Unsafe driving habits increase the severity of roadway accidents. The behaviors that are generally associated with unsafe driving are influenced by drivers and their decision to engage in dangerous habits. In order to solve this problem, Departments of Transportation use roadside safety campaigns. To gain a comprehensive understanding of the effectiveness of these campaigns, this research study captured five different metrics of effectiveness to understand what messages are effective and how to target messages to different groups of people. Since reading and interpreting the messages produces cognitive activation among participants, a neuroimaging technology called functional near-infrared spectroscopy (fNIRS) was used to measure neurocognitive activation as a proxy for response. The fNIRS system captures this cognitive activation by measuring change in oxygenated blood (oxy-Hb). An increase in oxy-Hb is a proxy for increased task engagement. The first journal paper provides an understanding of what types of messages are perceived as effective, are misunderstood, are memorable, are considered inappropriate, and cause the greatest increase in cognitive engagement. Overall, drivers perceive messages to be effective at changing behavior, but particular messages are perceived as more effective than others. Messages about distracted driving and driving without a seat belt, messages that are intended to produce a negative emotional response, and messages with statistics are the behaviors, emotions, and themes that are most likely to be perceived to change driver behavior. Messages about distracted driving and messages about statistics are most likely to be remembered by drivers. In general, drivers do not find messages used in safety campaigns to be inappropriate. Drivers elicit more cognitive attention to signs about distracted driving and signs with a humorous emotion. The second journal considers the effectiveness of these messages with different target demographics by further investigating the first journal's results by different dependent variables, including age, gender, and risky driving habits of the participants. In the second study, the results from the first study are further examined to determine if some campaigns are more effective among different demographics of drivers. The behavioral results indicated that females, drivers over 65, low-risk and high-risk drivers, and urban and rural drivers perceive the safety campaigns as more effective. The neurological data revealed that younger drivers had more activation in the ventrolateral prefrontal cortex, an area known for semantics and word processing, which might indicate more cognitive attention to these types of messages. This study provides a unique application of using neuroimaging techniques to understand driver response to safety messages. The recommendations for an effective safety campaign are to use messages about distracted driving, messages with an emotional stimulus, and messages about statistics. Messages about word play and rhyme are recommended for appealing to younger demographics. / Master of Science / Messages like "New year, new you, use your blinker" and "May the 4th be with you, text I will not" are increasingly used to catch drivers' attention. The development and use of these non-traditional safety messages are distinctly different than messages previously displayed on highway signs because the intent of these messages is to modify driver behavior rather than just provide information. Unfortunately, there is little empirical evidence measuring how effective these messages are at changing driver behavior or guidance on how to target messages for specific groups of people. The goal of this study was to understand what types of non-traditional safety messages are effective and how to target these messages to different target audiences. Roadway collisions are made more severe when the cause of the incident involves dangerous driving habits, such as distracted, impaired, or aggressive driving. The problem is made even more severe by the fact that the habits that make driving dangerous are affected by the driver's decision to engage in risky driving behavior. The solution to this problem is to gain an understanding of driver preferences and response, a research effort this study will address. Reading and interpreting the messages produces cognitive activation among participants. The study uses functional near-infrared spectroscopy (fNIRS), which allows researchers to capture this cognitive activation by measuring change in oxygenated blood (oxy-Hb). This provides not only the ability to gain a more detailed understanding of driver response, but the ability to triangulate this with what drivers perceive as effective in changing driver behavior. In the first study, the participants felt that campaigns targeting distracted driving, messages with a negative emotion, and campaigns about statistics were significantly more effective at changing driver behavior compared to other behaviors, emotions, and themes. The neurological data revealed that drivers respond more to campaigns about distracted driving. However, the neurological data indicates that humorous messages and messages that fit under the theme word play and rhyme elicit a greater cognitive response. The second study furthers the first study and revealed that females, drivers over 65, low-risk and high-risk drivers, and urban and rural drivers perceive the safety campaigns as more effective. The neurological data revealed that younger and older males and older high-risk drivers respond with greater peak oxy-Hb when compared to other groups of people. This study advances the applicability of fNIRS in traffic related studies.

