Luca Pollonini

Functional connectivity networks in the autistic and healthy brain assessed using Granger causality

In this study, we analyze brain connectivity based on Granger causality computed from magnetoencephalographic (MEG) activity obtained at the resting state in eight autistic and eight normal subjects along with measures of network connectivity derived from graph theory in an attempt to understand how communication in a human brain network is affected by autism. A connectivity matrix was computed for each subject individually and then group templates were estimated by averaging all matrices in each group. Furthermore, we performed classification of the subjects using support vector machines and Fishers criterion to rank the features and identify the best subset for maximum separation of the groups. Our results show that a combined model based on connectivity matrices and graph theory measures can provide 87.5% accuracy in separating the two groups. These findings suggest that analysis of functional connectivity patterns may provide a valuable method for the early detection of autism.

A Novel Handheld Device for Use in Remote Patient Monitoring of Heart Failure Patients--Design and Preliminary Validation on Healthy Subjects

Remote patient monitoring (RPM) holds great promise for reducing the burden of congestive heart failure (CHF). Improved sensor technology and effective predictive algorithms can anticipate sudden decompensation events. Enhanced telemonitoring systems would promote patient independence and facilitate communication between patients and their physicians. We report the development of a novel hand-held device, called Blue Box, capable of collecting and wirelessly transmitting key cardiac parameters derived from three integrated biosensors: 2 lead electrocardiogram (ECG), photoplethysmography and bioelectrical impedance (bioimpedance). Blue Box measurements include time intervals between consecutive ECG R-waves (RR interval), time duration of the ECG complex formed by the Q, R and S waves (QRS duration), bioimpedance, heart rate and systolic time intervals. In this study, we recruited 24 healthy subjects to collect several parameters measured by Blue Box and assess their value in correlating with cardiac output measured with Echo-Doppler. Linear correlation between the heart rate measured with Blue Box and cardiac output from Echo-Doppler had a group average correlation coefficient of 0.80. We found that systolic time intervals did not improve the model significantly. However, STIs did inversely correlate with increasing workloads.

Synchronization between the anterior and posterior cortex determines consciousness level in patients with traumatic brain injury (TBI)

Survivors of traumatic brain injury (TBI) often suffer disorders of consciousness as a result of a breakdown in cortical connectivity. However, little is known about the neural discharges and cortical areas working in synchrony to generate consciousness in these patients. In this study, we analyzed cortical connectivity in patients with severe neurocognitive disorder (SND) and in the minimally conscious state (MCS). We found two synchronized networks subserving consciousness; one retrolandic (cognitive network) and the other frontal (executive control network). The synchrony between these networks is severely disrupted in patients in the MCS as compared to those with better levels of consciousness and a preserved state of alertness (SND). The executive control network could facilitate the synchronization and coherence of large populations of distant cortical neurons using high frequency oscillations on a precise temporal scale. Consciousness is altered or disappears after losing synchrony and coherence. We suggest that the synchrony between anterior and retrolandic regions is essential to awareness, and that a functioning frontal lobe is a surrogate marker for preserved consciousness. This article is part of a Special Issue entitled: Brain Integration.

Auditory cortex activation to natural speech and simulated cochlear implant speech measured with functional near-infrared spectroscopy

The primary goal of most cochlear implant procedures is to improve a patients ability to discriminate speech. To accomplish this, cochlear implants are programmed so as to maximize speech understanding. However, programming a cochlear implant can be an iterative, labor-intensive process that takes place over months. In this study, we sought to determine whether functional near-infrared spectroscopy (fNIRS), a non-invasive neuroimaging method which is safe to use repeatedly and for extended periods of time, can provide an objective measure of whether a subject is hearing normal speech or distorted speech. We used a 140 channel fNIRS system to measure activation within the auditory cortex in 19 normal hearing subjects while they listed to speech with different levels of intelligibility. Custom software was developed to analyze the data and compute topographic maps from the measured changes in oxyhemoglobin and deoxyhemoglobin concentration. Normal speech reliably evoked the strongest responses within the auditory cortex. Distorted speech produced less region-specific cortical activation. Environmental sounds were used as a control, and they produced the least cortical activation. These data collected using fNIRS are consistent with the fMRI literature and thus demonstrate the feasibility of using this technique to objectively detect differences in cortical responses to speech of different intelligibility.

