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- All Subjects: Biomedical Engineering
- Genre: Academic theses
- Creators: Buneo, Christopher
- Creators: Abbas, James
- Creators: Towe, Bruce
Description
Transcranial electrical stimulation (tES) is a non-invasive brain stimulation therapy that has shown potential in improving motor, physiological and cognitive functions in healthy and diseased population. Typical tES procedures involve application of weak current (< 2 mA) to the brain via a pair of large electrodes placed on the scalp. While the therapeutic benefits of tES are promising, the efficacy of tES treatments is limited by the knowledge of how current travels in the brain. It has been assumed that the current density and electric fields are the largest, and thus have the most effect, in brain structures nearby the electrodes. Recent studies using finite element modeling (FEM) have suggested that current patterns in the brain are diffuse and not concentrated in any particular brain structure. Although current flow modeling is useful means of informing tES target optimization, few studies have validated tES FEM models against experimental measurements. MREIT-CDI can be used to recover magnetic flux density caused by current flow in a conducting object. This dissertation reports the first comparisons between experimental data from in-vivo human MREIT-CDI during tES and results from tES FEM using head models derived from the same subjects. First, tES FEM pipelines were verified by confirming FEM predictions agreed with analytic results at the mesh sizes used and that a sufficiently large head extent was modeled to approximate results on human subjects. Second, models were used to predict magnetic flux density, and predicted and MREIT-CDI results were compared to validate and refine modeling outcomes. Finally, models were used to investigate inter-subject variability and biological side effects reported by tES subjects. The study demonstrated good agreements in patterns between magnetic flux distributions from experimental and simulation data. However, the discrepancy in scales between simulation and experimental data suggested that tissue conductivities typically used in tES FEM might be incorrect, and thus performing in-vivo conductivity measurements in humans is desirable. Overall, in-vivo MREIT-CDI in human heads has been established as a validation tool for tES predictions and to study the underlying mechanisms of tES therapies.
ContributorsIndahlastari, Aprinda (Author) / Sadleir, Rosalind J (Thesis advisor) / Abbas, James (Committee member) / Frakes, David (Committee member) / Kleim, Jeffrey (Committee member) / Kodibagkar, Vikram (Committee member) / Arizona State University (Publisher)
Created2017
Description
Progressive gait disorder in Parkinson's disease (PD) is usually exhibited as reduced step/stride length and gait speed. People with PD also exhibit stooped posture, which can contribute to reduced step length and arm swing. Since gait and posture deficits in people with PD do not respond well to pharmaceutical and surgical treatments, novel rehabilitative therapies to alleviate these impairments are necessary. Many studies have confirmed that people with PD can improve their walking patterns when external cues are presented. Only a few studies have provided explicit real-time feedback on performance, but they did not report how well people with PD can follow the cues on a step-by-step basis. In a single-session study using a novel-treadmill based paradigm, our group had previously demonstrated that people with PD could follow step-length and back angle feedback and improve their gait and posture during treadmill walking. This study investigated whether a long-term (6-week, 3 sessions/week) real-time feedback training (RTFT) program can improve overground gait, upright posture, balance, and quality of life. Three subjects (mean age 70 ± 2 years) with mild to moderate PD (Hoehn and Yahr stage III or below) were enrolled and participated in the program. The RTFT sessions involved walking on a treadmill while following visual feedback of step length and posture (one at any given time) displayed on a monitor placed in front of the subject at eye-level. The target step length was set between 110-120% of the step length obtained during a baseline non-feedback walking trial and the target back angle was set at the maximum upright posture exhibited during a quiet standing task. Two subjects were found to significantly improve their posture and overground walking at post-training and these changes were retained six weeks after RTFT (follow-up) and the third subject improved his upright posture and gait rhythmicity. Furthermore, the magnitude of the improvements observed in these subjects was greater than the improvements observed in reports on other neuromotor interventions. These results provide preliminary evidence that real-time feedback training can be used as an effective rehabilitative strategy to improve gait and upright posture in people with PD.
