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Título: | A Neuroprosthesis for Tremor Management |
Autor: | Gallego, Juan Álvaro CSIC ORCID CVN | Director: | Pons, José L.; Rocon, Eduardo; Moreno, Luis E. | Palabras clave: | Neuroprótesis Temblor Tremor Management Neuroprosthesis Essential tremor Parkinson's disease Tremor Signal Processing Multimodal Human-Machine Interface Inertial Sensors Functional Electrical Stimulation Motor Unit Corticospinal Electromyography |
Fecha de publicación: | 10-oct-2013 | Resumen: | Tremor is the most common movement disorder, affecting 15 % of people over 50
years old according to some estimates. It appears due to a number of syndromes,
being essential tremor and Parkinson's disease the most prevalent among them. None
of these conditions is fully understood. Tremor is currently treated through drugs or
neurosurgery, but unfortunately, it is not managed e ectively in 25 % of the patients.
Therefore, it constitutes a major cause of loss of independence and quality of life.
Various alternative approaches for tremor management are reported in the literature.
Among them, those devices that rely on the application of forces to the tremulous segments
show a considerable potential. A number of prototypes that exploit this principle
are available, spanning xed devices and orthoses. However, none of them has fu lfilled
user's expectation for continuous use during daily living.
This thesis presents the development and validation of a neuroprosthesis for tremor management.
A neuroprosthesis is a system that restores or compensates for a neurological
function that is lost. In this case, the neuroprosthesis aims at compensating the functional
disability caused by the tremor. To this end, it applies forces to the tremulous
limb through the control of muscle contraction, which is modulated according to the
characteristics of the tremor. The concept design envisions the device as a textile that
is worn on the a ected limb, thus meeting the usability requirements de ned by the
patients. The development of the neuroprosthesis comprised the following tasks: 1. The development of a concept design of the neuroprosthesis, which incorporates state of the art knowledge on tremor, and user's needs. 2. The design and validation of a cognitive interface that parameterizes the tremor in functional contexts. This interface provides the information that the neuroprosthesis uses for tremor suppression. Two versions are developed: a multimodal interface that integrates the recordings of the whole neuromusculoskeletal system, and an interface incorporating only wearable movement sensors. The latter is intended for the functional validation of the neuroprosthesis, while the former is a proof of concept of an optimal interface for this type of applications.3. The development of a novel approach for tremor suppression through transcutaneous neurostimulation. The approach relies on the modulation of muscle cocontraction as a means of attenuating the tremor without the need of conventional actuators. The experimental validation here provided demonstrates the feasibility and interest of the approach. In parallel with the validation of the neuroprosthesis, I performed a detailed study on the physiology of motoneurons in tremor, given the lack of a complete description of its behavior. The outcome of this study contributes to the interpretation of the results obtained with the neuroprosthesis, and opens new research lines, both related to alternative interventions and basic neuroscience. In summary, the results here presented demonstrate that tremor may be accurately parameterized while the patient performs functional activities, and that this information may be exploited to drive a neuroprosthesis for tremor management. Furthermore, the novel approach for tremor suppression presented in this dissertation constitutes a potential approach for treating upper limb tremor, either alone, or as a complement to pharmacotherapy. These results encourage the validation of the neuroprosthesis in a large cohort of patients, in order to enable its translation to the market. |
Descripción: | Tesis Doctoral para la obtención del Título de Grado de Doctor. 154 p. : il., diagr. Fecha de defensa de la Tesis Doctoral: 6 de junio de 2013 | URI: | http://hdl.handle.net/10261/83762 |
Aparece en las colecciones: | (CAR) Tesis |
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JAGallego_Neuroprothesis_for_Tremor_Management_thesis.pdf | 16,09 MB | Adobe PDF | Visualizar/Abrir |
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