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The use of bias indicators in psychological measurement has been contentious, with some researchers questioning whether they actually suppress or moderate the ability of substantive psychological indictors to discriminate (McGrath, Mitchell, Kim, & Hough, 2010). Bias indicators on the MMPI-2-RF (F-r, Fs, FBS-r, K-r, and L-r) were tested for suppression

The use of bias indicators in psychological measurement has been contentious, with some researchers questioning whether they actually suppress or moderate the ability of substantive psychological indictors to discriminate (McGrath, Mitchell, Kim, & Hough, 2010). Bias indicators on the MMPI-2-RF (F-r, Fs, FBS-r, K-r, and L-r) were tested for suppression or moderation of the ability of the RC1 and NUC scales to discriminate between Epileptic Seizures (ES) and Non-epileptic Seizures (NES, a conversion disorder that is often misdiagnosed as ES). RC1 and NUC had previously been found to be the best scales on the MMPI-2-RF to differentiate between ES and NES, with optimal cut scores occurring at a cut score of 65 for RC1 (classification rate of 68%) and 85 for NUC (classification rate of 64%; Locke et al., 2010). The MMPI-2-RF was completed by 429 inpatients on the Epilepsy Monitoring Unit (EMU) at the Scottsdale Mayo Clinic Hospital, all of whom had confirmed diagnoses of ES or NES. Moderated logistic regression was used to test for moderation and logistic regression was used to test for suppression. Classification rates of RC1 and NUC were calculated at different bias level indicators to evaluate clinical utility for diagnosticians. No moderation was found. Suppression was found for F-r, Fs, K-r, and L-r with RC1, and for all variables with NUC. For F-r and Fs, the optimal RC1 and NUC cut scores increased at higher levels of bias, but tended to decrease at higher levels of K-r, L-r, and FBS-r. K-r provided the greatest suppression for RC1, as well as the greatest increases in classification rates at optimal cut scores, given different levels of bias. It was concluded that, consistent with expectations, taking account of bias indicator suppression on the MMPI-2-RF can improve discrimination of ES and NES. At higher levels of negative impression management, higher cut scores on substantive scales are needed to attain optimal discrimination, whereas at higher levels of positive impression management and FBS-r, lower cut scores are needed. Using these new cut scores resulted in modest improvements in accuracy in discrimination. These findings are consistent with prior research in showing the efficacy of bias indicators, and extend the findings to a psycho-medical context.
ContributorsWershba, Rebecca E (Author) / Lanyon, Richard I (Thesis advisor) / Barrera, Manuel (Committee member) / Karoly, Paul (Committee member) / Millsap, Roger E (Committee member) / Arizona State University (Publisher)
Created2013
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Description
Interictal spikes, together with seizures, have been recognized as the two hallmarks of epilepsy, a brain disorder that 1% of the world's population suffers from. Even though the presence of spikes in brain's electromagnetic activity has diagnostic value, their dynamics are still elusive. It was an objective of this dissertation

Interictal spikes, together with seizures, have been recognized as the two hallmarks of epilepsy, a brain disorder that 1% of the world's population suffers from. Even though the presence of spikes in brain's electromagnetic activity has diagnostic value, their dynamics are still elusive. It was an objective of this dissertation to formulate a mathematical framework within which the dynamics of interictal spikes could be thoroughly investigated. A new epileptic spike detection algorithm was developed by employing data adaptive morphological filters. The performance of the spike detection algorithm was favorably compared with others in the literature. A novel spike spatial synchronization measure was developed and tested on coupled spiking neuron models. Application of this measure to individual epileptic spikes in EEG from patients with temporal lobe epilepsy revealed long-term trends of increase in synchronization between pairs of brain sites before seizures and desynchronization after seizures, in the same patient as well as across patients, thus supporting the hypothesis that seizures may occur to break (reset) the abnormal spike synchronization in the brain network. Furthermore, based on these results, a separate spatial analysis of spike rates was conducted that shed light onto conflicting results in the literature about variability of spike rate before and after seizure. The ability to automatically classify seizures into clinical and subclinical was a result of the above findings. A novel method for epileptogenic focus localization from interictal periods based on spike occurrences was also devised, combining concepts from graph theory, like eigenvector centrality, and the developed spike synchronization measure, and tested very favorably against the utilized gold rule in clinical practice for focus localization from seizures onset. Finally, in another application of resetting of brain dynamics at seizures, it was shown that it is possible to differentiate with a high accuracy between patients with epileptic seizures (ES) and patients with psychogenic nonepileptic seizures (PNES). The above studies of spike dynamics have elucidated many unknown aspects of ictogenesis and it is expected to significantly contribute to further understanding of the basic mechanisms that lead to seizures, the diagnosis and treatment of epilepsy.
ContributorsKrishnan, Balu (Author) / Iasemidis, Leonidas (Thesis advisor) / Tsakalis, Kostantinos (Committee member) / Spanias, Andreas (Committee member) / Si, Jennie (Committee member) / Arizona State University (Publisher)
Created2012
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Description
From time immemorial, epilepsy has persisted to be one of the greatest impediments to human life for those stricken by it. As the fourth most common neurological disorder, epilepsy causes paroxysmal electrical discharges in the brain that manifest as seizures. Seizures have the effect of debilitating patients on a physical