Civil infrastructure serves as the driving force behind the evolution of a safe, sustainable, and efficient environment. However, the way information about civil infrastructure has been communicated to the public has been insufficient. Since every human is intrinsically different, designing, and dispersing information about civil infrastructure that accommodates everyone, while also being direct and concise has been a challenge for policymakers and other federal, state, local, and tribal civil engineering stakeholders. Though there has been a plethora of research conducted on message design and communication in other disciplines, little research has been done in the US that focuses on designing more accessible, actionable civil infrastructure messages. The objective of this research was to investigate how to improve the accessibility of civil infrastructure messages and communication infrastructure to enhance the public's ability to make daily infrastructure decisions. This research study utilized quantitative and qualitative methods to analyze and discuss various ways that civil infrastructure messages can be improved. Results from this study are based on the exploration of three different ways in which civil infrastructure messaging can be improved: policy, transportation/roadway safety, and emergency response. Data sources include eight publicly accessible energy policies from 1978-2022, a publicly available dataset of more than 75 thousand WEAs, and a dataset retrieved from Shealy et al. (2020), which collected data on 300 Virginia drivers in both rural and urban areas. A descriptive policy analysis and Flesch-Kincaid readability test were conducted to historically analyze energy policies and understand their accessibility impacts for research question 1; a brain activation network analysis was conducted and nodal network measures (i.e., network density, degree centrality) were used to investigate the cognitive response Virginia drivers had for various types of non-traditional traffic safety messages for research question 2; and sentiment analysis, emotion detection analysis, as well as a two-phased qualitative coding analysis (i.e., in-vivo coding, focused coding) were conducted to investigate how WEAs can be better designed to increase public attention and engagement for research question 3. The findings from this study demonstrate how emotional content that is present in tweets authored by community members affected by the natural disaster event can be incorporated into the WEA template. The findings from research question 1 identified potential issues with accessibility and energy policy. Also, the findings from this study describe the content included in the parallel documents that federal agencies use to communicate the most important information of a policy. The findings from research question 2 demonstrate that while the various types of non-traditional traffic safety messages produced variances in cognitive response, messages that included negative emotional content or statistics should be further explored on their impact on evoking safer driving behaviors. The findings from research question 3 reported on how emotional content could be incorporated into the template design of WEAs. The implications from this dissertation provide valuable insights for policymakers, civil engineers, transportation engineers, and emergency response stakeholders and the conclusions set the stage for future research to improve the design of more accessible civil infrastructure messages. / Doctor of Philosophy / Civil infrastructure messages are used daily, but improper design can make them difficult to understand or to continue to use over long periods of time. Also, every human is different and interprets information about civil infrastructure, which adds a level of difficulty to designing effective civil infrastructure messages. Though there has been a lot of research on the effectiveness of civil infrastructure, little research has used a human-centered design approach to improve civil infrastructure messages. This study analyzes three different ways to improve civil infrastructure messages: policy, traffic safety, and emergency response. We used publicly available energy policies from 1978-2022, data collected by co-authors from Shealy et al. (2020) to analyze the cognitive response of 300 Virginia drivers to various types of non-traditional traffic safety messages, a publicly available dataset of more than 75 thousand Wireless Emergency Alerts sent by FEMA, and a publicly available data set of more than 9.1 thousand tweets about Hurricane Harvey. To analyze this data, this research study utilized various methods to understand how easy policies are to read, to understand how the brains of Virginia drivers respond to different types of non-traditional traffic safety messages and to identify the differences between tweets and WEAs. Results from this study suggest that parallel documents should be published alongside energy policies to help the public understand the main points of the policy, establish a readability metric to use for all energy policies, continue to investigate non-traditional traffic safety messages that included negative emotional content or statistics, measure the brain activation and observe long-term driving behaviors, use more negative emotional content in templated WEAs, and use social media data to better design templated WEAs. The findings reported from this study can be beneficial for various types of civil infrastructure stakeholders such as policymakers, utilities, US State Departments of Transportation, FEMA, alerting officials, and the public to further explore ways in which the language of civil infrastructure messages can be improved to address accessibility issues with energy policy, traffic safety, and emergency response to the public.

De tout temps, les humains ont cherché différents moyens pour améliorer leur quotidien. Avec les avancées technologiques actuelles, cette quête s’en trouve facilitée, notamment dans la volonté d’accroître leurs capacités cognitives et/ou motrices. La neuro imagerie permet dorénavant de renseigner les aires cérébrales activées lors de différentes tâches fonctionnelles. Il est aussi possible de moduler l’activité cérébrale en stimulant localement le cerveau avec de faibles courants électriques. Une des techniques les plus répandues à cet effet est appelée tDCS pour transcranial direct current stimulation. Il s’agit en fonction de la polarité du courant induit de moduler à la hausse (stimulation anodale) ou à la baisse (stimulation cathodale) l’excitabilité cortico-spinale en dépolarisant ou en hyperpolarisant la membrane des neurones, respectivement. Malgré une démocratisation grandissante de la neuromodulation via tDCS, les résultats rapportés par la communauté scientifique sont relativement hétérogènes. Les travaux initiés au début des années 2000 sont remis en cause par des résultats actuels faisant état d’une variabilité inter et intra individuelle assez importante. Cette pierre d’achoppement nécessite de développer de nouveaux protocoles d’application de la tDCS. Dans cette thèse, nous avons étudié plusieurs modalités d’application de la tDCS afin d’accroître la persistance des effets neuroplastiques induits et d’augmenter les performances comportementales. Deux études ont