ContributorsBaskaran, Deepika (Author) / Krishnamurthi, Narayanan (Thesis advisor) / Abbas, James (Thesis advisor) / Honeycutt, Claire (Committee member) / Arizona State University (Publisher)
Created2017
Description
Lower-limb prosthesis users have commonly-recognized deficits in gait and posture control. However, existing methods in balance and mobility analysis fail to provide sufficient sensitivity to detect changes in prosthesis users' postural control and mobility in response to clinical intervention or experimental manipulations and often fail to detect differences between prosthesis users and non-amputee control subjects. This lack of sensitivity limits the ability of clinicians to make informed clinical decisions and presents challenges with insurance reimbursement for comprehensive clinical care and advanced prosthetic devices. These issues have directly impacted clinical care by restricting device options, increasing financial burden on clinics, and limiting support for research and development. This work aims to establish experimental methods and outcome measures that are more sensitive than traditional methods to balance and mobility changes in prosthesis users. Methods and analysis techniques were developed to probe aspects of balance and mobility control that may be specifically impacted by use of a prosthesis and present challenges similar to those experienced in daily life that could improve the detection of balance and mobility changes. Using the framework of cognitive resource allocation and dual-tasking, this work identified unique characteristics of prosthesis users’ postural control and developed sensitive measures of gait variability. The results also provide broader insight into dual-task analysis and the motor-cognitive response to demanding conditions. Specifically, this work identified altered motor behavior in prosthesis users and high cognitive demand of using a prosthesis. The residual standard deviation method was developed and demonstrated to be more effective than traditional gait variability measures at detecting the impact of dual-tasking. Additionally, spectral analysis of the center of pressure while standing identified altered somatosensory control in prosthesis users. These findings provide a new understanding of prosthetic use and new, highly sensitive techniques to assess balance and mobility in prosthesis users.
ContributorsHoward, Charla Lindley (Author) / Abbas, James (Thesis advisor) / Buneo, Christopher (Committee member) / Lynskey, Jim (Committee member) / Santello, Marco (Committee member) / Artemiadis, Panagiotis (Committee member) / Arizona State University (Publisher)
Created2017
Description
This dissertation aimed to evaluate the effectiveness and drawbacks of promising fall prevention strategies in individuals with stroke by rigorously analyzing the biomechanics of laboratory falls and compensatory movements required to prevent a fall. Ankle-foot-orthoses (AFOs) and functional electrical stimulators (FESs) are commonly prescribed to treat foot drop. Despite well-established positive impacts of AFOs and FES devices on balance and gait, AFO and FES users fall at a high rate. In chapter 2 (as a preliminary study), solely mechanical impacts of a semi-rigid AFO on the compensatory stepping response of young healthy individuals following trip-like treadmill perturbations were evaluated. It was found that a semi-rigid AFO on the stepping leg diminished the propulsive impulse of the compensatory step which led to decreased trunk movement control, shorter step length, and reduced center of mass (COM) stability. These results highlight the critical role of plantarflexors in generating an effective compensatory stepping response. In chapter 3, the underlying biomechanical mechanisms leading to high fall risk in long-term AFO and FES users with chronic stroke were studied. It was found that AFO and FES users fall more than Non-users because they have a more impaired lower limb that is not fully addressed by AFO/FES, therefore leading to a more impaired compensatory stepping response characterized by increased inability to generate a compensatory step with paretic leg and decreased trunk movement control. An ideal future AFO that provides dorsiflexion assistance during the swing phase and plantarflexion assistance during the push-off phase of gait is suggested to enhance the compensatory stepping response and reduce more falls. In chapter 4, the effects of a single-session trip-specific training on the compensatory stepping response of individuals with stroke were evaluated. Trunk movement control was improved after a single session of training suggesting that this type of training is a viable option to enhance compensatory stepping response and reduce falls in individuals with stroke. Finally, a future powered AFO with plantarflexion assistance complemented by a trip-specific training program is suggested to enhance the compensatory stepping response and decrease falls in individuals with stroke.
