September 01 2017     Article originally posted at ALZFORUM

Some older adults maintain good memory and cognitive skills even in the face of extensive amyloid and tau pathology in the brain. This resilience has been dubbed “cognitive reserve,” but researchers still do not know exactly what explains it or how to measure it directly. At the Alzheimer’s Association International Conference 2017, held July 16–20 in London, hints emerged that specific organizational features of the brain underlie this phenomenon. Several researchers highlighted functional brain networks that correlate with preserved cognition. One reported that more efficient neuronal networks help people resist the effects of AD pathology. Another suggested using brain volume to devise a simple num   erical measure of cognitive reserve, which scientists still cannot quantify. Such a measure could allow researchers to predict how quickly AD will progress in a given person. Though preliminary, these initial studies are beginning to paint a better picture of brain resilience.

Reserve has been loosely defined as the variation in functional brain characteristics that provides resilience against the cognitive decline brought on by aging, injury, or disease (Apr 2017 conference news). Researchers detect it by identifying people who maintain better cognition than expected given their age or disease stage. Because years of education and IQ score correlate with reserve, these measures are often used as proxies for it.

Frontoparietal Control Network Crucial for Reserve

Michael Ewers of Ludwig-Maximilians University, Munich, wondered if he could pinpoint a more specific measure of cognitive reserve. In previous work, he found that highly educated people with preclinical AD had worse brain glucose metabolism in the posterior cingulate and angular gyrus than less-educated people at the same level of cognitive performance (Ewers et al., 2013). This suggested to him that cognitive reserve was helping the more educated people resist declines due to hypometabolism.

What brain feature might explain this resistance? One candidate is a hub of the frontoparietal control network found in the left frontal cortex (LFC). This LFC hub has been associated with IQ in young people, and tends to be spared in AD, Ewers said. It couples with various other networks to perform different tasks. To find out what role this hub played in cognitive reserve, Ewers analyzed ADNI resting-state fMRI data on 44 amyloid-positive people with MCI. He found that MCI patients whose LFC hub was more tightly connected with the rest of the brain maintained sharper episodic memory than those with low connectivity for the same degree of hypometabolism. High connectivity also associated with more education, as would be expected for a measure of cognitive reserve (Franzmeier et al., 2017).

Was this link between resting-state connectivity and memory just a correlation, or does greater LFC connectivity actually help people perform better while doing a task? Ewers investigated this question in a cohort of 37 healthy controls and 17 MCI patients who completed a face-name association task that measured episodic memory while being scanned (see image above). Higher connectivity of the LFC hub to regions such as the medial temporal and parietal lobe during the task correlated with better performance, indicating that this network played a direct role in episodic memory. High connectivity again correlated with years of education, supporting the idea that LFC hub connectivity measures cognitive reserve (Franzmeier et al., 2017).

Ewers next wondered if high LFC connectivity might delay cognitive decline. He analyzed data from the Dominantly Inherited Alzheimer Network (DIAN) and from DELCODE, a German study of sporadic AD. In both cohorts, people with higher LFC connectivity had better cognitive abilities than those with low connectivity at any given level of pathology. Those with higher connectivity declined more slowly as well. Strengthening this network might be a therapeutic strategy, Ewers suggested.

Another talk at AAIC complemented these findings. Rachel Buckley of Massachusetts General Hospital in Charlestown investigated the relationships of five functional brain networks to several proxies of cognitive reserve, including education, IQ, occupational attainment, and self-reported cognitive activities. She analyzed resting-state fMRI data from 243 cognitively healthy participants in the Harvard Aging Brain Study; 182 were amyloid-negative, while 61 were amyloid-positive.

She found that connectivity in the right frontoparietal control network was most associated with cognitive reserve. While her data implicate the right rather than the left frontal cortex as Ewers found, the two studies both point to the importance of the frontoparietal network. The DMN, dorsal attention, and salience networks had a weaker relationship to proxies of cognitive reserve, and the motor network had none, as might be expected. Connectivity of these networks correlated least with occupational attainment and most strongly with IQ score, suggesting this was the best proxy for cognitive reserve. Amyloid burden did not affect the relationship between connectivity and reserve.

A Cognitive Reserve Network? Parts of the DMN and task-positive networks either activate (red), or deactivate (blue), respectively, during all cognitive tasks, and also correlate with IQ. [Courtesy of Yaakov Stern, AAIC 2017.]