été menées afin de révéler dans un premier temps les apports induits par le couplage tâche motrice-tDCS pour ensuite mettre en avant les effets cumulatifs de la répétition de sessions de tâche motrice-tDCS avec pré conditionnement sur la performance motrice. La première étude à travers l’utilisation de la spectroscopie dans le proche infrarouge a permis de rapporter des changements hémodynamiques distincts subséquents au couplage tâche motrice-tDCS par rapport à des protocoles tDCS plus conventionnels. La primauté de l’utilisation concomitante de la tDCS à la tâche motrice a été révélée par la moindre activation du cortex sensorimoteur durant la stimulation ainsi que par une activation cérébrale retardée accrue qui pourrait représenter une réorganisation neuroplastique. La seconde étude s’est intéressée aux effets de la polarité du conditionnement lors de sessions répétées avec comme objectif d’améliorer l’apprentissage et la rétention du système sensorimoteur. Le conditionnement par tDCS était plus propice lors de sessions répétées à engendrer des performances motrices supérieures contrairement à la condition sham. La polarité cathodale engendrait une persistance prolongée. Les premiers résultats de ces travaux de thèse ont permis de défendre l’usage concomitant de la tDCS avec la tâche motrice. De futures recherches sont nécessaires afin d’étudier le transfert de ces résultats dans le monde de l’entraînement ainsi que celui de la réhabilitation. / Historically, humans have sought various ways to improve their daily lives. With the current technological advances, this quest is facilitated, especially in the desire to increase their cognitive and / or motor skills. Neuro imagery now makes it possible to inform the areas activated during different functional tasks. Today, it is now possible to modulate brain activity by stimulating the brain locally with weak electrical currents. One of the most common techniques for this purpose is called tDCS for transcranial direct current stimulation. The polarity of the induced current (anodal or cathodal stimulation) allows to modulate upward or downward cortico-spinal excitability by depolarizing or hyperpolarizing the membrane of the neurons, respectively. Despite a growing interest of neuromodulation techniques via tDCS, the results reported by the scientific community are relatively heterogeneous. The work initiated at the beginning of the 2000s is called into question by current results showing a rather large inter and intra variability. This stumbling block requires the development of new protocols for the application of anodal tDCS (atDCS). In this thesis, we were interested in optimizing atDCS protocols in order to increase the persistence of the induced-neuroplastic effects and to increase the behavioral performances. Two studies were carried out in order to first reveal the impact from the motor task/atDCS coupling and then to highlight the cumulative effects of multiple motor-tDCS task sessions with priming atDCS on motor performance. The first study through the use of near infrared spectroscopy allowed to report various hemodynamic changes subsequent to the motor task/atDCS coupling with respect to independent and controlled stimulation protocols. The primacy of the concomitant use of tDCS with the motor task was revealed by the slightest activation of the sensorimotor cortex during stimulation and by an increased delayed cerebral activation which could represent a neuroplastic reorganization. The second study examined the effects of repeated atDCS sessions with anoadal or cathodal tDCS priming in order to improve the learning and retention gains of the sensorimotor system. TDCS priming was more favorable for repeated atDCS sessions to generate higher motor performances contrary to sham. The cathodal polarity produced prolonged persistence. The major findings of this work allow to support the concomitant use of atDCS with the motor task. Future research is needed to study the transfer of these results into the fields of coaching and rehabilitation.

Orientador: Prof. Dr. João Ricardo Sato / The brain is a complex system organized in structurally segregated and functionally specialized regions. The brain areas are composed of neuronal networks interconnected by axonal pathways that integrate through correlated neural activity. Recent studies on neural connectivity using graph theoretical analysis have revealed that brain networks interact through densely connected regions with high topological value called hubs. Previous studies of Default Mode Network (DMN), one of the most important resting-state networks, have improved the understanding of the intrinsic neuronal activity and the dynamics of the human brain. Spontaneous brain activity and Resting-State Functional Connectivity (RSFC) patterns of Resting-State Network (RSN) are essential for the comprehension of the brain function. Neuroimaging techniques such as functional Near Infrared Spectroscopy (fNIRS) make these studies possible. Thus, the main objective of this study was to investigate the RSFC using Eigenvector Centrality (EVC) measure of graph theory in fNIRS data. This work has demonstrated the effectiveness of the graph analysis for detection of hubs and mcommunities, and identified brain regions associated with rich-club, that integrates highly interconnected hubs and plays a central role in the flow and integration of Information throughout the brain. One can also conclude from the RSFC analysis the existence of functional hubs associated with DMN. / Dissertação (mestrado) - Universidade Federal do ABC, Programa de Pós-Graduação em Engenharia da Informação, 2017. / O cérebro é um sistema complexo organizado em regiões segregadas estruturalmente e especializadas funcionalmente que são compostas por redes neuronais interconectadas por vias axonais que se integram através de atividade neural correlacionada. Estudos recentes sobre conectividade neural usando teoria de grafos revelaram que as redes cerebrais interagem através de regiões densamente conectadas e com alto valor topológico denominadas hubs. Dentre as redes existentes destaca-se, por sua contribuição para a melhor compreensão do funcionamento do cérebro humano, a rede de modo padrão (Default Mode Network, DMN). A atividade espontânea do cérebro e os padrões de conectividade funcional (Resting-State Functional Connectivity, RSFC) das redes cerebrais na condição de repouso (Resting-State Network, RSN) também se tornam essenciais nos estudos que visam compreender a função desse órgão, estudos esses possibilitados graças às técnicas de neuroimagem destacando-se a espectroscopia funcional no infravermelho próximo (functional Near Infrared Spectroscopy, fNIRS). Assim, o objetivo principal deste estudo foi investigar a RSFC usando a medida de centralidade do autovetor (Eigenvector Centrality, EVC), técnica pertencente à teoria de grafos, em dados de fNIRS. Este estudo pode demonstrar a eficácia da metodologia empregada para analisar a RSFC além de revelar a existência de um núcleo estrutural, denominado hub complex, densamente conectado (rich-club), que integra hubs altamente interligados e desempenha papel central no fluxo e integração da informação ao longo do cérebro. Pode-se também concluir a partir da análise da RSFC a existência de hubs funcionais associados à DMN.

