Neuroscience and Biomedical Engineering (Discontinued) - Volume 4, Issue 1, 2016

Background: Alzheimer’s disease (AD) is the most seen cause of dementia. Biomarker tests will be essential to improve the early diagnosis of AD, as treatment is more effective in the early stage. The biomarkers of AD are divided into two main classes: amyloid β-peptide (Aβ) accumulation, and tau-related neuronal degeneration. Peripheral blood represents an alternative sample for reflecting pathological events occurring in the body. Blood samples are a possible alternative for cerebrovascular fluid samples. The potential advantages of blood biomarkers are obvious: less invasive; simple to perform, convenient to use, and not harmful to the patient. Methods: Review publications about peripheral blood amyloid and tau biomarker tests by ELISA for AD stages; analyze and interpret data in comparison with cerebrovascular fluid results. Also review publications about peripheral messenger RNA biomarkers tests for AD diagnosis; analyze feasibility of diagnostic tests using blood messenger RNA biomarkers for AD. Results: With sensitive and specific ELISA, extensive studies of plasma Aβ42 level and Aβ42/Aβ40 ratio were reported during the development of blood-based protein biomarkers. High level of plasma Aβ42 increased risk of AD or cognitive decline. The majority of the studies also indicated that increased plasma Aβ42 level was present prior to or at the start of the development of AD, and Aβ42 level decreased as disease progressed; the lowest Aβ42/Aβ40 ratio reported was associated with developing dementia. However, some studies showed inconsistent results. Reliable methods to determine levels of tau and phosphorylated tau in blood of AD patients are still being explored. Conclusion: The effort to discover and develop diagnostic protein biomarkers in blood has not led to feasible candidate markers close to CSF. It may be helpful for each laboratory to set its own normal value or cut-offs due to different ELISA kits used. Improving clinical diagnostic criteria may be another valuable option. Development of additional biomarkers may also increase diagnostic accuracy. Compared with other technologies used in routine diagnostic tests, real time reverse transcription polymerase chain reaction (RT-qPCR) is sensitive, specific, scalable, and cost-effective. There is relatively less evidence of blood mRNAs acting as biomarkers in AD. The scientific merit and feasibility of diagnostic tests for monitoring AD progress using blood mRNAs biomarker quantification need to be established.

Background: What is neural memory? How does it differ from binary encoded, computer memory? Attempts to model brain function using contemporary computer hardware and (information) theory suggests the need for a new paradigm. The disparity between (dry) electronic devices that “compute” in binary format (n=2) and biologic (wet) neural nets that mentate in “multinary” format (i.e. n>10), reflects drastically differing recall systems. Focusing on codes, we discuss Morse and Braille codes and note that a binary bit (0 /1) cannot encode a psychic (emotive) state. Between 0 and 1, there is no code for “emotions”. Hypothesis: “Form follows function”. There are no “naked neurons”. Neuron morphology (extended shape, large surface area) implies intimate contact with its surroundings. Based on observed morphological and biochemical evidence, we propose a tripartite, biochemical process for encoding neural memory, whereby the surrounding “neural extracellular matrix” (nECM), functions as a “memory material” to encode and store cognitive units of information (cuinfo). The dopants (>10 neuro-metals, >90 neuro-transmitters (NTs)) within vesicles ejected by neurons into the nECM, provide the neuron with Avogadro scale (A=6x10 23 ) “dopants” for encoding emotive memory. Calculations using experimentally determined (molar) levels of metals and NTs, reveal astronomical coding options and capacity. Conclusion: Neurons collectively generate memory, using both electrodynamic and chemodynamic signals. The NTs link physiology to psyche, functioning in memory as signifiers (enciphers) of emotions. An algorithm, blueprint, calculus, fractal, mimetic or simulation that ignores {neuron-nECM-NT} interactions, cannot emulate mental processes of the brain, recalling emotive memory to survive.

Background: Stroke is a major contributor to the reduced ability to carry out activities of daily living (ADL) post cerebral infarct. There has been a major focus on understanding and improving rehabilitation interventions in order to target cortical neural plasticity to support recovery of upper limb function. Conventional therapies delivered by therapists have been combined with the application of mechanical and robotic devices to provide controlled and assisted movement of the paretic upper limb. The ability to provide greater levels of intensity and reproducible repetitive task practice through the application of intervention devices are key mechanisms to support rehabilitation efficacy. Results: This review of literature published in the last decade identified 141 robotic or mechanical devices. These devices have been characterised and assessed by their individual characteristics to provide a review of current trends in rehabilitation device interventions. Correlation of factors identified to promote positive targeted neural plasticity has raised questions over the benefits of expensive robotic devices over simple mechanical ones. Conclusion: A mechanical device with appropriate functionality to support the promotion of neural plasticity after stroke may provide an effective solution for both patient recovery and to stimulate further research into the use of medical devices in stroke rehabilitation. These findings indicate that a focus on simple, cost effective and efficacious intervention solutions may improve rehabilitation outcomes.

Background: Patients with complex regional pain syndrome (CRPS) require long-term treatment. Virtual reality based mirror visual feedback (VR-MVF) can contribute to this treatment. A personal VR-MVF system has been proposed for treating patients at home. Assessment and understanding of a patient's condition is required for medical instruction in order to continue home-based treatment. However, diagnostic questionnaires alone are inadequate for complete assessment of a patient’s condition. The purpose of this study was to find movement indices for the improvement of CRPS by comparing hand movements of patients with CRPS to those of normal people. Method: We compared reaching movements of the wrist and elbow during the VR-MVF treatment task. A personal VRMVF system was used for collecting data. Reaching movements were defined as movements from 2 seconds before the grasp of the virtual object to the time at which the object was grasped. Result: The results showed that healthy participants performed reaching movements with their hand. On the other hand, the patients with CRPS tended to perform reaching movements by moving their elbow instead of their hand. In addition, the results showed that the increase in trajectory length of the patients’ hand relative to their elbow may relate to pain reduction. Conclusion: In accordance with these results, we suggest that focusing on the movements of the hand and the elbow may be useful for understanding the condition of these patients, and that hand and elbow movements may be used as indices.