Identifying a Cognitive Reserve Network for All Cognitive Domains

Another talk at AAIC identified a different brain network associated with IQ that may play an important role in cognitive reserve. Yaakov Stern of Columbia University, New York, used task-related fMRI rather than resting-state to find a network involved with preserving cognitive abilities. He noted that many previous studies of cognitive reserve examined the functional brain networks that activated when participants perform only a single cognitive task (e.g., Steffener et al., 2011). However, cognitive reserve preserves numerous cognitive abilities, such as memory, language, and executive function, not just single cognitive domains, Stern said. To identify a single brain network that correlated with reserve across a variety of mental challenges, Stern analyzed data from the Reference Ability Neural Network study. This aging study employs fMRI to identify brain networks responsible for the mental abilities that change the most with age: reasoning, episodic memory, processing speed, and vocabulary. About 300 cognitively healthy adults from age 20 to 80 completed 12 cognitive tasks that called on these skills while under the scanner (Stern et al., 2014; Habeck et al., 2016).

Stern analyzed data from 220 participants, using IQ scores as a proxy for cognitive reserve. He searched for a pattern of brain areas that activated during all 12 tasks, with the degree of activation correlating with IQ. He found a network that encompassed multiple brain areas, including parts of the default mode network (DMN) and parts of the task-positive network (see image above). The former, which includes the medial temporal lobe, medial prefrontal cortex, and posterior cingulate cortex, turns off during tasks, while the latter, which includes the superior parietal lobe, lateral prefrontal regions, and insular cortex, activates. To find out if this combination network responded during any mental challenge, Stern tested participants on a different type of activation task. Again, the same network lit up, with its degree of activation correlating with IQ score. Thus, this pattern of activation may point to a cognitive reserve (CR) network, Stern suggested.

To test this idea, Stern correlated the CR network activation with cognitive ability and brain volume. Normally, older people who have thinned cortices perform worse cognitively than those with more preserved thickness. Stern found that people who highly activated the putative cognitive reserve network executed better than expected on cognitive tests given their cortical thickness. This supports the idea that this network embodies cognitive reserve. Stern suggested that measuring this network could help predict the rate of cognitive decline in AD, and help researchers account for differences in cognitive reserve among clinical trial populations. In addition, interventions meant to raise cognitive reserve might measure activation of this network as an outcome, Stern said.

Efficient Brain Networks Lead to Better Performance

Marina Weiler, now at the National Institutes of Health, Bethesda, Maryland, took yet a different approach to identifying what underlies cognitive reserve. She noted that neuronal networks organize themselves according to psychologist Stanley Milgram’s “small-world problem,” a.k.a. six degrees of separation (Travers and Milgram, 1969). This is the idea that any two people in the world can be connected to each other by a chain of no more than six acquaintances. In the case of neurons, they achieve this high connectivity by making many local connections and only a few long-range connections. This allows them to perform complex local processing but also send messages across the brain quickly, reaching any other neuron through few intermediaries. Previous research demonstrated that such small-world networks are highly efficient, with a high benefit and low cost to the brain, Weiler said.

Does this type of organization help brains resist pathology? Weiler, who at the time worked at the University of Campinas, São Paulo, Brazil, examined a cohort of 70 people, which consisted of 28 controls, 28 people with amnestic MCI, and 14 with mild AD. Weiler noted that the participants represented a wide range of education levels and IQs. She measured pathology using cerebrospinal fluid markers of Aβ, t-tau, and p-tau, and brain efficiency by applying a graph theory approach to resting-state fMRI data. By analyzing functional connectivity data with the GraphVar toolbox, which allows users to deduce the brain’s topographic organization based on fMRI data, Weiler obtained multiple measures of network efficiency (Kruschwitz et al., 2015).

Across all diagnostic groups, the people who had the most cognitive reserve, as determined by education and IQ score, also had the greatest small-world connectivity, Weiler found, suggesting that this could be a measure of reserve. As some other studies have reported, higher levels of education and IQ did not protect people from developing the pathophysiological features of AD. Notably, however, education level did seem to modify the effects of pathology on network efficiency in aMCI and AD patients. AD patients normally lose the small-world organization of neuronal networks, but those with more education better maintained this. The finding suggests that AD patients with more reserve are better able to cope with the effects of pathology, Weiler said.

Late Onset, Faster Decline. People with high cognitive reserve better maintain abilities as pathology advances, but at late stages decline more quickly. [Courtesy of Anita Van Loenhoud, AAIC 2017.]