Das Wortlernen begleitet unser Leben von der Kindheit bis ins Alter. Kleinkinder lernen ihre Muttersprache(n), aber auch Erwachsene lernen neue Wörter, z.B. beim Fremdspracherwerb. Unter gewissen Umständen muss eine neue Sprache wieder erlernen werden, wie z.B. nach einer Gehirnläsion. Wie meistert unser Gehirn diese herausfordernden Wortlernsituationen? Um die Neuroplastizität des Wortlernens zu untersuchen, wurden unterschiedliche neurowissenschaftliche Methoden (Elektroenzephalographie, funktionelle Nahinfrarotspektroskopie, voxel-basierte Läsion-Verhalten/EEG Mapping), teilweise in Kombination, bei Kleinkindern, Kindern und Erwachsenen sowie Patienten mit einer Gehirnläsion im Vergleich zu älteren Kontrollprobanden angewendet. 5 Experimente untersuchten die neuronale Verarbeitung von Pseudowörtern, welche mutter- und fremdsprachlichen phonotaktischen Regeln (d.h. die Kombination von verschiedenen Phonemen) folgten, in unterschiedlichen Lernsettings bei monolingualen Teilnehmern. Gesunde Erwachsene aber auch 6monatige und ältere Teilnehmer und Patienten konnten diese Regeln differenzieren. Beteiligte Gehirnareale umfassten ein links-hemisphärisches fronto-temporales Netzwerk. Die Verarbeitung universeller Spracheigenschaften, andererseits, zeigte sich in parietalen Regionen. Während Erwachsene eine klare Dominanz der linken Hemisphäre aufwiesen, nutzten 6monatige noch beide Gehirnhälften. Unterschiedliche Sprachtrainings (semantische Trainings oder Passives Zuhören) an drei aufeinanderfolgenden Tagen veränderten auch die Gehirnaktivität der Kleinkinder und der Erwachsenen und wiesen auf eine erhöhte Lernflexibilität hin. Im 6. Experiment lernten 5jährige bilinguale Kinder anhand pragmatischer Eigenschaften neue Adjektive und zeigten effizientere neuronale Mechanismen als Monolinguale. Die Ergebnisse unterstreichen die Wichtigkeit multi-methodologischer Ansätze, um genauere Einblicke in die komplexen Mechanismen der Neuroplastizität zu erlangen. / Word learning accompanies our everyday life from infancy to advanced age. Infants have to learn the native language(s) but also during adulthood word learning can take place, for example if we learn a new foreign language. Sometimes people are confronted with a situation in which they have to re-learn a language because of a brain lesion. How does the brain master these challenging word learning settings? To assess neuroplasticity of word learning several neuroscientific methods (electroencephalography, functional near-infrared spectroscopy, voxel-based lesion-behavior/EEG mapping), partially in combination, were used in infants, children, and adults as well as in patients suffering from a brain lesion compared to matched elderly controls. In 5 experiments neuronal processing of pseudowords corresponding to native and non-native phonotactic rules (i.e., the combination of different phonemes) was investigated under different learning conditions in monolingual participants. Healthy adults but also 6-month-old infants and elderly subjects and patients were able to differentiate these rules. Involved brain areas included a left-hemispheric network of fronto-temporal regions. When processing universal linguistic features, however, more parietal regions were involved. While adults revealed a clear left-dominant network, 6-month-olds still recruited bilateral brain areas. Differential language trainings (semantic or passive listening trainings) over three consecutive days also modulated brain activation in both infants and adults suggesting a high flexibility for learning native and non-native linguistic regularities. In a 6th experiment, bilingual 5-year-old children learned novel adjectives by means of pragmatic cues and revealed more efficient neuronal mechanisms compared to monolingual children. Findings underline the importance of multi-methodological approaches to get clearer insights into the complex machinery of neuroplasticity.

