VarSeq 2.6.0: Advancing Pharmacogenomics and Genomic Analysis
ICT applied to Neurodegenerative Diseases
1. Information and Communication Technologies
applied to Neurodegenerative Diseases
Prof. José L. Ayala
jayala@ucm.es
Complutense University of Madrid
2. Interest from the technological community
● Ambient Assisted Living Programme – ICT for ageing well
– Time-to-market perspective of maximum 2 to 3 years after end
of the project;
– Project total budget: 1 – 7 M€;
– Maximum funding from the AAL Joint Programme: 3 M€;
– Significant involvement of industry and other business
partners, particularly SMEs are encouraged;
– Realistic trial set-up at the end of the project;
– Proactive end-user involvement throughout the life of the
project;
– Defined market segment(s), use cases and target group(s)
and address the wishes and needs of these specific group(s).
3. Interest from the technological community
● Horizon 2020 – Work Program 2014-2015
– 8. Health, demographic change and wellbeing
● PHC 10 – 2014: Development of new diagnostic tools and
technologies (in vitro)
● PHC 11 – 2015: Development of new diagnostic tools and
technologies (in vivo)
● PHC 12 – 2014/2015: Clinical research for the validation of
biomarkers and/or diagnostic medical devices
● PHC 17 – 2014: Comparing effectiveness of existing
healthcare interventions in the elderly
● PHC 19 – 2014: Advancing active and healthy ageing with ICT:
Service robotics with assisted living environments
4. Interest from the technological community
● Horizon 2020 – Work Program 2014-2015
– 8. Health, demographic change and wellbeing
● PHC 20 – 2014: Advancing active and healthy ageing with ICT:
ICT solutions for independent living with cognitive impairment
● PC21 – 2015: Advancing active and healthy ageing with ICT:
Early risk detection and intervention
● PHC 22 – 2015: Promoting mental well being in the ageing
population
● Etc
75% of the program is related to ICT!!!
5. ICT & Neurodegenerative diseases
● Where?
– Alzheimer's
– Parkinson's
– Sclerosis
● For?
– Early diagnosis
– Monitoring of symptoms
– Treatment and intervention
– Improve quality of daily life
Low Cost!
6. Alzheimer's
● More than 20 million people worldwide
● Number is expected to double in next 20 years
● Improving home and community-based coordinated care is
critical to mitigating effects and to reducing healthcare
costs
● Recognition of technology development: Alzheimer's
Association partnered with Intel from 2003 to establish the
Everyday Technologies for Alzheimer's Care (ETAC)
initiative (it supplies 3-years awards of up to US$200,000)
7. Alzheimer's
● Diagnosis and monitoring
– Early detection and diagnosis: complex due to
heterogeneity of symptoms.
– Two promising approaches presented at the 2013
Technology & Dementia symposium focus on identifying
early patterns of biological and behavioral changes
8. Alzheimer's
– Technology to detect voice responses to auditory pitch
perturbations, such as changing the sound of your own
voice.
– Typically, perturbing the sound of your voice results in a
compensatory pitch change in voice response; however,
damage to the white-matter tracts, linking auditory and
speech production networks in the brain, alters
compensatory responses to feedback perturbations.
– This approach is supported by preliminary work
demonstrating that individuals with Alzheimer's have a
diminished response amplitude and slower adaptation.
– Technology available in mobile phones a tablets
9.
10. Alzheimer's
– Another approach is to apply new technologies to standard
cognitive testing instruments, such as the Clock Drawing Test
(CDT).
– Package using a digitalizing pen and paper system to capture these
errors and provide metrics of hand kinematics in producing the
drawing.
– Pause times at critical points in the drawing, potentially indicate
deficits in movement planning that might help to distinguish between
healthy and pathological aging.
– The test can measure executive function by the presence of very
tiny “hooklets” that occur when drawers think about making the next
stroke before they finish the current one. Their disappearance may
indicate declining executive function.
– CDT can pick up preclinical cognitive changes that correlate with
atrophy in the parietal lobe
11.
12. Alzheimer's
● Monitoring everyday behavior to continuously asses functioning, such as
functional mobility.