A Dynamic Measure of Reserve

One drawback to these functional connectivity measures of cognitive reserve is that they are not easily quantifiable. Anita Van Loenhoud of VU University Medical Center, Amsterdam, derived a simpler, numerical measure of cognitive reserve. She used data from amyloid-positive participants in the Amsterdam Dementia Cohort, 56 of whom had subjective cognitive decline, 108 MCI, and 347 AD. She compared their brain volumes, as determined by structural MRI, to their scores on a cognitive composite. Because the brain shrinks with aging and with AD, people with lower volume typically have poorer cognition. Van Loenhoud calculated a statistical W-score for each person based on how much their cortical volume differed from what she expected given their cognitive score. W-scores are similar to z-scores, but adjusted for specific covariates like age and sex. Those who had a low W-score, meaning less brain volume than their cognitive scores would suggest, were considered to have high cognitive reserve.

Van Loenhoud then examined how W-scores related to disease progression. Unexpectedly, she found that MCI patients with low W-scores, and thus high cognitive reserve, were more likely to progress to AD than were their peers with high W-scores (van Loenhoud et al., 2017). Though initially puzzling, the data fit with some previous observations. Although people with high reserve have a lower risk of dementia, after an AD diagnosis, they actually progress more rapidly than others do, likely because they do not show symptoms until their pathological burden is large and their disease quite advanced. These MCI patients were probably already at the point in disease where decline accelerates, Van Loenhoud suggested (see image above).

W-scores represent a dynamic measure of cognitive reserve, since they depend on current brain volume, which changes over the course of the disease, van Loenhoud noted. This may make the measure more useful for prognosis than static measures. Supporting this, education level, a static measure, did not predict disease progression in this cohort. In future work, van Loenhoud plans to incorporate other measures of pathology into the score to refine its prognostic use.—Madolyn Bowman Rogers

April 13th, 2017     By Ricardo Schinaider – Redação WebContent

Controlling robots using animal brains may seem like science fiction, but it was a topic that interested Nathalia Peixoto as early as graduation.

Nathalia studied Electrical Engineering, but her curiosity and fascination with other areas of knowledge led her to explore several laboratories at Unicamp, where she studied. From March 27 to 29, 2017, Nathalia returned to the University to participate as a guest speaker at the IV BRAINN Congress. In an interview for the RICD´s website, she told us a bit about her career and highlighted the fundamental role that interdisciplinarity has in Academics.

INTERDISCIPLINARITY IN THE CENTER OF STUDIES

“I did scientific initiations in Mathematics, Biology and even in Linguistics“, recalls the scientist. “I was interested in everything. I would take my bicycle and ride through all the institutes. And I believe that these experiences gave me a different view than that a person who, for example, did only scientific initiation in Electrical Engineering. ”

I was interested in everything. I would take my bicycle and ride through all the institutes.

Researcher Nathalia Peixoto, one of the invited scientists at the 4th BRAINN Congress

Among all the areas that she played with, Nathalia chose Biomedical Engineering to take her Master’s degree. The choice came not only from the desire to unite brains and machines, but also because “there are a lot of neurological problems still unsolved, and I thought that Electrical Engineering could help bring some clarity to many of them,” she recalls.

In her Master’s project, the researcher used engineering tools to study models of migraine. Thus, the interdisciplinarity that marked her graduation continued to accompany her career, both in the doctorate at USP and postdoctoral at Stanford, and today it continues to be present in her research laboratory at George Mason University, in the United States. The research lines addressed by the laboratory are varied, but always seek to find a link between electrical engineering and neuroscience.

“I develop projects with my students related to voice-controlled wheelchairs, measurement of neurotransmitters in the brain and study of addiction: how to form and whether it is possible to get rid of it by electrically stimulating the brain,” says Nathalia.

BRINGING THE ORGANIC TO THE ROBOTIC WORLD

The idea of ​​controlling robots using brains – a concept that is always present in Nathalia’s curious mind – is the basis of one of her most interesting projects, which has gained increasing attention in the media.

The scientist and her research group work on the development of autonomous robots with biological components that can be used in high-risk situations for humans – such as in accidents involving radioactivity, chemical elements or the chance of an explosion.

“To develop this model, the first step is to extract a mouse´s brain and place it in a solution with adequate temperature to keep it active,” explains Nathalia. “Then we insert a part of the brain in a kind of computer chip, where we can stimulate it and measure the cell´s response.”

The first electrical stimulus applied to the brain is mild, and the reaction of the neurons is weak. The second electric stimulus is extremely strong. A few minutes after the strong stimulus, the weak stimulus is applied again. This time, however, the reaction of the neurons is quite different.

One of the advantages of this bioelectronic interface is that the robot would be completely autonomous, that is, it would not depend on the internet or GPS systems to work.