Thèse de doctorat présentée en vue de l'obtention du doctorat en psychologie (Ph.D). / L'enfance et l'adolescence sont des périodes uniques de la vie où les changements neuronaux favorisent l'établissement de réseaux cérébraux matures et le développement des capacités intellectuelles. Le langage est un domaine cognitif qui est, non seulement essentiel pour la communication interhumaine, mais qui contribue également au développement de nombreuse capacités et prédit de manière significative la réussite académique. Les régions cérébrales frontotemporales sont des régions clés du réseau langagier du cerveau. Il a été démontré que les neuropathologies telles que l'épilepsie des lobes frontal et temporal (ELF et ELT) interfèrent avec le développement des réseaux cérébraux du langage et provoquent des circuits cérébraux aberrants. Les patrons exacts de réorganisation des réseaux cérébraux fonctionnels ne sont toutefois, pas entièrement compris et l'association avec le profil neuropsychologique reste spéculative. Par conséquent, l'objectif principal de cette thèse est d'accroître la compréhension des altérations du réseau langagier et d'améliorer les connaissances de l'association de l'architecture du réseau et des capacités cognitives chez les enfants et les adolescents avec ELF ou ELT. La présente thèse est composée de trois articles scientifiques, les deux premiers présentant des travaux méthodologiques qui ont permis d'optimiser les méthodes appliquées dans le troisième article, l'étude empirique principale menée auprès d'enfants avec ELF et ELT. Le premier article présente le bilan neuropsychologique pédiatrique comme un outil important pour estimer les capacités cognitives et dresser un profil cognitif avec ses forces et ses faiblesses. Dans le deuxième article, l'analyse factorielle parallèle (PARAFAC) est présentée et validée comme une nouvelle technique employée pour corriger les artefacts de mouvement qui contaminent le signal hémodynamique évalué par la spectroscopie fonctionnelle proche infrarouge (fNIRS). Une meilleure qualité du signal permet une interprétation fiable de la réponse cérébrale en plis de déduire des métriques d'organisation du réseau cérébral. Le troisième article consiste en une étude empirique, où le traitement cérébral du langage, est comparé entre des enfants avec ELF et ELT, et des pairs neuroptypiques. Les schémas de connectivité fonctionnelle indiquent que le groupe de patients présente moins de connexions intra-hémisphériques dans l'hémisphère gauche et entre les hémisphères, et des connexions accrues dans l'hémisphère droit par rapport au groupe témoin. Les mesures de l'architecture du réseau révèlent en outre une efficacité de traitement local plus élevée dans l'hémisphère droit chez les enfants atteints de ELF et ELT par rapport aux enfants en bonne santé. L'architecture du réseau local de l'hémisphère gauche et la capacité intellectuelle globale dans le groupe de patients sont négativement liées, tandis que dans le groupe contrôle, aucune association de ce type n'est identifiable. Ces résultats suggèrent que la réorganisation du réseau de langage chez les enfants avec ELF ou ELT semble dans certains cas soutenir un meilleur résultat cognitif, soit lorsque l'efficacité du traitement local dans l'hémisphère gauche est diminuée. Au contraire, une plus grande efficacité de traitement local semble être une caractéristique d'un réseau de langage cérébral associé à de moins bonnes capacités cognitives. Les travaux de recherche de cette thèse de doctorat fournissent des lignes directrices pour l'utilisation de l'évaluation neuropsychologique pédiatrique, à la fois dans un contexte clinique et scientifique. L'introduction de PARAFAC pour corriger les artefacts de mouvement dans le signal fNIRS est un ajout important au pipeline de prétraitement qui permet d'augmenter la qualité du signal pour une analyse ultérieure. De futurs projets pourront s'appuyer sur cette validation initiale et étendre l'utilisation de PARAFAC pour les analyses du signal fNIRS. Sur cette base méthodologique solide, le travail empirique confirme l'incidence accrue de circuits cérébraux aberrants liés au traitement du langage chez les enfants atteints de ELF et de ELT, et soutient en outre l'efficacité du réseau local en tant que déterminant clé de l'impact de la plasticité cérébrale précoce sur les capacités cognitives. Afin de mieux comprendre les altérations du réseau en réponse aux neuropathologies et leur impact, des études avec des échantillons plus grands et de différents groupes d'âge, devraient étudier plus spécifiquement le rôle des facteurs cliniques (e.g., le type d'épilepsie, la latéralisation de l'épilepsie, le contrôle des crises, etc.) et aborder leurs influences sur le développement. À long terme, cela augmentera le pronostic des phénotypes cliniques chez les patients pédiatriques atteints de ELF et de ELT, et offrira des opportunités d'interventions précoces pour soutenir un développement typique. / Childhood and adolescence are unique periods in life where neuronal changes support the establishment of mature brain networks and the development of intellectual capacities. Language is one cognitive domain that is not only an essential part of inter-human communication but also contributes to the development of other capacities and significantly influences academic achievement. Frontotemporal brain areas are key regions of the brain's language network. Neuropathologies such as frontal and temporal lobe epilepsies (FLE and TLE) have been shown to interfere with developing brain language networks and cause aberrant cerebral circuits. The exact patterns of functional brain network reorganization are not fully understood and the association with the neuropsychological profile remains speculative. Therefore, the main objective of this thesis was to increase comprehension of language network alterations and enhance the knowledge on the association of network topology and cognitive capacities in children and adolescents with FLE or TLE. This thesis consists of three scientific articles, with the first two presenting methodological work that allowed for the optimization of the methods applied in the third article, which is the main empirical study conducted on children with FLE and TLE. The first article presents the pediatric neuropsychological assessment as a valuable tool to estimate cognitive capacities and draw a cognitive profile with strengths and weaknesses. In the second article, parallel factor analysis (PARAFAC) is presented and validated as a novel technique to correct motion artifacts that contaminate the hemodynamic signal assessed with functional near-infrared spectroscopy (fNIRS). A better signal quality is the basis for a reliable interpretation of the cerebral response and derive metrics of brain network organization. The third article consists of an empirical study where cerebral language processing is compared between children with FLE and TLE, and neuroptypical peers. Patterns of functional connectivity indicate that the patient group demonstrates fewer intra-hemispheric connections in the left hemisphere and between hemispheres, and increased connections within the right hemisphere as compared to the control group. Metrics of network architecture further reveal a higher local processing efficiency within the right hemisphere in children with FLE and TLE compared to healthy peers. Local network architecture of the left hemisphere and the overall intellectual capacity in the patient group is negatively related, while in the control group no such association is identifiable. These findings suggest that language network reorganization in children with FLE or TLE in some cases seems to support a better cognitive outcome, namely when local processing efficiency in the left hemisphere is decreased. On the contrary, a higher local processing efficiency seems to be a characteristic of a brain language network that goes along with worse cognitive capacities. The research work of this doctoral thesis provides guidelines for the use of pediatric neuropsychological assessment both in a clinical and scientific context. The introduction of PARAFAC to correct motion artifact in the fNIRS signal is an important add-on to the preprocessing pipeline that allows to increase signal quality for subsequent analysis. Future projects will be able to build on this initial validation and extend PARAFAC's use for fNIRS analysis. On this solid methodological foundation, the empirical work confirms the increased incidence of aberrant brain circuits related to language processing in children with FLE and TLE, and further supports local network efficiency as a key determinant of the impact of early brain plasticity on cognitive capacities. In order to further understand network alterations in response to neuropathologies and their impact, studies with larger samples sizes and different age groups should further investigate the specific role of clinical factors (e.g., epilepsy type, epilepsy lateralization, seizure control, etc.) and address developmental influences. Ultimately, this will increase prognosis of clinical phenotypes in pediatric patients with FLE and TLE, and offer opportunities for early interventions to support a healthy development.