ContributorsNevisipour, Masood (Author) / Honeycutt, Claire (Thesis advisor) / Sugar, Thomas (Thesis advisor) / Artemiadis, Panagiotis (Committee member) / Abbas, James (Committee member) / Lee, Hyunglae (Committee member) / Arizona State University (Publisher)
Created2019
Description
Previously accomplished research examined sensory integration between upper limb proprioception and tactile sensation. The active proprioceptive-tactile relationship points towards an opportunity to examine neuromodulation effects on sensory integration with respect to proprioceptive error magnitude and direction. Efforts to improve focus and attention during upper limb proprioceptive tasks results in a decrease of proprioceptive error magnitudes and greater endpoint accuracy. Increased focus and attention can also be correlated to neurophysiological activity in the Locus Coeruleus (LC) during a variety of mental tasks. Through non-invasive trigeminal nerve stimulation, it may be possible to affect the activity of the LC and induce improvements in arousal and attention that would assist in proprioceptive estimation. The trigeminal nerve projects to the LC through the mesencephalic nucleus of the trigeminal complex, providing a pathway similar to the effects seen from vagus nerve stimulation. In this experiment, the effect of trigeminal nerve stimulation (TNS) on proprioceptive ability is evaluated by the proprioceptive estimation error magnitude and direction, while LC activation via autonomic pathways is indirectly measured using pupil diameter, pupil recovery time, and pupil velocity. TNS decreases proprioceptive error magnitude in 59% of subjects, while having no measurable impact on proprioceptive strategy. Autonomic nervous system changes were observed in 88% of subjects, with mostly parasympathetic activation and a mixed sympathetic effect.
ContributorsOrthlieb, Gerrit Chi Luk (Author) / Helms-Tillery, Stephen (Thesis advisor) / Tanner, Justin (Committee member) / Buneo, Christopher (Committee member) / Arizona State University (Publisher)
Created2019
Description
Between 20%-30% of stroke survivors have foot drop. Foot drop is characterized by inadequate dorsiflexion required to clear the foot of the ground during the swing phase of gait, increasing the risk of stumbles and falls (Pouwels et al. 2009; Hartholt et al. 2011). External postural perturbations such as trips and slips are associated with high rate of falls in individuals with stroke (Forster et al. 1995). Falls often results in head, hip, and wrist injuries (Hedlund et al 1987; Parkkari et al. 1999). A critical response necessary to recover one’s balance and prevent a fall is the ability to evoke a compensatory step (Maki et al. 2003; Mansfield et al. 2013). This is the step taken to restore one’s balance and prevent a fall. However, this is difficult for stroke survivors with foot drop as normal gait is impaired and this translates to difficulty in evoking a compensatory step. To address both foot drop and poor compensatory stepping response, assistive devices such as the ankle-foot-orthosis (AFO) and functional electrical stimulator (FES) are generally prescribed to stroke survivors (Kluding et al. 2013; S. Whiteside et al. 2015). The use of these assistive devices improves walking speed, foot clearance, cadence, and step length of its users (Bethoux et al. 2014; Abe et al. 2009; Everaert et al. 2013; Alam et al. 2014). However, their impact on fall outcome in individuals with stroke in not well evaluated (Weerdesteyn et al. 2008). A recent study (Masood Nevisipour et al. 2019) where stroke survivors experienced a forward treadmill perturbation, mimicking a trip, reports that the impaired compensatory stepping response in stroke survivors in not due to the use of the assistive devices but to severe ankle impairments which these devices do not fully address. However, falls can also occur because of a slip. Slips constitute 40% of outdoor falls (Luukinen et al. 2000). In this study, results for fall rate and compensatory stepping response when subjects experience backward perturbations, mimicking slips, reveal that these devices do not impair the compensatory stepping response of its users.
