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No description available.

L'obiettivo principale del lavoro è stato di valutare il ruolo della neurostimolazione e della multimodalità (intesa come la presentazione visiva di un modello che esegue un movimento assieme a una musica sincrona) nell’apprendimento motorio, indagando sia gli effetti sugli adulti sani sia su pazienti affetti da Morbo di Parkinson (MP). Per raggiungere tale obiettivo, sono state condotte tre ricerche sperimentali e longitudinali, utilizzando diversi strumenti, come tDCS, biofeedback e KinectTM. Partendo da una sistematica revisione della letteratura nel campo della riabilitazione neuromotoria, sono state identificate tre forme di trattamento che sembrano efficaci contro i sintomi motori del MP. Tuttavia, pur riconoscendo la loro efficacia, non sono mai stati combinati nella pratica riabilitativa: l’Action Observation Learning (basato sulla teoria del sistema dei neuroni specchio), la neurostimolazione anodica non-invasiva sulla zona motoria primaria e l'uso della musica. I risultati dimostrano un chiaro sostegno della multimodalità e della neuro stimolazione nella fase di encoding e un loro supporto nel migliorare le funzioni motorie, anche a distanza di un mese. Questo lavoro offre nuove indicazioni per lo sviluppo di approcci innovativi ed efficaci nel campo dell’apprendimento motorio. / The main objective was to assess the role of neurostimulation and multimodality (namely the presentation of a visual model together with a synchronized musical track) in motor learning, by considering both healthy adults and Parkinsonian patients (PD). In order to achieve this goal, three experimental and longitudinal studies were carried out, using different tools such as tDCS, biofeedback and KinectTM. Starting with a systematic review, three innovative approaches which seem to be effective in treating the motor symptoms of PD, were identified. However, while recognizing the effectiveness of these three promising approaches, they have never been combined: Action Observation Learning (based on the theory of mirror neuron system), the non-invasive anodal neurostimulation on the primary motor area and the use of music. The results showed a clear support of multimodality and neurostimulation during the encoding phase and in improving motor functions, even after one month. This work provides new suggestions for innovative and effective treatments in motor learning field.

No description available.

No description available.

