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Melillo R, Leisman G, Machado C, Machado-Ferrer Y, Chinchilla-Acosta M, Melillo T, Carmeli E. The Relationship between Retained Primitive Reflexes and Hemispheric Connectivity in Autism Spectrum Disorders. Brain Sci 2023; 13:1147. [PMID: 37626503 PMCID: PMC10452103 DOI: 10.3390/brainsci13081147] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 07/20/2023] [Accepted: 07/29/2023] [Indexed: 08/27/2023] Open
Abstract
BACKGROUND Autism Spectrum Disorder (ASD) can be identified by a general tendency toward a reduction in the expression of low-band, widely dispersed integrative activities, which is made up for by an increase in localized, high-frequency, regionally dispersed activity. The study assessed ASD children and adults all possessing retained primitive reflexes (RPRs) compared with a control group that did not attempt to reduce or remove those RPRs and then examined the effects on qEEG and brain network connectivity. METHODS Analysis of qEEG spectral and functional connectivity was performed, to identify associations with the presence or absence of retained primitive reflexes (RPRs), before and after an intervention based on TENS unilateral stimulation. RESULTS The results point to abnormal lateralization in ASD, including long-range underconnectivity, a greater left-over-right qEEG functional connectivity ratio, and short-range overconnectivity in ASD. CONCLUSIONS Clinical improvement and the absence of RPRs may be linked to variations in qEEG frequency bands and more optimized brain networks, resulting in more developmentally appropriate long-range connectivity links, primarily in the right hemisphere.
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Affiliation(s)
- Robert Melillo
- Movement and Cognition Laboratory, Department of Physical Therapy, University of Haifa, Haifa 3498838, Israel
| | - Gerry Leisman
- Movement and Cognition Laboratory, Department of Physical Therapy, University of Haifa, Haifa 3498838, Israel
- Department of Neurology, University of the Medical Sciences of Havana, Havana 10400, Cuba
| | - Calixto Machado
- Department of Clinical Neurophysiology, Institute for Neurology and Neurosurgery, Havana 10400, Cuba
| | - Yanin Machado-Ferrer
- Department of Clinical Neurophysiology, Institute for Neurology and Neurosurgery, Havana 10400, Cuba
| | | | - Ty Melillo
- Northeast College of the Health Sciences, Seneca Falls, New York, NY 13148, USA
| | - Eli Carmeli
- Movement and Cognition Laboratory, Department of Physical Therapy, University of Haifa, Haifa 3498838, Israel
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Robles-Rubio CA, Kearney RE, Bertolizio G, Brown KA. Automatic unsupervised respiratory analysis of infant respiratory inductance plethysmography signals. PLoS One 2020; 15:e0238402. [PMID: 32915810 PMCID: PMC7485851 DOI: 10.1371/journal.pone.0238402] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Accepted: 08/15/2020] [Indexed: 11/19/2022] Open
Abstract
Infants are at risk for potentially life-threatening postoperative apnea (POA). We developed an Automated Unsupervised Respiratory Event Analysis (AUREA) to classify breathing patterns obtained with dual belt respiratory inductance plethysmography and a reference using Expectation Maximization (EM). This work describes AUREA and evaluates its performance. AUREA computes six metrics and inputs them into a series of four binary k-means classifiers. Breathing patterns were characterized by normalized variance, nonperiodic power, instantaneous frequency and phase. Signals were classified sample by sample into one of 5 patterns: pause (PAU), movement (MVT), synchronous (SYB) and asynchronous (ASB) breathing, and unknown (UNK). MVT and UNK were combined as UNKNOWN. Twenty-one preprocessed records obtained from infants at risk for POA were analyzed. Performance was evaluated with a confusion matrix, overall accuracy, and pattern specific precision, recall, and F-score. Segments of identical patterns were evaluated for fragmentation and pattern matching with the EM reference. PAU exhibited very low normalized variance. MVT had high normalized nonperiodic power and low frequency. SYB and ASB had a median frequency of respectively, 0.76Hz and 0.71Hz, and a mode for phase of 4o and 100o. Overall accuracy was 0.80. AUREA confused patterns most often with UNKNOWN (25.5%). The pattern specific F-score was highest for SYB (0.88) and lowest for PAU (0.60). PAU had high precision (0.78) and low recall (0.49). Fragmentation was evident in pattern events <2s. In 75% of the EM pattern events >2s, 50% of the samples classified by AUREA had identical patterns. Frequency and phase for SYB and ASB were consistent with published values for synchronous and asynchronous breathing in infants. The low normalized variance in PAU, was consistent with published scoring rules for pediatric apnea. These findings support the use of AUREA to classify breathing patterns and warrant a future evaluation of clinically relevant respiratory events.
