particularly looked to the folk melodies of his native Asia Minor and the nearby Dodecanese Islands. His musical output includes operettas, musical comedies, orchestral works, chamber and vocal music, and much piano music, all of which draws upon folk repertories for thematic material. The present essay examines how he incorporates this thematic material in his piano compositions, written between 1943 and 1971, with a special focus on the 22 Songs and Dances from the Dodecanese. In general, Constantinidis's pianistic style is expressed through miniature pieces in which the folk tunes are presented mostly intact, but embedded in accompaniment based in early twentieth-century modal harmony. Following the dictates of the founding members of the Greek National School, Manolis Kalomiris and Georgios Lambelet, the modal basis of his harmonic vocabulary is firmly rooted in the characteristics of the most common modes of Greek folk music. A close study of his 22 Songs and Dances from the Dodecanese not only offers a valuable insight into his harmonic imagination, but also demonstrates how he subtly adapts his source melodies. This work also reveals his care in creating a musical expression of the words of the original folk songs, even in purely instrumental compositon.
ContributorsSavvidou, Dina (Author) / Hamilton, Robert (Thesis advisor) / Little, Bliss (Committee member) / Meir, Baruch (Committee member) / Thompson, Janice M (Committee member) / Arizona State University (Publisher)
Created2011
Description
This paper describes six representative works by twentieth-century Chinese composers: Jian-Zhong Wang, Er-Yao Lin, Yi-Qiang Sun, Pei-Xun Chen, Ying-Hai Li, and Yi Chen, which are recorded by the author on the CD. The six pieces selected for the CD all exemplify traits of Nationalism, with or without Western influences. Of the six works on the CD, two are transcriptions of the Han Chinese folk-like songs, one is a composition in the style of the Uyghur folk music, two are transcriptions of traditional Chinese instrumental music dating back to the eighteenth century, and one is an original composition in a contemporary style using folk materials. Two of the composers, who studied in the United States, were strongly influenced by Western compositional style. The other four, who did not study abroad, retained traditional Chinese style in their compositions. The pianistic level of difficulty in these six pieces varies from intermediate to advanced level. This paper includes biographical information for the six composers, background information on the compositions, and a brief analysis of each work. The author was exposed to these six pieces growing up, always believing that they are beautiful and deserve to be appreciated. When the author came to the United States for her studies, she realized that Chinese compositions, including these six pieces, were not sufficiently known to her peers. This recording and paper are offered in the hopes of promoting a wider familiarity with Chinese music and culture.
ContributorsLuo, Yali, D.M.A (Author) / Hamilton, Robert (Thesis advisor) / Campbell, Andrew (Committee member) / Pagano, Caio (Committee member) / Cosand, Walter (Committee member) / Rogers, Rodney (Committee member) / Arizona State University (Publisher)
Created2012
Description
The purpose of this project was to examine the lives and solo piano works of four members of the early generation of female composers in Taiwan. These four women were born between 1950 and 1960, began to appear on the Taiwanese musical scene after 1980, and were still active as composers at the time of this study. They include Fan-Ling Su (b. 1955), Hwei-Lee Chang (b. 1956), Shyh-Ji Pan-Chew (b. 1957), and Kwang-I Ying (b. 1960). Detailed biographical information on the four composers is presented and discussed. In addition, the musical form and features of all solo piano works at all levels by the four composers are analyzed, and the musical characteristics of each composer's work are discussed. The biography of a fifth composer, Wei-Ho Dai (b. 1950), is also discussed but is placed in the Appendices because her piano music could not be located. This research paper is presented in six chapters: (1) Prologue; the life and music of (2) Fan-Ling Su, (3) Hwei-Lee Chang, (4) Shyh-Ji Pan-Chew, and (5) Kwang-I Ying; and (6) Conclusion. The Prologue provides an overview of the development of Western classical music in Taiwan, a review of extant literature on the selected composers and their music, and the development of piano music in Taiwan. The Conclusion is comprised of comparisons of the four composers' music, including their personal interests and preferences as exhibited in their music. For example, all of the composers have used atonality in their music. Two of the composers, Fan-Ling Su and Kwang-I Ying, openly apply Chinese elements in their piano works, while Hwei-Lee Chang tries to avoid direct use of the Chinese pentatonic scale. The piano works of Hwei-Lee Chang and Shyh-Ji Pan-Chew are chromatic and atonal, and show an economical usage of material. Biographical information on Wei-Ho Dai and an overview of Taiwanese history are presented in the Appendices.
ContributorsWang, Jinding (Author) / Pagano, Caio (Thesis advisor) / Campbell, Andrew (Committee member) / Humphreys, Jere T. (Committee member) / Meyer-Thompson, Janice (Committee member) / Norton, Kay (Committee member) / Arizona State University (Publisher)
Created2011