“The response is about 10 times more intense when compared to the first stimulus,” says Nathalia. “This shows that cells can remember a specific stimulus. We want to prove that we can use this ability of the brain to make it recognize and remember a number of patterns and eventually use it to control a robot. One of the advantages of this bioelectronic interface is that the robot would be completely autonomous, that is, it would not depend on the internet or GPS systems to function. ”

PROMOTING STUDIES ABOUT ALZHEIMER

Plaques are formed when pieces of beta-amyloid protein cluster. Small clusters can block signaling between cells at the synapses. They can also activate the cells of the immune system that cause inflammation and destroy deficient cells. Source: Alzheimer’s Association. Source: Alzheimer´s Association

The researcher points out that with only one mouse, it is possible to obtain 50 fractions of the brain and, consequently, to control 50 different robots. This procedure, which allows a large number of samples to be obtained from a single animal, is also attractive for research that seeks to test drugs against neurological and neurodegenerative diseases. Nathalia’s own group has already used this approach to evaluate, for example, the protective effects of turmeric in Alzheimer’s Disease.

The experiment consisted of adding beta-amyloid protein plaques (a characteristic of Alzheimer’s Disease) in the solution containing part of the brain of a mouse. In some solutions, turmeric has also been added. The result showed that brain cells from turmeric-containing solutions took longer to undergo the neurodegenerative effects of beta-amyloid plaques. The possible implications of this finding are enormous, specially for Alzheimer´s patients, and continue to be explored by the group.

NEW RESEARCH, NEW PARTNERSHIPS

For the future, the researcher intends to continue linking engineering and neuroscience for the development of new robots and the study of neurological diseases. In addition, she also wants to start collaborations with BRAINN. For Nathalia, the RICD has the ideal interdisciplinary environment for the development of projects in these areas.

“Here we see physicists talking to neuroscientists, neuroscientists talking to engineers, engineers talking to doctors and so on,” the scientist said.

“Therefore, I believe that BRAINN offers this opportunity for interdisciplinarity to bloom, something that today is critical for doing research,” concludes Nathalia.

Excerpt from Science Magazine,  10 Jun 2016

Early data-sharing efforts have led to improved variant interpretation and development of treatments for rare diseases and some cancer types. However, such benefits will only be available to the general population if researchers and clinicians can access and make comparisons across data from millions of individuals.

Despite much progress, genomic and clinical data are still generally collected and studied in silos: by disease, by institution, and by country. Regulatory data-privacy requirements do not seamlessly lend themselves to the secure sharing of data within and across institutions and countries. Current practices in research and medicine hinder the sharing of data in ways that tangibly recognize an individual’s contributions. Tools and analytical methods are nonstandardized and incompatible, and the data are often stored in incompatible file formats. If we stay this course, the likely outcome will be an assortment of balkanized systems akin to those developed for U.S. electronic health records, which, although designed to advance human health by sharing clinical data across institutions, have by all measures fallen short of that goal because of a lack of interoperability.

A FEDERATED DATA ECOSYSTEM. The Global Alliance for Genomics and Health (GA4GH) was established in 2013 to enable responsible and effective sharing of genomic and clinical data in a way that is as simple as using the World Wide Web. GA4GH, which now brings together hundreds of individuals and organizations, was built on the hypothesis that the data underlying genomic medicine must be federated. That is, whereas data may be distributed across many databases and computers around the world, they must be virtually connected through software interfaces that allow seamless, authorized access. In contrast to large centralized data repositories, a federated system will allow legal data control to remain within the originating jurisdiction (see the figure). International consortia such as the International Cancer Genome Consortium (ICGC) have already adopted federated databases because the model allows local databases to maintain autonomy .

TOOL DEVELOPMENT AND USE. As a first step, the GA4GH Regulatory and Ethics Working Group (REWG) developed a framework document that provides basic principles and core elements for responsible data sharing and is founded on Article 27 of the 1948 Universal Declaration of Human Rights. This focus on human rights represents a paradigm shift with respect to data sharing, as most previous discussions focused solely on protection from harm without acknowledging the right to benefit from the fruits of scientific and medical advances. In practical terms, increased data sharing will enable researchers to make better predictions about disease risk, prevention, and treatment by virtue of having access to larger data sets. And through data exchanges that link the clinical and research communities, clinicians will be able to make better precision medicine decisions for individual patients.

Nature Editorial – 21 June 2016

Excerpt below:

When doctors in Ottawa saw a child with an unusual developmental disorder last year, they were stumped. Their patient had an abnormally small head and face and had been slow to develop. They sequenced the child’s genome hoping to find a genetic explanation, but came up with too many possible candidate genes to pinpoint a likely culprit. This still happens a lot in medicine: people with rare problems go undiagnosed. And that’s one reason behind a big push in science in recent years — the pooling and sharing of clinically relevant information.

