Medgadget

We See the Future: A World Without Quotient ADHD System

Thu, 11 Feb 2010 07:44:25 -0800

Here's an idea for a startup. Someone has to write an application for computers and game consoles that can ask kids to perform various tasks, watch them via a webcam, and help clinicians diagnose ADHD. Sure, product development and trials will cost millions, but the end result, say in the form of a friendly Wii game, should be more palatable than the monster on the right. Would you be able to sit still in front of the Quotient ADHD System from BioBehavioral Diagnostics Co., a Westford, Mass firm? We doubt it. Perhaps sticking a few strategically placed Dilbert cartoons on the walls of this system would help take the drab out of it. Regardless, this is the option currently available and if your office needs one then the fantasy Wii version is no competition for an existing system.

Here's more about the Quotient ADHD technology:

The Quotient™ ADHD System collects and reports objective, accurate data on hyperactivity, impulsivity and inattention. The clinician integrates the Quotient™ ADHD Test report with information from other assessment tools and the clinical evaluation to guide treatment decisions.

ADHD historically has been challenging to diagnose because many of the assessment tools rely largely on subjective information from parents and teachers, in addition to clinical evaluation.

The Quotient™ ADHD System accurately measures motion and analyzes shifts in attention state to give a clear picture of ADHD symptoms. The Quotient™ ADHD Test gives objective and accurate data on the core symptom areas of ADHD:

Hyperactivity (the inability to control movement and sit still while working)

Impulsivity (the inability to inhibit inappropriate responses)

Inattention (the difficulty in staying focused and on task)

1. Motion Tracking System
The Motion Tracking System captures each movement 50 times per second and plots the pattern of movement of the reflector(s).

2. Reflectors
A small reflector is placed on the forehead. If the patient is 13 years old or older, additional reflectors are placed on the shins to capture leg motion.

3. LCD Screen
The patient responds to different geometric shapes that flash randomly on the LCD screen

4. Keyboard
Patient responds to visual stimuli by pressing the space bar.

Product page: Quotient™ ADHD System...

MassDevice: BioBehavioral Diagnostics closes $7 million tranche in Series B round...

Magnetoencephalography as An Objective Test for PTSD

Fri, 22 Jan 2010 08:40:59 -0800

Post-traumatic stress disorder (PTSD) can be a difficult condition to diagnose in patients that have difficulty "opening up" to a psychiatrist. Moreover, because symptoms of PTSD are often used as evidence in court cases, an objective test can be a welcome tool in helping to convict violent criminals. Now clinical researchers from the VA and University of Minnesota are reporting in the Journal of Neural Engineering that magnetoencephalography can provide an accurate analysis of the existence of PTSD in the brains of its victims.

From the University of Minnesota:

The researchers examined 74 veterans of conflicts in World War II, Vietnam, Iraq, or Afghanistan who had been diagnosed with PTSD, along with 250 healthy volunteers. Using a technique developed by [Apostolos Georgopoulos, Professor of Neuroscience and director of the Brain Sciences Center at the Minneapolis Veterans Affairs Medical Center], they monitored magnetic signals from groups of neurons in communication with each other.
They noted a pattern of miscommunication that was nearly unique to PTSD patients. Overall, they were able to identify people as PTSD patients or healthy controls with more than 90 percent accuracy.

"Compared to evidence from functional MRI and other diagnostic tools currently being accepted by courts for other disorders, this test is much stronger and has a higher probability of being accepted as evidence by courts," Georgopoulos says.

The pattern seen in PTSD patients appears to be a flaring up of brain networks that have to do with reliving experiences. Also, the strength of the pattern mirrored the severity of symptoms, suggesting that the test may be used to monitor a patient's progress during treatment.

A Minnesota Public Radio interview with Brian Engdahl, one of the authors of the study:

University of Minnesota statement: Researchers report first objective test for post-traumatic stress disorder...