ContributorsAnnan, Theophilus (Author) / Honeycutt, Claire (Thesis advisor) / Abbas, James (Committee member) / Peterson, Daniel (Committee member) / Arizona State University (Publisher)
Created2021
Description
Motor skill learning is important to rehabilitation, sports, and many occupations. When attempting to learn or adapt a motor skill, some individuals learn slower or less compared to others despite the same amount of motor practice. This dissertation aims to understand the factors that contributed to such variability in motor learning, and thereby identify viable methods to enhance motor learning. Behavioral evidence from our lab showed that visuospatial ability is positively related to the extent of motor learning. Neuroimaging studies suggest that motor learning and visuospatial processes share common frontoparietal neural structures, and that this visuospatial-motor relationship may be more pronounced in the right hemisphere compared to the left. Thus, the overall objective of this dissertation is to determine if aspects of motor learning (such as the rate and extent of skill acquisition) may be modifiable through neuromodulation of the right frontoparietal network. In Aim 1, anodal transcranial direct current stimulation (tDCS) was used to test whether modulating the right parietal area affects visuospatial ability and motor skill acquisition. A randomized, three-arm design was used, which added a no-tDCS control group to the double-blinded sham-control protocol to address placebo effects. No tDCS treatment effect was observed, likely due to low statistical power to detect any treatment effects as the study is still ongoing. However, the current results revealed a unique finding that the placebo effect of tDCS was stronger than its treatment effect on motor learning, with implications that tDCS and motor studies should measure and control for placebo effects.
In Aim 2, right frontoparietal connectivity during resting-state EEG was estimated via alpha band imaginary coherence to test whether it correlated with visuospatial performance and motor skill acquisition. As a preliminary step towards leveraging the frontoparietal network for EEG-neurofeedback applications, this work found that alpha imaginary coherence was positively correlated with visuospatial function, but not with motor skill acquisition during a limited dose of motor practice (only 5 trials). This work establishes a premise for developing frontoparietal alpha IC-based neurofeedback for cognitive training in rehabilitation, while warranting future studies to test the relationship between alpha IC and motor learning with a more extensive motor training regimen.
ContributorsWang, Peiyuan (Author) / Schaefer, Sydney Y (Thesis advisor) / Buneo, Christopher A (Committee member) / Abbas, James (Committee member) / Lohse, Keith R (Committee member) / Wyckoff, Sarah N (Committee member) / Arizona State University (Publisher)
Created2021
Description
The use of a non-invasive form of energy to modulate neural structures has gained wide spread attention because of its ability to remotely control neural excitation. This study investigates the ability of focused high frequency ultrasound to modulate the excitability the peripheral nerve of an amphibian. A 5MHz ultrasound transducer is used for the study with the pulse characteristics of 57msec long train burst and duty cycle of 8% followed by an interrogative electrical stimulus varying from 30μsecs to 2msecs in pulse duration. The nerve excitability is determined by the compound action potential (CAP) amplitude evoked by a constant electrical stimulus. We observe that ultrasound's immediate effect on axons is to reduce the electrically evoked CAP amplitude and thereby suppressive in effect. However, a subsequent time delayed increased excitability was observed as reflected in the CAP amplitude of the nerve several tens of milliseconds later. This subsequent change from ultrasound induced nerve inhibition to increased excitability as a function of delay from ultrasound pulse application is unexpected and not predicted by typical nerve ion channel kinetic models. The recruitment curve of the sciatic nerve modified by ultrasound suggests the possibility of a fiber specific response where the ultrasound inhibits the faster fibers more than the slower ones. Also, changes in the shape of the CAP waveform when the nerve is under the inhibitive effect of ultrasound was observed. It is postulated that these effects can be a result of activation of stretch activation channels, mechanical sensitivity of the nerve to acoustic radiation pressure and modulation of ion channels by ultrasound.
The neuromodulatory capabilities of ultrasound in tandem with electrical stimulation has a significant potential for development of neural interfaces to peripheral nerve.
The neuromodulatory capabilities of ultrasound in tandem with electrical stimulation has a significant potential for development of neural interfaces to peripheral nerve.
ContributorsChirania, Sanchit (Author) / Towe, Bruce (Thesis advisor) / Abbas, James (Committee member) / Muthuswamy, Jitendran (Committee member) / Arizona State University (Publisher)
Created2016