In the Ottawa case, the doctors got lucky. They were able to search a database that contained information about other patients with undiagnosed diseases, and when they did so they found a second person with similar symptoms — and an identical mutation in one gene, EFTUD2. The finding allowed the Ottawa doctors to diagnose their patient with a disease called mandibulofacial dysostosis with microcephaly, and to begin to understand why mutations in EFTUD2 cause the disease’s symptoms.

That’s the upside of the new era of data sharing. But there is a possible downside too: invasion of privacy. Massive genetic studies in countries such as the United States, Qatar, Saudi Arabia and Brazil are collecting genetic data on millions of people, so there is a chance that a person’s identity could be dragged from those data ­— especially if they are linked to clinical information, such as medical history. The risk is that someone who volunteers their DNA could see their medical problems opened to public scrutiny.

This is a legitimate concern for many researchers, and is one reason why data sharing is easier said than done. Others include the lingering sense of ownership, and the career benefits offered to those who have privileged access. Those concerns relate to the standard model of data sharing, in which different groups of scientists deposit their results into centralized databases. This model has had some success, but researchers have already encountered problems, such as how to grant and control access to the pooled information.

Pooling it in the first place becomes more difficult as the data sets get larger and the underlying techniques more varied. Imagine the difficulty of finding a specific book by gathering all the contents of a dozen different national libraries and then devising a way to integrate the numerous ways in which they are filed, tracked, recorded and made available. It would be much easier to ask each library whether it holds that book. What if data sharing in science could go the same way?

May 24th, 2016

by Erik Nardini Medina *

Imagine how it would feel for a person with a high degree of motor impairment to have a little bit more independence. Tasks of different complexities are now possible through a methodology called BCI. The Brain Computer Interface is far from being a new subject. However, it is an area that always reinvents itself and brings about both small and great achievements.

Researcher André Ferreira, of the Electrical Engineering Department at the Federal University of Espírito Santo (UFES), said that a number of activities can be done – incredible as it may seem! – using the power of thought, thanks to a paradigm called motor imagery.

“You just have to think, for example, of moving the right hand, or think of moving your feet. You don´t have to actually do the movement – the person sometimes is not able to–, just imagine it and the system detects the thought. This is much more intuitive and you do not depend on external stimuli, but it requires a whole period of learning”, explains Ferreira.

The patient just have to think of performing a movement (including moving a paralyzed limb) for the system to recognize his intention and transmit the command to the machine.

HOW CAN THE BRAIN COMMUNICATE WITH THE MACHINE?

In order to achieve results like these, the brain needs to communicate without interference with the computer. That takes place through three main stages: signal processing, feature selection and classification.

In short, the first step amplifies data extracted from the brain via electroencephalogram. In the second step, the researchers isolate the data, and in the third the information is sorted so it can be recognized with precision by the computer – as summarizes Professor Dr. Romis Attux, of the School of Electrical and Computer Engineering (FEEC) at the State University Campinas (Unicamp).

“We basically process signals from electroencephalography (EEG). These are electrical signals, electrical potentials measured on the scalp region, and the purpose of the proceeding is to improve the quality of the signals so that we can then translate user intent – which will be passed to us by his brain – into a command, to be used for example by a robotic wheelchair or some other destination”, explains Attux, who is also a researcher at the Brazilian Institute of Neuroscience and Neurotechnology (BRAINN).

DIVERSE USES FOR THE TECHNOLOGY

In addition to motor imagery, which allows users to perform tasks just by thinking about what they want to do, there are other resources the scientists may employ to help people with disabilities. One of them, widely used, is the SSVEP. In this method, a computer screen emits light stimuli at different frequencies. These signals are picked up by an electroencephalogram and are then processed, so that the computer understands which action the user plans to execute.

In this example of BCI in action, a user wears a ‘helmet’ with electrodes and is thus able to move, remotely, the little red car. Watch the demonstration in the video below.

“[The SSVEP] are the permanent state visually evoked potentials. Basically, if I present you a light stimulus at a given frequency, when we look at the EEG in the occipital part of the brain (which is responsible for the visual areas), you will see that that stimulation frequency will have a peak power”, says Ferreira, adding:

“What are we able to do then? I present you with different actions, each blinking at a different frequency. For example, I put an arrow to turn left at a 10 hertz frequency. An arrow to turn right, another frequency. Then the user simply looks, focus on the visual stimuli, and the EEG is contaminated by this stimulus and the software recognizes and performs the necessary action. ”

With the SSVEP paradigm, the user transmits his intentions to the machine by fixing his gaze on light stimuli. He does not have to do anything beyond that.

AN ELECTRODE ‘HELMET’ TRANSMITS THE SIGNALS

Professor Romis Attux / BRAINN.