La spectroscopie proche infrarouge fonctionnelle (SPIRf) est une technique de neuro-imagerie noninvasive permettant de mesurer les changements de concentration d’hémoglobine oxygéné (Δ[HbO]) et désoxygéné (Δ[HbR]). Au cours des deux dernières décennies, notre groupe (et d’autres) ont combiné la SPIRf avec l'électroencéphalographie (EEG) pour effectuer des enregistrements chez des patients avec épilepsie réfractaire afin d’évaluer son potentiel comme 1) technique de cartographie cérébrale noninvasive (par exemple, localisation des aires impliquées dans le langage et localisation du foyer épileptique) et 2) comme approche noninvasive pour étudier le couplage neurovasculaire pendant les pointes épileptiques interictales ainsi que lors des crises épileptiques. Malgré des résultats prometteurs, de nombreux enjeux demeurent avant que la EEG-SPIRf puisse être implantée en pratique clinique. En effet, l’installation de l’équipement prend encore trop de temps, l’obtention de signaux de qualité nécessite encore une surveillance serrée et un certain inconfort apparaît au fur et à mesure que les enregistrements progressent dans le temps. C’est d’ailleurs pourquoi les enregistrements EEG-SPIRf ont, jusqu’à maintenant, été généralement de courte durée (c. à d. rarement plus de deux heures) avec une couverture limitée du cortex cérébral (c. à d. généralement une ou deux aires corticales) et dans un milieu contrôlé de recherche (plutôt qu’au chevet dans un milieu clinique). Compte tenu de son potentiel clinique, il y a lieu de poursuivre les efforts pour développer la EEG-SPIRf pour usage clinique. Notamment, un grand potentiel est pressenti pour la EEG-SPIRf aux soins intensifs neurologiques. D’une part, les patients qui y sont admis étant souvent comateux et/ou sous sédation, l’inconfort relié au port d’électrodes et d’optodes n’est plus en enjeu. D’autre part, ces patients présentent généralement des pathologies graves souvent associées à des anomalies épileptiformes fréquentes à l’EEG (décharges périodiques, crises subcliniques, état de mal non convulsif) dont l’impact hémodynamique sur cerveau tout comme leur prise en charge demeurent controversés. Les techniques actuellement utilisées aux soins intensifs (moniteur de pression intracrânienne, sonde de saturation veineuse jugulaire en oxygène, doppler transcrânien, EEG seul sans SPIRf) présentant des limitations, l’ajout d’une composante de SPIRf à l’EEG permettrait possiblement d’élucider l’impact de certaines de ces anomalies épileptiformes, guider leur traitement et en améliorer leur surveillance. Ainsi, cette thèse visait à 1) développer et valider un système d’EEG-SPIRf compact, sans fil et couvrant toute la tête, destinée à une surveillance à long terme de patients souffrant de divers troubles neurologiques; 2) évaluer la faisabilité et le potentiel d’une surveillance vidéo-EEG-SPIRf (vEEG-SPIRf) à long terme auprès de patients comateux admis aux soins intensifs neurologiques présentant des décharges périodiques, des crises ou un patron électrophysiologique de bouffées-suppression; et 3) étudier la dynamique neurovasculaire associée à l'état de mal épileptique non convulsif chez des patients comateux. La première et la deuxième partie du projet décrivent le développement et la validation d'un système EEG-SPIRf hybride et de "casques" EEG-SPIRf personnalisés destinés à surveiller l'hémodynamique corticale entière chez les patients neurologiques. Nous avons d'abord démontré sa performance globale chez des participants sains effectuant deux tâches cognitives spécifiques (c.-à-d. des tâches linguistiques et visuelles) en position assise (pour la première) et en pédalant sur une bicyclette (pour la seconde). Les mesures électrophysiologiques et hémodynamiques ont été validées à l'aide de deux systèmes commerciaux et ont montré, chez tous les participants, une sensibilité et une spécificité spatiotemporelle élevées. Nous avons ensuite démontré le potentiel clinique de notre système chez quatre patients souffrant de divers troubles neurologiques (par exemple, épilepsie réfractaire et maladies vasculaires cérébrales). Nous avons ainsi réalisé avec succès des enregistrements prolongés vEEG-SPIRf au chevet de tous ces patients et observé des changements hémodynamiques cliniquement pertinents et en concordance avec d’autres modalités de neuro-imagerie fonctionnelle. Une originalité particulière de ce projet réside dans sa capacité à "personnaliser" une technique d’imagerie fonctionnelle prometteuse à un environnement clinique (c.-à-d., à l’étage de neurologie et à l’unité de soins intensifs dans notre cas). Cette étude est la première à rapporter avec succès des changements hémodynamiques sur l’ensemble du cortex chez des patients neurologiques à l'aide d’une surveillance vEEG-SPIRf prolongée au chevet. Par la suite, nous avons évalué la faisabilité de la surveillance vEEG-SPIRf à long terme dans un environnement plus ardu : les soins intensifs neurologiques. Nous avons réalisé avec succès de multiples sessions de surveillance vEEG-SPIRf de très longue durée auprès de 11 patients comateux présentant différentes anomalies épileptiformes. Une augmentation significative de [HbO] et une diminution de [HbR] était présentes lors des crises. De plus, ces changements étaient relativement proportionnels à la durée des crises. Bien qu’elles étaient de moins grande