Abstract in Journal of Neural Engineering: The synchronous neural interactions test as a functional neuromarker for post-traumatic stress disorder (PTSD): a robust classification method based on the bootstrap

Image: Magnetoencephalography machine from VSM MedTech

Virtual Iraq Computer Simulator Helps Tackle Combat Induced PTSD

Fri, 22 Jan 2010 07:17:25 -0800

The US military is famous for employing emerging technologies to assist or replace its professionals on battlefields and beyond. As the wars in Iraq and Afghanistan continue, psychiatrists at the Department of Defense are now testing a virtual reality system as a therapy tool to address the causes of Post-Traumatic Stress Disorder (PTSD). Currently, psychiatrists use what is known as "exposure therapy" to have the soldiers repeatedly recall the events that led to the development of PTSD. Many of the soldiers, though, find it difficult to recall the events and to synthesize them in their imagination effectively during therapy sessions. To overcome this problem and to bring a bit of the original reality back, a program called Virtual Iraq is currently being trialed as an aid to traditional imagination based exposure therapy.

Army Medicine reports:

The congressionally-funded medical research study is the first randomized clinical trial that uses active-duty military diagnosed with combat-related PTSD to compare VRET results to traditional "imaginal" prolonged exposure therapy, and to a control group that waits five weeks for any type of treatment.
The study's sample size is 120 servicemembers to complete the three types of treatment options. Treatment sessions for each type of therapy last about 90 minutes, said Dr. Greg Reger, the chief of T2's Innovative Technology Applications division.

Patients undergoing VRET still explain to the therapist what happened that caused the trauma, but are exposed to a variety of computer-generated stimuli with the program "Virtual Iraq." VRET is designed to promote a multi-sensory emotional connection to the memory, thus helping the patient be able to gradually face the traumatic experiences that underlie his or her distressing memories after a number of treatment sessions.

This connection is facilitated by having the patient put on a head-mounted display (over-the-eyes video glasses) and either ride or drive in a simulated convoy, and Reger matches the scenario to the event. Or a Soldier will be given a dummy M-4 with a mounted game controller and conduct a dismounted patrol, and Reger could simulate gunfire.

Reger can customize the simulation experience ensuring ample control of the exposure to the programmed situations - changing weather conditions, terrain, helicopter flyovers, types of attack; even add in Muslim prayer call.

Press release: Virtual Reality Exposure Therapy to combat PTSD...

New Intel Device Helps Overcome Problems With Reading, Learning

Thu, 12 Nov 2009 00:00:03 -0800

Intel has released a new gadget for people with vision problems, autism, dyslexia, and other conditions that can make reading difficult. With the Intel Reader you can take pictures of book pages, letters, and product labels and the device will read out the text back while showing magnified print on the screen. While designed to be used by people with certain disabilities, we can also see using this device to learn how to read a new language.

The Intel Reader, about the size of a paperback book, converts printed text to digital text, and then reads it aloud to the user. Its unique design combines a high-resolution camera with the power of an Intel® Atom™ processor, allowing users to point, shoot and listen to printed text.

When the Intel Reader is used together with the Intel® Portable Capture Station, large amounts of text, such as a chapter or an entire book, can be easily captured for reading later. Users will have convenient and flexible access to a variety of printed materials, helping to not only increase their freedom, but improve their productivity and efficiency at school, work and home. The Intel Reader has been endorsed by the International Dyslexia Association as an important advance in assistive technology. Additionally, Intel is working with the Association of Assistive Technology Act Programs, the Council for Exceptional Children, Lighthouse International, the National Center for Learning Disabilities and the National Federation of the Blind to help reach and address the needs of people who have difficulty reading print.

Press release: Ready, Set, Read: Intel® Reader Transforms Printed Text to Spoken Word ...

Product page: Intel Reader ...

Image Recognition Technology to Expand Abilities of Microsoft's Digital Camera Device

Wed, 21 Oct 2009 00:55:48 -0800

Microsoft has partnered with Oxford Metrics Group (Oxford, UK), a company specializing in computer vision applications, to further develop Microsoft's ViconRevue (formerly SenseCam) digital camera-like gadget. The device continuously snaps a picture every 30 seconds, hence it might be worn around the neck by patients with memory problems (i.e. Alzheimer's, s/p hypoxic/ischemic encephalopathy). The device is thought to help people refresh themselves on the activities of the past day. With Oxford Metrics Group's software built-in, the ViconRevue should be able to perform some pretty nifty tricks by recognizing objects and faces in its field of view.

Press release: IP LICENSE AGREEMENT WITH MICROSOFT...