From time immemorial, epilepsy has persisted to be one of the greatest impediments to human life for those stricken by it. As the fourth most common neurological disorder, epilepsy causes paroxysmal electrical discharges in the brain that manifest as seizures. Seizures have the effect of debilitating patients on a physical and psychological level. Although not lethal by themselves, they can bring about total disruption in consciousness which can, in hazardous conditions, lead to fatality. Roughly 1\% of the world population suffer from epilepsy and another 30 to 50 new cases per 100,000 increase the number of affected annually. Controlling seizures in epileptic patients has therefore become a great medical and, in recent years, engineering challenge.



In this study, the conditions of human seizures are recreated in an animal model of temporal lobe epilepsy. The rodents used in this study are chemically induced to become chronically epileptic. Their Electroencephalogram (EEG) data is then recorded and analyzed to detect and predict seizures; with the ultimate goal being the control and complete suppression of seizures.



Two methods, the maximum Lyapunov exponent and the Generalized Partial Directed Coherence (GPDC), are applied on EEG data to extract meaningful information. Their effectiveness have been reported in the literature for the purpose of prediction of seizures and seizure focus localization. This study integrates these measures, through some modifications, to robustly detect seizures and separately find precursors to them and in consequence provide stimulation to the epileptic brain of rats in order to suppress seizures. Additionally open-loop stimulation with biphasic currents of various pairs of sites in differing lengths of time have helped us create control efficacy maps. While GPDC tells us about the possible location of the focus, control efficacy maps tells us how effective stimulating a certain pair of sites will be.



The results from computations performed on the data are presented and the feasibility of the control problem is discussed. The results show a new reliable means of seizure detection even in the presence of artifacts in the data. The seizure precursors provide a means of prediction, in the order of tens of minutes, prior to seizures. Closed loop stimulation experiments based on these precursors and control efficacy maps on the epileptic animals show a maximum reduction of seizure frequency by 24.26\% in one animal and reduction of length of seizures by 51.77\% in another. Thus, through this study it was shown that the implementation of the methods can ameliorate seizures in an epileptic patient. It is expected that the new knowledge and experimental techniques will provide a guide for future research in an effort to ultimately eliminate seizures in epileptic patients.
ContributorsShafique, Md Ashfaque Bin (Author) / Tsakalis, Konstantinos (Thesis advisor) / Rodriguez, Armando (Committee member) / Muthuswamy, Jitendran (Committee member) / Spanias, Andreas (Committee member) / Arizona State University (Publisher)
Created2016
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Description
Epilepsy is a chronic illness impacting the lives of over 300,000 children nationally. Sexson and Madan-Swain offer a theory that addresses successful school reentry in children that are chronically ill. Their theory posits that successful school reentry is influenced by school personnel with appropriate attitudes, training experiences, and by factors

Epilepsy is a chronic illness impacting the lives of over 300,000 children nationally. Sexson and Madan-Swain offer a theory that addresses successful school reentry in children that are chronically ill. Their theory posits that successful school reentry is influenced by school personnel with appropriate attitudes, training experiences, and by factors relating to the child's illness. The parents of 74 students, between second and twelfth grades, completed a questionnaire addressing their child's epilepsy and their current level of seizure control. Each child's homeroom teacher also completed a survey regarding their training experiences about epilepsy and their attitudes towards individuals with epilepsy. Additional information was gathered from the child's school regarding attendance rates, most recent Terra Nova test scores (a group achievement test), and special education enrollment status. Data were analyzed via four multiple regression analyses and one logistic regression analysis. It was found that seizure control was a significant predictor for attendance, academic achievement (i.e., mathematics, writing, and reading), and special education enrollment. Additionally, teachers' attitudes towards epilepsy were a significant predictor of academic achievement (writing and reading) and special education enrollment. Teacher training experience was not a significant predictor in any of the analyses.
ContributorsBohac, Genevieve (Author) / Wodrich, David L (Thesis advisor) / Lavoie, Michael (Committee member) / Thompson, Marilyn (Committee member) / Arizona State University (Publisher)
Created2011
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Description
For patients with focal drug-resistant epilepsy, surgical remediation can be a hopeful last resort treatment option, but only if enough clinical signs can point to an epileptogenic tissue region. Subdural grids offer ample cortical surface area coverage to evaluate multiple regions of interest, yet they lack the spatial resolution typical