For BCI to happen, the user stays with electrodes attached to the head (as shown in the above pictures). These devices are on the outside of a ‘helmet’, so there´s no need for surgery or other medical procedures. In the case of motor imagery, the researchers found that the simple act of imagining a movement is enough to generate activity in the motor cortex, and is right in this region that the electrodes are implanted.

“We use the same electrodes. But on the imagery techniques we focus our attention on the electrodes which are in the motor cortex, and on the SSVEP we work primarily with the electrodes that are close to the visual cortex. Thus, we are able to detect information that the person is picking up visually. But the electrodes are the same, “says Attux.

Now that you understand a little more about what the BCI,  you can watch movies like “Phenomenon,” in which John Travolta takes control of things with the mind, “X-Men” or “Matrix” with a much more critical look!

* Journalist graduated from the Pontifical Catholic University of Campinas (PUC-Campinas), student of Science Journalism specialization at the Advanced Studies in Journalism Laboratory (Labjor / Unicamp). Has a MídiaCiência / FAPESP scholarship.

April 28th, 2016

by Erik Nardini Medina *

Picture this: a patient with a paralyzed arm (as a result of a stroke) has his image captured by a camera and transmitted to a computer. Then, a software analyzes the patient’s body and “replaces” the member without movement with a healthy arm, virtually created by a technology known as augmented reality. Incredible, right?

It may sound like science fiction, but research on techniques like this one is already happening – including in Brazil. The BRAINN – Brazilian Institute of Neuroscience and Neurotechnology – is one of the reference centers in this area. Institute researchers are studying the use of the latest technology to assist in the recovery of those who have suffered a stroke.

HOW TO TREAT A STROKE?

Despite those scary numbers, there is reason to cheer. Treatments for those who have suffered strokes have evolved considerably in recent years.

Apart from the drugs field – whose administration usually occurs only in the period when the patient is in hospital -, physiotherapy sessions are prescribed, but usually for an indefinite amount of time. This is when patients and physiotherapists can be given support by technologies associated with Virtual Reality (VR) and Augmented Reality (AR).

RESEARCH MADE BY BRAINN

Pioneering studies on these two virtual applications have been conducted under the supervision of BRAINN´s Gabriela Castellano, associate professor of the Institute of Physics “Gleb Wataghin” at the State University of Campinas (Unicamp), and BRAINN´s scientific diffusion coordinator.

The projects, still in their early stages, adopt strategies to encourage motor coordination in the patients, transforming the exercises into more fun and effective activities.

DIFFERENCES BETWEEN VIRTUAL AND AUGMENTED REALITY

We live in the age of Virtual Reality. The technology will be more and more used in educational and medical scenarios.

In the studies conducted by BRAINN, two assistive technologies gain the spotlight: Virtual Reality and Augmented Reality. Do you know the differences between them?

Virtual Reality (VR): this is the one in which the subject is ‘inserted’ into a three-dimensional interface and participates in certain scenarios – in other words, his/her movements are played in a fictional environment.

The Kinetic motion sensor device – the same one used for Xbox games – is employed in the VR activities. “In this case, the person handles objects in the video through gestures. Sometimes, the patient controls an avatar on the screen, which reproduces in the virtual space their movements in real space”, explains Gabriela Castellano.

Augmented Reality (AR): 3D elements can be “inserted in the real world.” To illustrate this concept, just look at what financial institutions are doing nowadays. Banks use AR, for example, to allow users to search for agencies in the city. When someone points the camera phone to a certain position, the application adds visual elements to the screen that mingle with the real images captured by the phone. It is the fictitious presenting itself in the reality.

“For the AR, the focus lies on patients with limited movement in their arms”, said Castellano. “A camera captures the image of the patient and transmits it to a computer. The software then analyzes the patient’s body and ‘replaces’ the numb member for an arm through augmented reality”, explained the professor.

NEUROPLASTICITY

VR has been used for some time now to help wounded soldiers reclaim movements and get back to life.

The projects aim to assess the possible effects of neuroplasticity, which is the ability of the nervous system to adapt at the structural and functional levels when subjected to new experiences. “We want to understand the evolution of the nervous system after using these applications in motor rehabilitation,” says Castellano.

“With the advancement of research techniques, we can compare the results of a rehabilitation supported by AR and VR with the results obtained in ‘conventional’ rehabilitation”, concludes the researcher.

With the help of science and high technology, health teams are already able to handle the aftereffects of strokes with utmost care and efficiency. This partnership will bear even greater fruit in the coming years, when techniques such as Virtual Reality and Augmented Reality are perfected and become routine in medical care. In this way, stroke sequelae may stop debilitating thousands of people every year, both in Brazil and throughout the world.