● System that includes not only motion, contact, and medication sensors, as well
as load sensors that detect someone lying on a bed, but also monitors social
activity. This includes telephone sensors that record the amount of time spent
on the phone and whether the call was likely to be personal.
● Motion sensors track time spent out of the house, and voice sensors record
time spent talking aloud, which typically reflects face-to-face conversations with
other people
● Most of the measures of functional and cognitive status drop off over
time in people with mild cognitive impairment (MCI), but not in cognitively
healthy elderly. Intriguingly, increased day-to-day variability emerged as one
of the earliest signs of decline, perhaps reflecting the fact that people in the
early stages of AD tend to have “bad days” and “good days. This system
detects change in early MCI with greater sensitivity than current clinical
methods at a much lower cost.
13. Alzheimer's
● Other positioning devices based on BT and GPS
● Fall-detection system based on building vibration patterns
associated with fall events
● Localization devices based on radio-frequency emitting
modules attached to the walls
14. Alzheimer's
● Treatment and intervention
● Art-based therapies (valuable outlet for
expression for people with varying stages of
dementia, offering a creative activity that fosters
engagement)
● The device lets art therapists create customized
painting and drawing screens to accommodate
specific client needs, selecting different tools,
colors, sounds, and animation. An artificial
intelligence program runs behind the client
interface and employs audible and visual prompts
to reengage a client that becomes disengaged.
15. Alzheimer's
– Other works on integrating cognitive exercise, physical
exercise, sleep management , and socialization, with
each module incorporating both assessment (home
monitoring and self-reporting) and coaching
● Providing assistance for activities of daily living
– Intelligent technologies can help people with dementia
complete activities of daily living (independent hand-
washing, making a cup of coffee...) → cognitive orthosis
– Although the most require help with dressing, no
assistive technology for that
– Context-aware computing with motivational counseling
to provide dressing assistance
17. Parkinson's
● Diagnosis and evaluation of gravity
● Tremor analysis by accelerometers on upper and
lower extremities, and mouth
18. Parkinson's
● Diagnosis and evaluation of gravity
● Analysis from speech (iPhone applications, 99% accuracy
with a 20s phone call)
– Parkinsonian dysarthria: phonatory impairment
(hoarseness, hypophony, or tremulousness; incomplete
closure of vocal folds causing turbulent air flow) and
articulatory impairment (speech rate accelerates initially,
then slows with disease progression)
– Patients tend to speak in a soft, breathy monotone
– Reduction of fundamental frequency variability leads to
‘‘monopitch’’ intonation
– Feedback mechanism is interrupted and patients feel they
are speaking normal volume
– Speech declines earlier than gait
20. Parkinson's
● Diagnosis and evaluation of gravity
● Analysis from speech: speech disorder treated by iParkinson (it
changes how your hear your voice in earphones, in three ways)
– Multitalker babble noise treats hypophonia or low vocal
volume. It sounds likes a party with people talking around
you. This induces the Lombard effect and increases vocal
volume 5-10 dB.
– Delayed auditory feedback (DAF) treats festinating speech
or "run together" words. The user hears his or her voice
delayed a fraction of a second. This helps pace the user’s
speech.
– Pitch-shifting frequency-altered auditory feedback (FAF)
changes the pitch of the user’s voice in his or her
earphones. This increases speech motor activity and
articulation clarity in some persons with Parkinson’s.
25. Where are we heading to?
● Ambulatory non-intrusive monitoring devices
● Wireless technologies
● Earlier, pre-symptomatic, diagnosis techniques
● GRAPHENE!!!
– Neuromonitoring: electrochemical sensors, electrical field
stimulator to increase cerebral blood flow
– Molecular diagnosis: detection of DNA strands and dopamine, it
is able to strongly quench fluorescent molecules (graphene
biosensors based on fluorescence resonance energy – FRET)
– Neuroregeneration: Because of the unique electroconductive
properties of graphene → design of electroactive scaffolds that
may be able to transmit externally applied electrical stimuli and,
therefore, to enhance neuroregeneration.