Design and performance of a wide-bandwidth and sensitive instrument for near-infrared spectroscopic measurements on human tissue

The article describes an instrument designed to perform in vivo near-infrared spectroscopic measurements on human tissues. The system integrates five continuous-wave laser diode sources emitting in the near-infrared spectral region and a low-noise detection system based on an avalanche photodiode. The optical probe is based on a compact, reliable, and low-cost fiber based system with four quantitative measuring points. The excellent sensitivity of the instrument allows one to perform quantitative assessments of the hemoglobin concentration exploiting precise absorption measurements close to the absorption peak of the water: 975 nm. Moreover, a good signal to noise ratio is obtained also at a high acquisition rate, allowing us to follow rapid changes in oxidative metabolism. The system bandwidth is selectable within the range 2.3–27 Hz, i.e., 20 channels (five chromatic and four spatial channels) can be acquired 27 times for each measuring second, whereas the system amplification can be set to measure opti...

Cortical Activation Patterns Correlate with Speech Understanding After Cochlear Implantation.

Objectives: Cochlear implants are a standard therapy for deafness, yet the ability of implanted patients to understand speech varies widely. To better understand this variability in outcomes, the authors used functional near-infrared spectroscopy to image activity within regions of the auditory cortex and compare the results to behavioral measures of speech perception. Design: The authors studied 32 deaf adults hearing through cochlear implants and 35 normal-hearing controls. The authors used functional near-infrared spectroscopy to measure responses within the lateral temporal lobe and the superior temporal gyrus to speech stimuli of varying intelligibility. The speech stimuli included normal speech, channelized speech (vocoded into 20 frequency bands), and scrambled speech (the 20 frequency bands were shuffled in random order). The authors also used environmental sounds as a control stimulus. Behavioral measures consisted of the speech reception threshold, consonant-nucleus-consonant words, and AzBio sentence tests measured in quiet. Results: Both control and implanted participants with good speech perception exhibited greater cortical activations to natural speech than to unintelligible speech. In contrast, implanted participants with poor speech perception had large, indistinguishable cortical activations to all stimuli. The ratio of cortical activation to normal speech to that of scrambled speech directly correlated with the consonant-nucleus-consonant words and AzBio sentences scores. This pattern of cortical activation was not correlated with auditory threshold, age, side of implantation, or time after implantation. Turning off the implant reduced the cortical activations in all implanted participants. Conclusions: Together, these data indicate that the responses the authors measured within the lateral temporal lobe and the superior temporal gyrus correlate with behavioral measures of speech perception, demonstrating a neural basis for the variability in speech understanding outcomes after cochlear implantation.

A novel tissue oxymeter combining the multidistance approach with an accurate spectral analysis

In this paper a novel optical tissue oxymeter that integrates the multidistance approach and the evaluation of the differential pathlength exploiting the absorption features of water is presented. This system takes advantage from the peculiarities of these techniques to extract the scattering and the absorption coefficient reducing errors introduced by the heterogeneous structure of the tissue and improving the signal-to-noise ratio. I. INTRODUCTION Continuous-Wave Near-InfraRed Spectroscopy (CW- NIRS) was first introduced more than twenty years ago as a tool for in-vivo monitoring of the tissue oxygenation (1). This technique is based on the low extinction coefficient of tissue in the near infrared region combined with the fact that tissue contains chromophores, principally water, lipids, melanin, deoxyhaemoglobin, oxyhaemoglobin, and cytochrome oxidase. In the spectral range 700-1000nm, light can interrogate the whole brain or muscle allows assessing changes in concentration of these chromophores. One of the major limitations of the CW-NIRS systems is the coupling between the scattering and the absorption coefficient causing the lack of quantitative assessment. Two possible ways to uncouple absorption from scattering have so far been proposed: (i) the multidistance approach, i.e. the analysis of the spatial decay of re-emitted light (2, 3) and (ii) the evaluation of the differential pathlength of photons utilizing the absorption features of water (4). Both these techniques suffer by errors introduced by the heterogeneous structure of the tissue. In this article, we present a novel optical tissue oxymeter that integrates these two techniques to achieve more quantitative data and to improve the quality of the signal. Particularly, we describe the system configuration, the system performance and the theory of operation. Moreover, the calibration procedure and a preliminary in-vivo test are discussed.