For patients with focal drug-resistant epilepsy, surgical remediation can be a hopeful last resort treatment option, but only if enough clinical signs can point to an epileptogenic tissue region. Subdural grids offer ample cortical surface area coverage to evaluate multiple regions of interest, yet they lack the spatial resolution typical of penetrating electrodes. Additionally, subthreshold stimulation through subdural grids is a stable source for detecting eloquent cortex surrounding potential epileptic tissue. Researchers have each tried introducing microelectrodes to increase the spatial resolution but ran into connectivity challenges as the desired surface area increased. Meanwhile, clinical hybrid options have shown promise by combining multiple electrode sizes, maintaining surface area coverage with an increased spatial resolution where necessary. However, a benchtop method to quantify spatial resolution or test signal summation, without the complexity of an in vivo study, has not been found in the literature; a subdural grid in gel solution has functioned previously but without a published method. Thus, a novel hybrid electrode array with a telescopic configuration including three electrode geometries, called the M$^3$ array, is proposed to maintain cortical surface area coverage and provide spatial clarity in regions of interest using precision microfabrication techniques. Electrophysiological recording with this array should enhance the clinical signal portfolio without changing how clinicians interface with the broad surface data from macros. Additionally, this would provide a source for simultaneous recording and stimulation from the same location due to the telescopic nature of the design. A novel benchtop test method should remove complexity from in vivo tests while allowing direct comparison of recording capabilities of different cortical surface electrodes. Implementing the proposed M$^3$ electrode array in intracranial monitoring improves the current technology without much compromise, enhancing patient outcomes, reducing risks, and encouraging swift clinical translation.
ContributorsGarich, Jonathan Von (Author) / Blain Christen, Jennifer M (Thesis advisor) / Abbas, James J (Committee member) / Helms Tillery, Stephen I (Committee member) / Muthuswamy, Jitendran (Committee member) / Raupp, Gregory B (Committee member) / Arizona State University (Publisher)
Created2022
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Description
Neurological disorders are the leading cause of physical and cognitive declineglobally and affect nearly 15% of the current worldwide population. These disorders include, but are not limited to, epilepsy, Alzheimer’s disease, Parkinson’s disease, and multiple sclerosis. With the aging population, an increase in the prevalence of neurodegenerative disorders is expected. Electrophysiological monitoring of

Neurological disorders are the leading cause of physical and cognitive declineglobally and affect nearly 15% of the current worldwide population. These disorders include, but are not limited to, epilepsy, Alzheimer’s disease, Parkinson’s disease, and multiple sclerosis. With the aging population, an increase in the prevalence of neurodegenerative disorders is expected. Electrophysiological monitoring of neural signals has been the gold standard for clinicians in diagnosing and treating neurological disorders. However, advances in detection and stimulation techniques have paved the way for relevant information not seen by standard procedures to be captured and used in patient treatment. Amongst these advances have been improved analysis of higher frequency activity and the increased concentration of alternative biomarkers, specifically pH change, during states of increased neural activity. The design and fabrication of devices with the ability to reliably interface with the brain on multiple scales and modalities has been a significant challenge. This dissertation introduces a novel, concentric, multi-scale micro-ECoG array for neural applications specifically designed for seizure detection in epileptic patients. This work investigates simultaneous detection and recording of adjacent neural tissue using electrodes of different sizes during neural events. Signal fidelity from electrodes of different sizes during in vivo experimentation are explored and analyzed to highlight the advantages and disadvantages of using varying electrode sizes. Furthermore, the novel multi-scale array was modified to perform multi-analyte detection experiments of pH change and electrophysiological activity on the cortical surface during epileptic events. This device highlights the ability to accurately monitor relevant information from multiple electrode sizes and concurrently monitor multiple biomarkers during clinical periods in one procedure that typically requires multiple surgeries.
ContributorsAkamine, Ian (Author) / Blain Christen, Jennifer (Thesis advisor) / Abbas, Jimmy (Committee member) / Muthuswamy, Jitendran (Committee member) / Goryll, Michael (Committee member) / Helms Tillery, Stephen (Committee member) / Arizona State University (Publisher)
Created2024