Interictal High Frequency Oscillations Detected with Simultaneous Magnetoencephalography and Electroencephalography as Biomarker of Pediatric Epilepsy

Crucial to the success of epilepsy surgery is the availability of a robust biomarker that identifies the Epileptogenic Zone (EZ). High Frequency ...

Boston Children's Hospital, Harvard Medical School

The Sucking Efficiency (SEF) is one of the main parameters used to monitor and assess the sucking pattern development in infants. Since Nutritive Sucking (NS) is one of the earliest motor activity performed by infants, its objective monitoring may allow to assess neurological and motor development of newborns. This work proposes a new ecological and low-cost method for SEF monitoring, specifically designed for feeding bottles. The methodology, based on the measure of the hydrostatic pressure exerted by the liquid at the teat base, is presented and experimentally validated at different operative conditions. Results show how the proposed method allows to estimate the minimum volume an infant ingests during a burst of sucks with a relative error within the range of [3-7]% depending on the inclination of the liquid reservoir

A new ecological method for the estimation of Nutritive Sucking Efficiency in newborns: measurement principle and experimental assessment.

Recent advances in wearable sensor technologies for motion capture have produced devices, mainly based on magneto and inertial measurement units (M-IMU), that are now suitable for out-of-the-lab use with children. In fact, the reduced size, weight and the wireless connectivity meet the requirement of minimum obtrusivity and give scientists the possibility to analyze children's motion in daily life contexts. Typical use of magneto and inertial measurement units (M-IMU) motion capture systems is based on attaching a sensing unit to each body segment of interest. The correct use of this setup requires a specific calibration methodology that allows mapping measurements from the sensors' frames of reference into useful kinematic information in the human limbs' frames of reference. The present work addresses this specific issue, presenting a calibration protocol to capture the kinematics of the upper limbs and thorax in typically developing (TD) children. The proposed method allows the construction, on each body segment, of a meaningful system of coordinates that are representative of real physiological motions and that are referred to as functional frames (FFs). We will also present a novel cost function for the Levenberg-Marquardt algorithm, to retrieve the rotation matrices between each sensor frame (SF) and the corresponding FF. Reported results on a group of 40 children suggest that the method is repeatable and reliable, opening the way to the extensive use of this technology for out-of-the-lab motion capture in children.

A new calibration methodology for thorax and upper limbs motion capture in children using magneto and inertial sensors.

Nutritive Sucking (NS) is a highly organized process that is essential for infants' feeding during the first six months of their life. It requires the complex coordination of sucking, swallowing and breathing. The infant's inability to perform a safe and successful oral feeding can be an early detector of immaturity of the Central Nervous System (CNS). Even though the importance of early sucking measures has been confirmed over the years, the need for standardized instrumental assessment tools still exists. Clinicians would benefit from specifically designed devices to assess oral feeding ability in their routine clinical monitoring and decision-making process. This work is a review of the main instrumental solutions developed to assess an infant's NS behavior, with a detailed survey of the main quantities and indices measured and/or estimated to characterize sucking behavior skills and their development. The adopted sensing measuring systems will be described, and their main advantages and weaknesses will be discussed, taking into account their application to clinical practice, or to at-home monitoring as post-discharge assessment tools. Finally, the study will highlight the most suitable sensing solutions and give some prompts for further research.

Technological solutions and main indices for the assessment of newborns' nutritive sucking: a review.

Action selection is extremely important, particularly when the accomplishment of competitive tasks may require access to limited motor resources. The spontaneous exploration of the world plays a fundamental role in the development of this capacity, providing subjects with an increasingly diverse set of opportunities to acquire, practice and refine the understanding of action-outcome connection. The computational modeling literature proposed a number of specific mechanisms for autonomous agents to discover and target interesting outcomes: intrinsic motivations hold a central importance among those mechanisms. Unfortunately, the study of the acquisition of action-outcome relation was mostly carried out with experiments involving extrinsic tasks, either based on rewards or on predefined task goals. This work presents a new experimental paradigm to study the effect of intrinsic motivation on action-outcome relation learning and action selection during free exploration of the world. Three- and four-year-old children were observed during the free exploration of a new toy: half of them were allowed to develop the knowledge concerning its functioning; the other half were not allowed to learn anything. The knowledge acquired during the free exploration of the toy was subsequently assessed and compared.

Development of goal-directed action selection guided by intrinsic motivations: an experiment with children.

The assessment of Oral-Motor Behavior (OMB) represents one the earliest noninvasive ways to evaluate the newborns' well-being and neuromotor behavior. This work aimed at developing a new low-cost, easy-to-use and noninvasive system for a technology-aided assessment of newborns' OMB during bottle feeding. A SUcking MOnitoring Device (SUMOD) was designed and developed to be easily integrated on a typical feeding bottle. A software system was developed to automatically treat and analyze the acquired data: proper algorithms for a fully automatic segmentation and features extraction are proposed and implemented. A set of measures of motor control and coordination are introduced and implemented for the specific application to the OMB analysis. Experimental data were collected on two groups of newborns (Healthy vs. Low Birth Weight) with the SUMOD in a clinical setting. Statistical tests pointed out the most sensitive features to group differences, and the results from Principal Component Analysis also suggested the system suitability to automatically identify peculiar OMBs. Concluding, we developed a system that is suitable for easy implementation in clinical setting and that may contribute in the objective noninvasive neonatal assessment of OMB. Such system might support health care professionals in assessing newborns' neuromotor status and planning for subsequent care.

An Automated System for the Analysis of Newborns' Oral-Motor Behavior.

In this work a novel unobtrusive technology-aided system is presented and tested for the assessment of newborns' oral-motor behavior and coordination during bottle feeding. A low-cost monitoring device was designed and developed in order to record Suction (S) and Expression (E) pressures from a typical feeding bottle. A software system was developed to automatically treat the data and analyze them. A set of measures of motor control and coordination has been implemented for the specific application to the analysis of sucking behavior. Experimental data were collected with the developed system on two groups of newborns (Healthy vs. Low Birth Weight) in a clinical setting. We identified the most sensitive S features to group differences, and analyzed their correlation with S/E coordination measures. Then, Principal Component Analysis (PCA) was used to explore the system suitability to automatically identify peculiar oral behaviors. Results suggest the suitability of the proposed system to perform an objective technology-aided assessment of the newborn's oral-motor behavior and coordination during the first days of life.

Eleonora Tamilia

Fetal-Neonatal Neuroimaging and Developmental Science Center,
Division of Newborn Medicine,
Department of Medicine,
Fetal-Neonatal Neuroimaging and Developmental Science Center, Division of Newborn Medicine, Department of Medicine

Boston Children's Hospital, Harvard Medical School

Interictal High Frequency Oscillations Detected with Simultaneous Magnetoencephalography and Electroencephalography as Biomarker of Pediatric Epilepsy