amplitude, de similaires Δ[HbO] et de Δ[HbR] était présents durant les bouffées lors de patrons de bouffées-suppression et lors de décharges périodiques de basses fréquences (i.e., < 2Hz). Finalement, dans une étude subséquente, nous avons exploré l'hémodynamique corticale chez 11 patients comateux en état de mal épileptique non convulsif. Nous avons observé dans la majorité des cas, une augmentation de [HbO], du volume sanguin cérébral et du débit sanguin cérébral, mais avec des changements variables de [HbR] lors de courtes crises (inférieure à 100s). Cependant, lors de longues crises (plus de 100s), une augmentation de [HbR] était observée. Ces résultats préliminaires suggèrent que les mécanismes de couplage neurovasculaire pendant l’état de mal épileptique peuvent être dysfonctionnels chez certains patients et induire un état hypoxique, notamment lors de crises prolongées. En conclusion, les observations rapportées dans cette thèse confirment le potentiel clinique de la vEEG-SPIRf chez l'adulte, notamment pour la surveillance des patients admis aux soins intensifs neurologiques à haut risque de décharges épileptiformes. La poursuite de son développement pourrait éventuellement fournir aux neurologues et intensivistes un autre outil de surveillance neurologique. / Functional near-infrared spectroscopy (fNIRS) is a noninvasive neuroimaging technique that measures concentration changes in oxy- and deoxyhemoglobin (Δ[HbO] and Δ[HbR]) associated with brain activity. Over the past two decades, our group (and others) have combined fNIRS with electroencephalography (EEG) to record patients with refractory epilepsy and evaluate its potential as 1) a noninvasive brain mapping technique (e.g., language area localization and localization of epileptic foci) and 2) as a noninvasive approach to study neurovascular coupling during interictal spikes as well as during seizures. Despite promising results, many challenges remain before the EEG-fNIRS can be implemented in clinical practice. Indeed, installing the equipment still takes too much time, obtaining and maintaining good signal quality still requires close monitoring, and the appearance of discomfort as the recordings progress in time. For those reasons, EEG-fNIRS recordings to date have generally been of short duration (i.e., rarely more than two hours) with limited coverage of the cerebral cortex (i.e., typically one or two cortical areas) and in a controlled research setting (rather than at the bedside in a clinical setting). Given its clinical potential, there is a need for continued efforts to develop fNIRS-EEG for clinical use. In particular, fNIRS-EEG has great potential in neurological intensive care. On the one hand, since patients admitted to the ICU are often comatose and/or sedated, the discomfort of wearing electrodes and optodes is no longer an issue. On the other hand, these patients generally present serious pathologies often associated with frequent epileptiform abnormalities on the EEG (periodic discharges, nonconvulsive seizures and status) whose hemodynamic impact on the brain, as well as their management remain controversial. The techniques currently used in intensive care units (intracranial pressure monitor, jugular venous oxygen saturation probe, transcranial Doppler, EEG alone without fNIRS) have limitations. Adding an fNIRS component to the EEG could perhaps elucidate the impact of some of these epileptiform abnormalities, guide their treatment and improve their monitoring. Thus, this thesis aimed to 1) develop and validate a compact, wireless, whole-head EEG-fNIRS system for long-term monitoring of patients with various neurological disorders; 2) to evaluate the feasibility and potential of long-term video EEG-fNIRS (vEEG-fNIRS) monitoring of comatose patients admitted to the neurological intensive care unit with periodic discharges, seizures or an electrophysiological pattern of burst-suppression; and 3) to study the neurovascular dynamics associated with nonconvulsive status epilepticus in comatose patients. The first and second parts of the project describe the development and validation of a hybrid EEG-fNIRS system and personalized EEG-fNIRS "caps" to monitor whole cortical hemodynamics in neurological patients. We first demonstrated its overall performance in healthy participants performing two specific cognitive tasks (i.e., language and visual tasks) while sitting (for the former) and pedalling a bicycle (for the latter). Electrophysiological and hemodynamic measurements were validated using two commercial systems and showed, in all participants, high sensitivity and spatiotemporal specificity. We then demonstrated the clinical potential of our system in four patients suffering from various neurological disorders (e.g., refractory epilepsy and cerebrovascular diseases). We successfully performed prolonged vEEG-fNIRS recordings at the bedside of all these patients and observed clinically relevant hemodynamic changes* in agreement with other functional neuroimaging modalities. A particular originality of this project is its ability to "customize" a promising functional imaging technique specific clinical settings (i.e., neurology ward, epilepsy monitoring unit, and intensive care unit in our case). This study is the first to successfully report hemodynamic changes across the cortex in neurological patients using