Flashback: Digital Cameras for Dementia Patients

Novel Product Design Aims to Address Common Autism Behavior

Tue, 20 Oct 2009 00:43:02 -0800

Some children with autism tend to perform compulsive rituals, and these can distract kids from the rest of the world. Jesse Resnick, a recent graduate of the product design program at Parsons the New School for Design, proposes a new toy-like device to grab kids' attention and limit compulsive behavior to a short time. The Repeat wrist worn device has flashing rubber knobs that blink in preprogrammed patterns, while the child follows along by using fingers to pinch them. According to the product page, Repeat is "an early-intervention tool for autistic children designed to replace repetitive behaviours (arm flapping, head banging, etc.) with a less distracting, less harmful alternative." It's not clear whether the benefit will be clinically valuable, but it does seem like a novel idea.

Product design page: REPEAT...

(hat tip: Yanko Design)

Aspect Medical's Quantitative EEG Predicts Long Term Effectiveness of Anti Depression Medication

Wed, 23 Sep 2009 01:00:58 -0800

Aspect Medical Systems, maker of the bispectral index (BIS) monitor thought to be useful for monitoring anesthesia awareness, has been dealt a devastating blow last year by a study published in NEJM under the title Anesthesia Awareness and the Bispectral Index. The 2000 strong patient trial reported by Avidan, et al from Washington University School of Medicine in St. Louis has found the company's processed electroencephalogram technology is not essential "as part of standard practice."

Now Aspect Medical Systems is trying its hand in a new market: psychiatry. Finding an appropriate medication, as well as its dose, for a particular patient with bipolar disorder can take a good deal of time and is done without real quantitative tools. The clinical trial being reported by Aspect Medical is supposedly showing that the company's EEG-based system can be used to track whether a given SSRI (selective serotonin reuptake inhibitor, like Prozac or Paxil) is having positive results on a patient a week after initial doses were administered.

The BRITE trial was conducted in collaboration with leading investigators from nine facilities across the United States and enrolled 375 patients. Patient response was defined by researchers as a 50 percent improvement in depression symptoms as measured by the Hamilton Depression Rating Scale (HAM-D) after seven weeks of treatment, and remission was defined as recovery from depression (HAM-D <7) after seven weeks of treatment. In the BRITE study, ATR at one week predicted response and remission with 74 percent accuracy in subjects treated for seven weeks with escitalopram, which was statistically significant. Modeled study data also indicates that subjects who were ATR predicted non-responders to escitalopram had better outcomes if they were randomized to switch to bupropion, an antidepressant with a different mechanism of action than escitalopram.
Data from a study at Massachusetts General Hospital (MGH) investigating ATR as a predictor of treatment response was also recently published in European Neuropsychopharmacology. The MGH study evaluated ATR in 82 major depression patients receiving selective serotonin reuptake inhibitors (SSRI), and venlafaxine, and showed that use of ATR after the first week of antidepressant treatment may be predictive of treatment efficacy.

Continuing the ATR research effort, BRITE trial investigator Dr. Ian Cook at UCLA received a significant grant from the National Institutes of Mental Health to conduct a multi-year follow-on study of ATR called the PRISE-MD study (Personalized Response Indicators of SSRI Effectiveness in Major Depression). The PRISE-MD study will prospectively evaluate the ability of ATR to predict response to escitalopram as well as the clinical utility of ATR-directed treatment with escitalopram or an alternate treatment with bupropion.

Aspect Medical Systems press statement: Aspect Medical Systems Announces Publication of BRITE-MD Trial Results in Psychiatry Research...

More about the technology at Technology Review...

Abstract in Psychiatry Research: Comparative effectiveness of biomarkers and clinical indicators for predicting outcomes of SSRI treatment in Major Depressive Disorder: Results of the BRITE-MD study

LENA Audio Monitor Analyses Speech Patterns to Help Detect Autism Earlier

Wed, 16 Sep 2009 00:35:27 -0800

Autistic children often show specific behavior patterns in the way they speak with others. These patterns, if detected, could be used as an early sign of autism, but enough data needs to be collected in order to help with making a diagnosis. LENA, a device from the LENA Foundation that became available earlier this month, is a portable recorder that can make available a day's worth of a child's interaction to professionals for close review.

From the product page:

What is LENA? LENA is the only technology that automatically collects and analyzes information about a child’s natural language environment and development. The LENA feedback reports help parents improve a child’s cumulative language experience and accelerate that child’s language and cognitive development, and preparedness for school.
Who is LENA for? Parents and caregivers of children ages 0 to 4.