La tomografía de impedancia eléctrica (EIT) permite estimar la conductividad eléctrica interna de un cuerpo. Consiste en aplicar una corriente eléctrica sobre su frontera y medir el potencial eléctrico resultante mediante un arreglo de sensores. Es considerada como una potencial herramienta de diagnóstico médico, caracterizada principalmente por su portabilidad y relativo bajo costo. Si bien se encuentra aún en etapa de desarrollo, está comenzando a ser utilizada en centros de salud para la caracterización del aparato cardio-respiratorio y existe un creciente interés en su aplicación a las neurociencias. Por ejemplo, es posible utilizar la EIT para construir modelos virtuales de la cabeza más precisos mediante la estimación de la conductividad eléctrica de los principales tejidos de la cabeza como un conjunto de parámetros relativamente pequeño, modalidad denominada EIT paramétrico. También se puede utilizar la EIT para generar un mapa de la distribución de conductividad eléctrica interna de un objeto, llamado problema de reconstrucción en EIT. Los cambios de la conductividad eléctrica en la cabeza pueden estar asociados a la actividad neuronal, a focos epilépticos, a accidentes cerebro-vasculares o a tumores. Ambas modalidades de EIT requieren la resolución del problema directo (PD), que consiste en el cálculo de la distribución de potencial eléctrico en el objeto originada por la inyección de corriente sobre su superficie, suponiendo que la conductividad interna es conocida. La estimulación de corriente continua transcraneal (tDCS) es físicamente muy similar a la EIT, pero la corriente eléctrica es aplicada sobre el cuero cabelludo de modo de alterar la tasa de disparos de poblaciones de neuronas en una región de interés. Es una potencial alternativa al empleo de psicofármacos para tratar desórdenes como epilepsia o depresiones. En esta tesis se desarrollan y analizan nuevos métodos para distintos problemas de EIT, centrándose mayormente en aplicaciones a la cabeza humana, y de tDCS. En primer lugar, se describen soluciones analíticas y numéricas para el PD en EIT, estas últimas basadas en el método de los elementos finitos. Luego, se desarrolla un nuevo procedimiento para resolver el PD con bajo costo computacional basado en la formulación del PD en electroencefalografía (EEG). Se propone un nuevo método para determinar la forma de onda de la fuente de corriente que permite desafectar la actividad propia del cerebro con un bajo número de muestras temporales. En EIT paramétrico, se utiliza la cota de Cramér-Rao (CRB) para determinar pares de electrodos convenientes para la inyección de corriente y para analizar límites teóricos en la estimación de las conductividades del cráneo y del cuero cabelludo, modelizándolos como tejidos isótropos y anisótropos. A su vez, se propone el estimador de máxima verosimilitud (MLE) como herramienta para realizar las estimaciones. El MLE se aplica a mediciones simuladas y reales de EIT mostrando un desempeño muy cercano a los límites teóricos. Para el problema de reconstrucción en EIT se adapta el algoritmo sLORETA, muy utilizado en el problema de localización de fuentes de actividad neuronal en EEG. Además, se lo modifica levemente para incorporar la regularización espacial de Laplace. Por otro lado, se introduce la utilización de filtros espaciales adaptivos para localizar cambios de conductividad de pequeño tamaño y estimar su variación temporal. Los resultados muestran mejoras en sesgo y resolución, en comparación con algoritmos de reconstrucción típicos en EIT. Estas mejoras son potencialmente ventajosas en la detección de accidentes cerebro-vasculares y en la localización indirecta de fuentes de actividad neuronal. En tDCS, se desarrolla un nuevo algoritmo para la determinación de patrones de inyección de corriente basado en el principio de reciprocidad y que considera restricciones de seguridad y de hardware. Los resultados obtenidos a partir de simulaciones muestran que el desempeño de dicho algoritmo es comparable al desempeño de algoritmos de optimización tradicionales cuyas soluciones implicarían un equipamiento comparativamente más complejo y costoso. Los métodos desarrollados en la tesis son comparados con métodos pre-existentes y validados a través de simulaciones numéricas por computadora, mediciones sobre maquetas experimentales (ó fantomas) y, de acuerdo con las posibilidades experimentales y respetando los principios de la bioética, mediciones reales sobre humanos. / Electrical impedance tomography (EIT) is a technique to estimate the electrical conductivity of an object. It consists in the application of an electric current on its boundary and the measurement of the resulting electric potential with a sensor array. In clinical practise, it is considered as a potential diagnostic tool characterized by its portability and relatively low cost. While it is still in a development stage, it is starting to be used in health centers to characterize the cardio-respiratory system. In turn, there is an increasing interest of EIT in neuroscience. For example, EIT can be used to estimate the electrical conductivity of the main tissues of the head as a set of a relatively low number of parameters, which is known as bounded or parametric EIT. This is useful for several medical imaging techniques that require realistic and accurate virtual models of the head. EIT can also be used to generate a map of the internal distribution of the electrical conductivity, known as the reconstruction problem. Tracking conductivity changes inside the head is of great interest as they may be related to neuronal activity, epileptic foci, acute stroke, or tumors. Both modalities of EIT require the solution of the EIT forward problem (FP), i.e., the computation of the electric potential distribution due to current injection on the scalp assuming that the electrical conductivity is known. The transcranial direct current stimulation (tDCS) is another technique which is physically very similar to EIT. It consists in injecting a small electric current in a convenient way such that it stimulates specific neuronal populations, increasing or decreasing their firing rate. It is considered as an alternative to psychoactive drugs in the treatment of brain disorders such as epilepsy or depression. This thesis describes the development and analysis of new methods for EIT FP, parametric EIT, reconstruction in EIT, and tDCS, focusing primarily (although not exclusively) in applications to human head. We first describe analytical and numerical approaches for the EIT FP, where the numerical approach is based on the finite element method. Then, we develop a new procedure to solve the EIT FP based on the electroencephalography (EEG) FP formulation, which results in computational advantages. We propose a new method to determine the waveform of the electric current source such that the neuronal activity of the brain can be neglected with the smallest possible number of time samples. In parametric EIT, we use the Cramér-Rao bound (CRB) to determine convenient electrode pairs for the current injection and theoretical limits in the estimation of the electrical conductivity of the main tissues of the head, which we model as isotropic and anisotropic. We propose the maximum likelihood estimator (MLE) to estimate these conductivities and we test it with simulated and real EIT measurements, showing that the MLE performs close to the CRB. We adapt the sLORETA algorithm to the reconstruction problem in EIT. This algorithm is being widely used in the source localization problem in EEG. We also slightly modify it to include the Laplace smoothing prior in the solution. Likewise, we introduce the use of adaptive spatial filters in the localization of conductivity changes and the estimation of its time courses from EIT measurements. The results show improvements over typical EIT algorithms. These improvements may benefit the early detection of acute strokes and the localization of neuronal activity using EIT. In tDCS, we develop a new algorithm to determine convenient current injection patterns. It is based on the reciprocity principle and considers hardware and safety constraints. Our simulation results show that this method performs similarly to other commonly used algorithms that require more complex and costly equipments. The methods we develop and study in this thesis are compared with pre-existing methods and are validated through numerical simulations, measurements on phantoms and, according to the experimental possibilities and bioethical principles, humans.