extended bedside vEEG-fNIRS monitoring. Subsequently, we evaluated the feasibility of long-term vEEG-fNIRS monitoring in a more challenging environment: the neurological intensive care unit. We successfully performed multiple sessions of very long-term vEEG-fNIRS monitoring in 11 comatose patients with different epileptiform abnormalities. During seizures, a significant increase in [HbO] and a decrease in [HbR] were present. Moreover, these changes were relatively proportional to the duration of the seizures. Although they were of lesser magnitude, similar changes in [HbO] and [HbR] were present during bursts in burst-suppression patterns and with low-frequency (i.e., < 2Hz) periodic discharges. Finally, in a subsequent study, we explored cortical hemodynamics in 11 comatose patients in nonconvulsive status epilepticus. We observed in the majority of cases an increase in [HbO], CBV and CBF, but with variable changes in [HbR] during short seizures (less than 100s). However, during prolonged seizures (more than 100s), an increase in [HbR] was seen. These preliminary results suggest that neurovascular coupling mechanisms during status epilepticus may be dysfunctional in some patients and induce a hypoxic state, especially during protracted seizures. In conclusion, the observations reported in this thesis confirm the clinical potential of vEEG-fNIRS in adults, especially for monitoring patients admitted to neurological intensive care units at high risk of epileptiform discharges. Further development could eventually provide neurologists and intensivists with another tool for neurological monitoring.

Den tekniska utvecklingen har lett till att massiva mängder av information sänds, i högahastigheter. Detta flöde måste vi lära oss att hantera. För att maximera nyttan av de nyateknikerna och undkomma de problem som detta enorma informationsflöde bär med sig, börinteraktionskvalitet studeras. Vi måste anpassa gränssnitt efter användaren eftersom denneinte har möjlighet att anpassa sig till, och sortera i för stora informationsmängder. Vi måsteutveckla system som gör människan mer effektiv vid användande av gränssnitt.För att anpassa gränssnitten efter användarens behov och begränsningar krävs kunskaperom den mänskliga kognitionen. När kognitiv belastning studeras är det viktigt att en såflexibel, lättillgänglig och icke-påträngande teknik som möjligt används för att få objektivamätresultat, samtidigt som pålitligheten är av största vikt. För att kunna designa gränssnittmed hög interaktionskvalitet krävs en teknik att utvärdera dessa. Målet med uppsatsen är attfastställa en mätmetod väl lämpad för mätning av interaktionskvalitet.För mätning av interaktionskvalitet rekommenderas en kombinering av subjektiva ochfysiologiska mätmetoder, detta innefattar en kombination av Functional near-infraredspecroscopy; en fysiologisk mätmetod som mäter hjärnaktiviteten med hjälp av ljuskällor ochdetektorer som fästs på frontalloben, Electrodermal activity; en fysiologisk mätmetod sommäter hjärnaktiviteten med hjälp av elektroder som fästs över skalpen och NASA task loadindex; en subjektiv, multidimensionell mätmetod som bygger på kortsortering och mäteruppfattad kognitiv belastning i en sammanhängande skala. Mätning med hjälp av dessametoder kan resultera i en ökad interaktionskvalitet i interaktiva, fysiska och digitalagränssnitt. En uppskattning av interaktionskvalitet kan bidra till att fel vid interaktionminimeras, vilket innebär en förbättring av användares upplevelse vid interaktion. / Technical developments have led to the broadcasting of massive amounts of information, athigh velocities. We must learn to handle this flow. To maximize the benefits of newtechnologies and avoid the problems that this immense information flow brings, interactionquality should be studied. We must adjust interfaces to the user because the user does nothave the ability to adapt and sort overly large amounts of information. We must developsystems that make the human more efficient when using interfaces.To adjust the interfaces to the user needs and limitations, knowledge about humancognitive processes is required. When cognitive workload is studied it is important that aflexible, easily accessed and non assertive technique is used to get unbiased results. At thesame time reliability is of great importance. To design interfaces with high interaction quality,a technique to evaluate these is required. The aim of this paper is to establish a method that iswell suited for measurement of interaction quality.When measuring interaction quality, a combination of subjective and physiologicalmethods is recommended. This comprises a combination of Functional near-infraredspectroscopy; a physiological measurement which measures brain activity using light sourcesand detectors placed on the frontal lobe, Electrodermal activity; a physiological measurementwhich measures brain activity using electrodes placed over the scalp and NASA task loadindex; a subjective, multidimensional measurement based on card sorting and measures theindividual perceived cognitive workload on a continuum scale. Measuring with these methodscan result in an increase in interaction quality in interactive, physical and digital interfaces.An estimation of interaction quality can contribute to eliminate interaction errors, thusimproving the user’s interaction experience.