A multi-layer monitoring system for clinical management of Congestive Heart Failure.

BackgroundCongestive Heart Failure (CHF) is a serious cardiac condition that brings high risks of urgent hospitalization and death. Remote monitoring systems are well-suited to managing patients suffering from CHF, and can reduce deaths and re-hospitalizations, as shown by the literature, including multiple systematic reviews.MethodsThe monitoring system proposed in this paper aims at helping CHF stakeholders make appropriate decisions in managing the disease and preventing cardiac events, such as decompensation, which can lead to hospitalization or death. Monitoring activities are stratified into three layers: scheduled visits to a hospital following up on a cardiac event, home monitoring visits by nurses, and patients self-monitoring performed at home using specialized equipment. Appropriate hardware, desktop and mobile software applications were developed to enable a patients monitoring by all stakeholders. For the first two layers, we designed and implemented a Decision Support System (DSS) using machine learning (Random Forest algorithm) to predict the number of decompensations per year and to assess the heart failure severity based on a variety of clinical data. For the third layer, custom-designed sensors (the Blue Scale system) for electrocardiogram (EKG), pulse transit times, bio-impedance and weight allowed frequent collection of CHF-related data in the comfort of the patients home.We also performed a short-term Heart Rate Variability (HRV) analysis on electrocardiograms self-acquired by 15 healthy volunteers and compared the obtained parameters with those of 15 CHF patients from PhysioNets PhysioBank archives.ResultsWe report numerical performances of the DSS, calculated as multiclass accuracy, sensitivity and specificity in a 10-fold cross-validation. The obtained average accuracies are: 71.9% in predicting the number of decompensations and 81.3% in severity assessment. The most serious class in severity assessment is detected with good sensitivity and specificity (0.87 / 0.95), while, in predicting decompensation, high specificity combined with good sensitivity prevents false alarms. The HRV parameters extracted from the self-measured EKG using the Blue Scale system of sensors are comparable with those reported in the literature about healthy people.ConclusionsThe performance of DSSs trained with new patients confirmed the results of previous work, and emphasizes the strong correlation between some CHF markers, such as brain natriuretic peptide (BNP) and ejection fraction (EF), with the outputs of interest. Comparing HRV parameters from healthy volunteers with HRV parameters obtained from PhysioBank archives, we confirm the literature that considers the HRV a promising method for distinguishing healthy from CHF patients.

A system for the inspection and quality control of glass slabs

This article describes an innovative interferometric system for the inspection and quality control of glass slabs. The instrument exploits a self-mixing superluminescent diode scheme to improve the interferometric signal and to reject typical noise and electromagnetic interference existing in industrial environments. Various instrumental aspects and performance issues are discussed. Experimental activities demonstrate a system measuring range of 4.5 mm with a relative measurement uncertainty of less than 2%. Whereas, the measuring stability was measured to be about 2.5 μm over 20 min.

Pulse transit time measured by photoplethysmography improves the accuracy of heart rate as a surrogate measure of cardiac output, stroke volume and oxygen uptake in response to graded exercise

Heart rate (HR) is a valuable and widespread measure for physical training programs, although its description of conditioning is limited to the cardiac response to exercise. More comprehensive measures of exercise adaptation include cardiac output (Q̇), stroke volume (SV) and oxygen uptake (V̇O2), but these physiological parameters can be measured only with cumbersome equipment installed in clinical settings. In this work, we explore the ability of pulse transit time (PTT) to represent a valuable pairing with HR for indirectly estimating Q̇, SV and V̇O2 non-invasively. PTT was measured as the time interval between the peak of the electrocardiographic (ECG) R-wave and the onset of the photoplethysmography (PPG) waveform at the periphery (i.e. fingertip) with a portable sensor. Fifteen healthy young subjects underwent a graded incremental cycling protocol after which HR and PTT were correlated with Q̇, SV and V̇O2 using linear mixed models. The addition of PTT significantly improved the modeling of Q̇, SV and V̇O2 at the individual level ([Formula: see text] for SV, 0.548 for Q̇, and 0.771 for V̇O2) compared to predictive models based solely on HR ([Formula: see text] for SV, 0.503 for Q̇, and 0.745 for V̇O2). While challenges in sensitivity and artifact rejection exist, combining PTT with HR holds potential for development of novel wearable sensors that provide exercise assessment largely superior to HR monitors.