Made available in DSpace on 2016-03-15T19:40:41Z (GMT). No. of bitstreams: 1 Rita dos Santos de Carvalho Picinini.pdf: 1897105 bytes, checksum: 40db215aab8bca0781df1d15de88b3d3 (MD5) Previous issue date: 2009-01-27 / Fundo Mackenzie de Pesquisa / Different mathematical skills have been investigated over time and, with the advance of neuroimaging techniques, such as PET (Positron Emission Tomography) and fMRI (functional Magnetic Resonance), central components of arithmetical processing have been identified in the parietal and the pre-frontal cortices. Besides the advances of the neuroimaging techniques, other techniques such as non-invasive brain modulation have also been studied such as the transcranial magnetic stimulation (TMS) and the transcranial direct current stimulation (TDCS) in the involvement of cognitive functions in the area of calculation. This study aimed at investigating the impact of anodal TDCS applied over the left dorsolateral pre-frontal cortex (LDLPFC), right parietal cortex (RPC), left parietal cortex (LPC) while the subject was performing multiplication operations. Fifteen healthy volunteers, students of psychology, aged between 18 and 30 years old, have held subtests of the WAIS III and the multiplication task. The results showed that the anodal TDCS over the RPC improved the performance of men regarding the number of rightness. The influence of TDCS on volunteers who had worse performance took place not on complex tasks, but simple arithmetical ones. Besides, the influence of TDCS on volunteers who had better performance was in complex tasks, not simple ones. These results show that the effects of the TDCS on a certain function depend on the baseline values of each volunteer. The other stimulation conditions over the LDLPFC and LPC did not show any significant results. The TDCS can bring a beneficial effect in calculation tasks, depending on the intensity, polarity, time and location of stimulation, resulting in the increased or diminished cortex excitability. / Diferentes habilidades matemáticas vêm sendo investigadas ao longo dos tempos e, com o avanço das técnicas de neuroimagem, como PET (Tomografia por emissão de Pósitrons) e fMRI (ressonância magnética funcional) componentes centrais no processamento aritmético vêm sendo identificados em córtex parietal e pré-frontal. Além do avanço das técnicas de neuroimagem, outras técnicas como de modulação cerebral não-invasiva também vêm sendo estudadas, como Estimulação Magnética Transcraniana (EMT) e a Estimulação Transcraniana por Corrente Contínua (ETCC) no envolvimento das funções cognitivas com a área de cálculo. Este estudo teve como objetivo investigar o impacto da ETCC anódica quando aplicada no Córtex Pré-Frontal Dorsolateral (CPFDLE), Córtex Parietal Direito (CPD), Córtex Parietal Esquerdo (CPE) no desempenho em operações de multiplicação. Quinze voluntários saudáveis, estudantes de psicologia, com faixa etária entre 18 e 30 anos, realizaram subtestes do WAIS III e a tarefa de multiplicação. Os resultados desse estudo mostraram que a ETCC anódica aplicada no CPD melhorou o desempenho dos homens em relação ao número de acertos. A influência da ETCC em participantes com pior desempenho em Aritmética se deu em tarefa simples de multiplicação, mas não complexa, ao passo que a influência da ETCC em participantes com melhor desempenho em Aritmética se deu em tarefa complexa de multiplicação, mas não em simples. Tais resultados sinalizam que os efeitos da estimulação em uma determinada função dependem dos valores de linha de base de cada participante As outras condições de estimulações, CPFDLE e CPE não resultaram em efeitos significativos. A ETCC pode produzir um efeito benéfico em tarefas de cálculo, dependendo da intensidade, polaridade, tempo e localização da estimulação, podendo resultar em aumento ou diminuição na excitabilidade do córtex.

Background: Gait initiation is a major issue in Parkinson’s disease (PD). Moreover, the effect of current treatment on motor deficits vary alongside individual differences and disease severity. In some cases, postural instability has been documented as a major side-effect and refractory symptom to dopaminergic medication. Despite these shortcomings, research involving other forms of therapy including deep brain stimulation (DBS) and transcranial magnetic stimulation (TMS), has evidenced the improvement of postural deficits in PD. In this regard, there is a strong rational for the modulation of subcortical brain activity via the application of non-invasive transcranial direct current stimulation (tDCS) to interconnected cortical brain structures. Purpose: Therefore, we sought to determine the effect of tDCS applied to the supplementary motor area (SMA), on gait initiation preparation and performance in PD. Methods: A within subjects repeated measures quasi-experimental design was used to investigate the effects of a 10-minute sham-controlled tDCS intervention. Clinically diagnosed participants (n=12) with idiopathic PD were tested on medication during two sessions that bookended one week. Those who had previously undergone other forms of brain stimulation, had diabetes, severe freezing of gait, or any other neurological or functional limitations that could interfere with gait initiation were excluded from the study. Statistical Analyses/Results: Two-way repeated measures ANOVAs with Bonferroni corrections and a post-hoc analyses when appropriate, revealed a significant reduction in the magnitude of center of pressure (CoP) displacement and velocity in the mediolateral (ML) direction following tDCS. Conclusions: Findings from this study provide insights that may guide scientific research regarding the effects of tDCS on gait initiation among those with PD. Additionally, our work may highlight the importance of ML postural stability for individuals with comorbid and/or pharmacologically induced postural instabilities.