* Journalist graduated from the Pontifical Catholic University of Campinas (PUC-Campinas), student of Science Journalism specialization at the Advanced Studies in Journalism Laboratory (Labjor / Unicamp). Has a MídiaCiência / FAPESP scholarship.

April 18th, 2016

by Erik Nardini Medina *

PEOPLE WITH DISABILITIES – A PANORAMA

The “Handbook of Census 2010 – People with Disabilities”, the latest national survey on the topic produced in Brazil, offers a panorama of people with vision, hearing, mobility, mental and intellectual impairments.

The document, published in 2012 by the Brazilian Institute of Geography and Statistics (IBGE), reveals that 23.9% of the population (45,606,048 people) has some kind of disability among the five categories mentioned, and 7% suffer from some form of motor dysfunction.

ASSISTIVE DEVICES – WE NEED MANY MORE

The agents working nowadays with assistive technologies are not few. In addition to the private sector, the very own World Health Organization (WHO) recognizes that “more than one billion assistive products” are needed today, and that the number will rise to “more than two billion in 2050”.

In an important initiative, inspired by the successful “Essential Drugs List”, the organization developed the “Model List of Priority Assistive Products“, open to public responses, which aimed to compose a list of 50 essential products for people with some kind deficiency. Find out more by clicking here.

Give more freedom to those who live in a wheelchair is one of the goals of the research groups.

WHAT ARE THE RESEARCHERS DOING?

A lot, we would say! At first, it may seem that scientific development is progressing slowly, but we must know that there is an active community of researchers working intensively on the development of machines that may radically change the autonomy of people with disabilities.

When such equipment will arrive in the market is still unknown. Science, after all, is also an exercise in patience.

AN AMAZING ROBOTIC WHEELCHAIR

One of the most important assistive projects underway in Brazil takes place in the School of Electrical and Computer Engineering (FEEC) at the State University of Campinas (Unicamp).

A team of researchers, now working with the Brazilian Institute of Neuroscience and Neurotechnology (BRAINN), develops a prototype of a robotic wheelchair that can be controlled by head and facial movements.

Model of an assistive wheelchair being developed by the BRAINN team.

“We do research on several fronts, including technologies that respond to facial expressions, other from visual stimuli (eyetracking), driven by voice, and, finally, technologies based on Brain-Computer Interface (BCI), which is able to convert electrical pulses into brain commands, recognizable by computers”, explains Professor Eleri Cardozo, a member of the team. It is so advanced it sound like science fiction.

The researcher reveals that there is no forecast for when the prototype will reach the market, but the ambitions of those involved generate enormous expectations.

“The laboratory tests are essential so that we can produce a comfortable equipment, one that can be used all the time, in a natural way,” said Cardozo.

“Our expectation is not to launch a fully-functional wheelchair, but to put what’s best of all this technology in a module that can be installed in common wheelchairs, that is, something that the person already has”, he continues.

ASSISTIVE AND AFFORDABLE

Researcher Eleri Cardozo, BRAINN. Photo: Antoninho Perri / UNICAMP

Cardozo expects that the module, when released, will be more accessible than other chairs now on the market. Eleri is used to receiving requests from people all over the country looking to buy the technology, so he emphatically explains that there is no forecast of when the product will be released.

In the future, public health policies might subsidize part of the cost (or even the total cost) of such technologies, but this is something that can only be discussed in depth when the assistive wheelchair is, in fact, available.

[1] Bersch e Tonolli

* Journalist graduated from the Pontifical Catholic University of Campinas (PUC-Campinas), student of Science Journalism specialization at the Advanced Studies in Journalism Laboratory (Labjor / Unicamp). Has a MídiaCiência / FAPESP scholarship.

Que esporte e saúde são aliados, todos sabem. Mas há casos em que a prática esportiva pode até ser fatal. Segundo o neurocirurgião e professor de Neurocirurgia da Universidade Federal de São Paulo (Unifesp), Feres Chaddad Neto, não é incomum a ocorrência de AVCs, sigla para Acidente Vascular Cerebral, durante partidas e exercícios físicos. A boa notícia é que esse risco pode ser evitado.

Cerca de 5% da população têm aneurisma, ou seja, uma malformação nas artérias cerebrais. “A maioria das pessoas vai viver com ele sem nenhum problema, mas, caso ele se rompa, pode ser fatal ou deixar sequelas”, explica. Uma das causas do rompimento de aneurismas cerebrais é justamente a hipertensão arterial. “Durante a prática esportiva, há picos de pressão. Caso a pessoa tenha um aneurisma, correrá mais chances de que ele se rompa, gerando uma hemorragia cerebral, conhecida popularmente como derrame”, completa Chaddad Neto.