Background: The area of the kinetic visual field becomes smaller as the brightness of targets becomes darker. Additionally, this ability to recognize an object is decreasing depends on age. However, whether not only the target brightness, but also the background brightness will make the area of the kinetic visual field decrease in ranging of age. We aim of our study in to investigate the differences in the kinetic visual field at several levels of background brightness in young and elder participants. Methods: The kinetic visual field was measured with three levels of background brightness (0.003 cd/m2, 1.6 cd/m2, 64 cd/m2) in contrast ratio (1.4) within younger and elder participants using the Goldman perimeter, which utilizes an electromotive slider to control the speeds of the target’s movement. Results: The isopter for elder adults was smaller than for younger adults. Additionally there was a significant difference between the younger and elder participants for each level of background brightness when tested by ANOVA. Furthermore the results suggested that the isopter’s shape of 0.003 cd/m2 was smaller, and for 1.6 cd/m2 and 200 cd/m2, the shape was substantially the same. In addition, on the ear side relative to the nose side, the isopter spread largely to the lower area relative to the upper, and this trend seen in elder adults was substantially the same in younger adults. Conclusion: The kinetic visual field decreased as background brightness in ranging of age. Although previous studies concluded that the eccentric angle of the upper side of the visual field was reduced, this study found that the visual field on the nose side was also reduced. On the other hand, it was found that the reduction of the eccentric angle was less than in the downward visual field. If the visual field is binocular, the downward visual field will be less influenced by aging.

Background: Clinical information have been stored electronically as a hospital information system(HIS). The database stores all the data related with medical actions, including accounting information, laboratory examinations, and patient records described by medical staff and becomes the indispensable infrastructure for clinical decision process. However, clinical environment is very complex, and flexible and adaptive service improvement is crucial in maintaining quality of medical care. Thus, incremental software development in hospital information system and its evaluation is important. Methods: The following software development process is proposed. First, data extracted from hospital information system is used to capture the peculiarities of the divisions in a university hospital. Then, the mining results are interpreted by medical staff and the solutions are discussed. Based on the discussions, new interfaces are developed, and their performance was evaluated using the service logs. The data used for hypothesis generation is the chronological change of the number of clinical orders and waiting time. Analytical method of temporal data is based on multiscale matching method. Experiments were conducted from fiscal year 2010 to 2012. In the ends of fiscal year 2010 and 2011, the new software was embedded into hospital information system and service logs are collected. From the service log, the times when a patient came to visit a reception and a laboratory division, when results of laboratory examinations were output, when a doctor started to examine in his/her clinic were extracted, the time differences between events were calculated and these values were used for the evaluation statistics. Fiscal year 2010, 2011 and 2012 were regarded as the baseline, the period when the first improvement was implemented, and that when the second improvement implemented, respectively. Comparison of statistics (median and mean) were used for evaluation and Kruskal-Wallis test was applied for checking the differences among three years. For statistical analysis, R3-1-1 was used. Results: Two divisions, hepatology and rheumatology were selected for comparison. The obtained results gave a hypothesis that the workflow of rheumatology is different from that of hepatology, which reflected the ordinary workflow in the outpatient clinics of the university hospital and caused the problem where experts forgot to issue the orders. The first step was to implement an interface for double checking: if a clinician input the comment on laboratory examination in a reservation sheet but he/she has not yet issued an order before they closed their windows for a patient, an alert will come up from the screen. After one year trial, statistics showed a small improvement in waiting time was very small as shown in the next section, we discussed with rheumatologists again, and in fiscal year 2012, we set up the management screen where all the forgotten orders for patients who visited that day would be displayed, and the doctors could go back to issue orders. The workflow and waiting time were improved after the second installation. Conclusion: The process, which can be viewed as a variant of active mining process, will give a new framework for quantitative evaluation of software development in hospital information system, which can be viewed as an application of active mining process.

Background: Representation of objects can be obtained through tactual perception alone. The previous studies showed that there were no significant differences between the index finger and middle finger when the participants perceived the length of the presented objects, however, the length perception characteristics between the thumb and each of the four other fingers remains unclear. Objective: To investigate the length perception characteristics between the thumb and each of the four other fingers, the current study using a four-degree-of-freedom (4DOF) length display device with an adjustable distance conducted length perception experiments. Methods: We performed two experiments: experiment I, perception of different lengths (natural position), and experiment II, perception of the same length (same length position). In experiment I, the length presented to each pair of fingers was different. In experiment II, the length presented to finger pairs of the participants was the same. Results: The results showed that in both experiments, the perceived length was relatively shorter than the presented length, and when the presented length was longer than 70 mm, the error becomes smaller. The comparison of results indicated that for the perception of the index finger, no significant differences existed between the two experiments under any condition; for the middle and ring fingers, significant differences were found only when the presented length was approximately 100 mm; for the little finger, significant differences were found for lengths ranging from 45 mm to 90 mm. Conclusion: These results indicated that the perceptual accuracy at the natural position of the fingers is worse than that when the finger is in a bent position, and when the finger is spread beyond the neutral position, the relative positon affects the length perception.