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Affiliation(s)
| | - Robert E. Kearney
- Department of Biomedical Engineering, McGill University, Montreal, Quebec, Canada
| | - Gianluca Bertolizio
- Department of Anesthesia, Division of Pediatric Anesthesia, McGill University Health Centre, Montreal, Quebec, Canada
| | - Karen A. Brown
- Department of Anesthesia, Division of Pediatric Anesthesia, McGill University Health Centre, Montreal, Quebec, Canada
- * E-mail:
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Fonseca P, Aarts RM, Long X, Rolink J, Leonhardt S. Estimating actigraphy from motion artifacts in ECG and respiratory effort signals. Physiol Meas 2015; 37:67-82. [DOI: 10.1088/0967-3334/37/1/67] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Machado C, Rodríguez R, Estévez M, Leisman G, Melillo R, Chinchilla M, Portela L. Anatomic and Functional Connectivity Relationship in Autistic Children During Three Different Experimental Conditions. Brain Connect 2015; 5:487-96. [PMID: 26050707 DOI: 10.1089/brain.2014.0335] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
A group of 21 autistic children were studied for determining the relationship between the anatomic (AC) versus functional (FC) connectivity, considering short-range and long-range brain networks. AC was assessed by the DW-MRI technique and FC by EEG coherence calculation, in three experimental conditions: basal, watching a popular cartoon with audio (V-A), and with muted audio track (VwA). For short-range connections, basal records, statistical significant correlations were found for all EEG bands in the left hemisphere, but no significant correlations were found for fast EEG frequencies in the right hemisphere. For the V-A condition, significant correlations were mainly diminished for the left hemisphere; for the right hemisphere, no significant correlations were found for the fast EEG frequency bands. For the VwA condition, significant correlations for the rapid EEG frequencies mainly disappeared for the right hemisphere. For long-range connections, basal records showed similar correlations for both hemispheres. For the right hemisphere, significant correlations incremented to all EEG bands for the V-A condition, but these significant correlations disappeared for the fast EEG frequencies in the VwA condition. It appears that in a resting-state condition, AC is better associated with functional connectivity for short-range connections in the left hemisphere. The V-A experimental condition enriches the AC and FC association for long-range connections in the right hemisphere. This might be related to an effective connectivity improvement due to full video stimulation (visual and auditory). An impaired audiovisual interaction in the right hemisphere might explain why significant correlations disappeared for the fast EEG frequencies in the VwA experimental condition.
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Affiliation(s)
- Calixto Machado
- 1 Department of Clinical Neurophysiology, Institute of Neurology and Neurosurgery , Havana, Cuba
| | - Rafael Rodríguez
- 2 International Center for Neurological Restoration , Havana, Cuba
| | - Mario Estévez
- 1 Department of Clinical Neurophysiology, Institute of Neurology and Neurosurgery , Havana, Cuba
| | - Gerry Leisman
- 3 The National Institute for Brain & Rehabilitation Sciences , Nazareth, Israel .,4 Biomechanics Laboratory, O.R.T.-Braude College of Engineering , Karmiel, Israel .,5 Facultad Manuel Fajardo, University of the Medical Sciences , Havana, Cuba
| | - Robert Melillo
- 6 Institute for Brain and Rehabilitation Science , Gilbert, Arizona
| | - Mauricio Chinchilla
- 1 Department of Clinical Neurophysiology, Institute of Neurology and Neurosurgery , Havana, Cuba
| | - Liana Portela
- 1 Department of Clinical Neurophysiology, Institute of Neurology and Neurosurgery , Havana, Cuba
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QEEG spectral and coherence assessment of autistic children in three different experimental conditions. J Autism Dev Disord 2015; 45:406-24. [PMID: 24048514 PMCID: PMC4309919 DOI: 10.1007/s10803-013-1909-5] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
We studied autistics by quantitative EEG spectral and coherence analysis during three experimental conditions: basal, watching a cartoon with audio (V–A), and with muted audio band (VwA). Significant reductions were found for the absolute power spectral density (PSD) in the central region for delta and theta, and in the posterior region for sigma and beta bands, lateralized to the right hemisphere. When comparing VwA versus the V–A in the midline regions, we found significant decrements of absolute PSD for delta, theta and alpha, and increments for the beta and gamma bands. In autistics, VwA versus V–A tended to show lower coherence values in the right hemisphere. An impairment of visual and auditory sensory integration in autistics might explain our results.