Foi esse o caso do lutador de MMA Leandro Caetano de Souza, o Leandro Feijão, que morreu vítima de um aneurisma aos 26 anos, em 2013, na véspera de entrar no ringue.

Segundo Chaddad Neto, há ainda os AVCs isquêmicos, que é a falta de sangue no cérebro, causados por um trombo (coagulação do sangue dentro de um vaso sanguíneo). Foi o que aconteceu com a jogadora da Seleção Brasileira de Handebol, Daniela Piedade, em 2012, durante o aquecimento para uma partida.

Para o neurocirurgião, é fundamental que profissionais do esporte, treinadores, diretores e presidentes de clube, bem como qualquer pessoa que pratique esporte, realizem exames preventivos. “Da mesma maneira que se faz exames para ver a situação cardíaca antes de se praticar esporte, é importante também ver como está a saúde do cérebro”.

“Um clube de futebol de elite deveria proporcionar a angiotomografia de todos os jogadores. Dessa maneira, seria possível diagnosticar a existência de aneurisma antes de seu rompimento, que poderá ser corrigido via cirurgia”, reitera Feres. No caso de atletas amadores, a recomendação é particularmente válida quando há casos de aneurisma na família, pois há mais risco de sua incidência.

Risco para os jovens – O risco de acidentes vasculares cerebrais em jovens é bastante grande, pois, diferentemente de pessoas mais velhas, ainda não desenvolveram plenamente a circulação colateral. Um atleta tem um bom fluxo sanguíneo, uma circulação adequada, mas pode não ter uma circulação colateral desenvolvida, que são vias alternativas para a chegada do sangue ao cérebro. “Assim como um rio vai criando caminhos quando encontra barreiras, também no ser humano o sistema circulatório vai buscando canais opcionais de fluxo sanguíneo quando há obstrução por placas de gordura, por exemplo. Nas pessoas mais velhas, há a circulação colateral, que ainda não foi desenvolvida no jovem, mesmo que este pratique esportes”, diz o médico.

O neurocirurgião, contudo, destaca a importância da prática esportiva regular para uma saúde melhor, inclusive para se evitar AVCs. “A atividade física traz inúmeros benefícios: aumenta os níveis de HDL (lipoproteína de alta densidade, o “bom colesterol”); regula o açúcar no sangue, reduzindo o risco de diabetes; melhora a capacidade mental, como reflexos mais rápidos, maior nível de concentração e memória mais apurada; fortalece os músculos e a manutenção da massa óssea, fundamentais para retardar o envelhecimento; alivia o estresse e a ansiedade; melhora a qualidade do sono, além de ajudar na autoestima”, reforça Feres Chaddad Neto. “Portanto, para usufruir de todos esses benefícios sem riscos, antes de iniciar uma atividade desportiva, convém incluir o exame vascular do cérebro como quesito da avaliação física.”

FONTE: press release

Musical Glove é um dispositivo de computação em formato de luva que promete ser um grande aliado na reabilitação de pessoas que sofreram um AVC, pois ajuda a melhorar suas habilidades motoras finas. A luva é equipada com minúsculos sensores que são capazes de controlar os movimentos das mãos do usuário, permitindo com que ele jogue jogos apertando e segurando teclas na tela de uma tablet.

Segundo Nizan Firedman, fundador da Flint Dispositivos para Reabilitação, são esses alguns dos exercícios recomendados para serem executados pelos pacientes depois de deixar o hospital, pois são de alta repetição. A ideia da luva musical é manter as pessoas mais motivadas a fazerem os exercícios, sem ficarem entediados.

Friedman teve a ideia de criar o dispositivo enquanto fazia doutorado em engenharia biomédica na Universidade da Califórnia, com David Reinkesmeyer e Mark Bachman. Inicialmente, queriam juntar robótica e musicoterapia, mas, por causa dos elevados custos da robótica, surgiu a ideia da luva, que se saiu melhor do que eles imaginavam. “As pessoas que não tinham usado as mãos em meses ou até mesmo anos, estavam vendo benefício”, lembra Friedman.

Além das vendas para clínicas de reabilitação de pacientes, uma versão doméstica da novidade também é vendida em um kit com, além da própria luva, um tablet projetado especialmente para ela.

Ainda, a empresa oferece uma versão terapeuta que inclui um computador de mesa. O kit mais simples custa a partir de U$ 1.099 (cerca de R$ 3.573,07) e, até o momento, ainda não é vendido para o mercado brasileiro.

Fonte: TechTudo