Why is it important? Several hundred research studies over the last 50 years document the importance of talking to and interacting with your baby, especially during the first three years. Groundbreaking research by two renowned university researchers, Drs. Betty Hart, Ph.D., and Todd Risley, Ph.D., revealed that the quantity of talk a child experienced between birth and age 3 directly correlated with the child’s IQ and vocabulary size. The LENA Foundation was founded based on the key elements of this study and our own normative study shows that saying 17,000 words per day, which is equal to the 85th percentile, will greatly enhance your child’s potential.

Who developed it? A team of world-class scientists, including experts in linguistics, speech recognition technology, computer engineering, speech analysis, statistics, speech language pathology, language research and developmental pediatrics. Recognizing that achievement gaps already exist at kindergarten entry, LENA was developed to give parents useful information to help ensure they are providing the richest language environment possible to their children during the critical years between birth and age 4, before they enter school.

How does it work? Parents follow a simple three-step process, 2-3 times a month:

1. In the morning, slip the LENA Digital Language Processor (DLP) into the pocket of specially designed LENA clothing.
2. At the end of the day, plug the DLP into your PC. The audio data will transfer and software analysis begins.
3. View your reports to analyze your conversations, identify patterns of talk throughout the day and receive percentile rank information.

MIT Technology Review provides additional details:

Richards [Jeffrey Richards, a statistician and database technician for the LENA Foundation --ed.] says the LENABaby software, which he helped develop, starts by breaking down the 16-hour audio stream into segments. Each segment is automatically classified according to the type of sound contained in the clip, such as sounds from the child, a parent, or television. Vocalizations from the child are then assessed further using complex algorithms that look at a variety of factors, such as the phonological composition of the each sound and how sounds are clustered and paired. "We're simultaneously looking across many dimensions at the same time," says Richards. Using LENA's database of previously analyzed audio, the software considers how these characteristics compare to those of children developing normally, children with delayed language development, and autistic children.
LENABaby can be used for more than a basic diagnosis, helping to track a child's language development. This could make it a valuable tool for clinicians who otherwise have to rely on data collected during brief, infrequent visits.

Brainsway's Transcranial Magnetic Stimulation Gets European Regulatory Approval for Treatment of Depression

Tue, 08 Sep 2009 08:15:01 -0800

Brainsway, a firm building transcranial magnetic stimulation systems (TMS) out of Jerusalem, Israel, just received European approval to market its devices for the treatment of depression. The TMS treatment is likely to be used initially for cases of severe drug resistant depression. But we can envision a day when this technology becomes a mainstream therapeutic option for bipolar disorder and some other psychiatric diseases.

About the technology from Brainsway:

Transcranial magnetic stimulation (TMS) is a noninvasive technique used to apply brief magnetic pulses to the brain. The pulses are administered by passing high currents through an electromagnetic coil placed adjacent to a patient's scalp. The pulses induce an electric field in the underlying brain tissue. When the induced field is above a certain threshold, and is directed in an appropriate orientation relative the brain's neuronal pathways, localized axonal depolarizations are produced, thus activating the neurons in the relevant brain structure.
Standard TMS coils are limited to activation of only cortical brain regions, up to a depth of about 1.5 cm. Hence when treating depression with a standard TMS system, the limbic system, which is related to mood regulation and is generally deeper than 1.5 cm, is only indirectly affected, through secondary processes involving cortical structures, which are directly activated by TMS and then affect the deeper limbic system structures.

Globes Online: Brainsway depression treatment gets European OK...

Product page: Brainsway Deep TMS System...

Flashbacks: Brainsway TMS archives...

rethink autism Online Platform for Autism Therapy at Home

Tue, 01 Sep 2009 11:06:44 -0800

Therapy sessions for autistic kids are not only expensive, but can also present a daunting challenge that typically involves going to an unfamiliar clinical environment. To help parents and caretakers work directly with kids in their own home, rethink autism online training application has been developed. According to the company with the same name, the application is based on applied behavior analysis (ABA) techniques. By offering video demonstrations of effective therapeutic approaches, coupled with a platform for development of personalized lesson plans, rethink autism may serve as a complement to existing therapy sessions as well as an effective option for those without access to professionals.

Here's a company introduction to the rethink autism program:

Link: rethink autism