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Robles-Rubio CA, Bertolizio G, Brown KA, Kearney RE. Scoring Tools for the Analysis of Infant Respiratory Inductive Plethysmography Signals. PLoS One 2015. [PMID: 26218351 PMCID: PMC4517879 DOI: 10.1371/journal.pone.0134182] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Infants recovering from anesthesia are at risk of life threatening Postoperative Apnea (POA). POA events are rare, and so the study of POA requires the analysis of long cardiorespiratory records. Manual scoring is the preferred method of analysis for these data, but it is limited by low intra- and inter-scorer repeatability. Furthermore, recommended scoring rules do not provide a comprehensive description of the respiratory patterns. This work describes a set of manual scoring tools that address these limitations. These tools include: (i) a set of definitions and scoring rules for 6 mutually exclusive, unique patterns that fully characterize infant respiratory inductive plethysmography (RIP) signals; (ii) RIPScore, a graphical, manual scoring software to apply these rules to infant data; (iii) a library of data segments representing each of the 6 patterns; (iv) a fully automated, interactive formal training protocol to standardize the analysis and establish intra- and inter-scorer repeatability; and (v) a quality control method to monitor scorer ongoing performance over time. To evaluate these tools, three scorers from varied backgrounds were recruited and trained to reach a performance level similar to that of an expert. These scorers used RIPScore to analyze data from infants at risk of POA in two separate, independent instances. Scorers performed with high accuracy and consistency, analyzed data efficiently, had very good intra- and inter-scorer repeatability, and exhibited only minor confusion between patterns. These results indicate that our tools represent an excellent method for the analysis of respiratory patterns in long data records. Although the tools were developed for the study of POA, their use extends to any study of respiratory patterns using RIP (e.g., sleep apnea, extubation readiness). Moreover, by establishing and monitoring scorer repeatability, our tools enable the analysis of large data sets by multiple scorers, which is essential for longitudinal and multicenter studies.
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Affiliation(s)
| | - Gianluca Bertolizio
- Department of Anesthesia, McGill University Health Centre, Montreal, Quebec, Canada
| | - Karen A. Brown
- Department of Anesthesia, McGill University Health Centre, Montreal, Quebec, Canada
| | - Robert E. Kearney
- Department of Biomedical Engineering, McGill University, Montreal, Quebec, Canada
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Aoude AA, Kearney RE, Brown KA, Galiana HL, Robles-Rubio CA. Automated off-line respiratory event detection for the study of postoperative apnea in infants. IEEE Trans Biomed Eng 2011; 58:1724-33. [PMID: 21317076 DOI: 10.1109/tbme.2011.2112657] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Previously, we presented automated methods for thoraco-abdominal asynchrony estimation and movement artifact detection in respiratory inductance plethysmography (RIP) signals. This paper combines and improves these methods to give a method for the automated, off-line detection of pause, movement artifact, and asynchrony. Simulation studies demonstrated that the new combined method is accurate and robust in the presence of noise. The new procedure was successfully applied to cardiorespiratory signals acquired postoperatively from infants in the recovery room. A comparison of the events detected with the automated method to those visually scored by an expert clinician demonstrated a higher agreement (κ = 0.52) than that amongst several human scorers (κ = 0.31) in a clinical study . The method provides the following advantages: first, it is fully automated; second, it is more efficient than visual scoring; third, the analysis is repeatable and standardized; fourth, it provides greater agreement with an expert scorer compared to the agreement between trained scorers; fifth, it is amenable to online detection; and lastly, it is applicable to uncalibrated RIP signals. Examples of applications include respiratory monitoring of postsurgical patients and sleep studies.
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Affiliation(s)
- Ahmed A Aoude
- Department of Biomedical Engineering, McGill University, Montreal, QC, Canada.
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