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Biomedical subjects

A Fadda

Publications and source records attributed to A Fadda.

15 recordsLinked to original sources

WARD: a pneumatic system for body weight relief in gait rehabilitation.

The paper presents Walking Assistance and Rehabilitation Device (WARD), a system for walking rehabilitation devised to relieve the patient of his/her body weight of a constant and prescribed amount by externally supporting the subject at the upper trunk and pelvis level by means of a harness. The system is based on a pneumatic actuator that has proved to be effective at maintaining a constant relief force. The constancy of this force that should be maintained even under high body weight support (BWS) conditions (70-80% of body weight) seems to be important for a correct motor pattern. A law has been identified that may be useful to adjust walking speed as a function of the prescribed BWS. WARD is simple to construct, practical to use, and has been characterized on healthy subjects.

Adult↗

Retinal sensitivity to flicker modulation: reduced by early age-related maculopathy.

PURPOSE: To evaluate retinal, cone-mediated flicker sensitivity (CFS) in age-related maculopathy (ARM) by quantifying response gain and threshold of the focal electroretinogram (FERG) to flicker modulation. METHODS: Nineteen patients with ARM (visual acuity > or =20/30) and 11 age-matched control subjects were examined. Twelve patients had less than 20 soft drusen in the macular region and no hyper-/hypopigmentation (early lesion), whereas seven had more than 20 soft drusen and/or focal hyper-/hypopigmentation (advanced lesion). Macular (18 degree ) FERGs were elicited by a sinusoidally flickering (41 Hz) uniform field (on a light-adapting background) whose modulation depth was varied between 16.5% and 94%. Amplitude and phase of the response's fundamental harmonic were measured. RESULTS: In both control subjects and patients with ARM, log FERG amplitude increased with log stimulus modulation depth with a straight line (power law) relation. However, the slope (or gain) of the function was, on average, steeper in control subjects than in patients with either early or advanced lesions. Mean FERG threshold, estimated from the value of the log modulation depth that yielded a criterion response, did not differ between control subjects and patients with early lesions but was increased (0.35 log units) compared with control subjects in those with advanced lesions. In both patient groups, but not in control subjects, mean FERG phase tended to delay with decreasing stimulus modulation depth. CONCLUSIONS: Retinal CFS losses can be detected in ARM by evaluating the FERG as a function of flicker modulation depth. Reduced response gain and phase delays, with normal thresholds, are associated with early lesions. Increased response thresholds, in addition to gain and phase abnormalities, may reflect more advanced lesions. Evaluating CFS by FERG may directly document different stages of macular dysfunction in ARM.

Aged↗

Focal electroretinograms and fundus appearance in nonexudative age-related macular degeneration. Quantitative relationship between retinal morphology and function.

BACKGROUND: The aim of this study was to evaluate the focal electroretinogram (FERG), an objective indicator of outer retinal function, in nonexudative age-related macular degeneration (NE-AMD), and to compare FERG results with morphological lesions assessed by stereoscopic fundus photographs and fluorescein angiograms. METHODS: Twenty-five patients (25 eyes) with bilateral NE-AMD (visual acuity of the study eyes > or = 0.4) as well as 10 age- and sex-matched control subjects (10 eyes) were evaluated. FERGs were recorded from the macular region (9 degrees) in response to sinusoidal stimuli flickered at 32 Hz. Amplitude and phase angle of the Fourier-analyzed FERG fundamental component were measured. Fundus lesions were graded from color slides according to the Wisconsin age-related maculopathy grading system . Fluorescein angiograms were evaluated by an image analysis technique to compute the area with pathological hyperfluorescence (associated with drusen and/or retinal pigment epithelial atrophy) within the macular (approximately 9 degrees x 9 degrees) region. RESULTS: Compared to control eyes, NE-AMD eyes had a reduction in the mean FERG amplitude (57% loss, P<0.001) with no phase changes. Amplitudes of individual affected eyes were negatively correlated with either the Wisconsin grading score (r = -0.63, P < 0.001) or the percentage area of pathological hyperfluorescence (r = -0.70, P<0.01). Eyes with minimal NE-AMD lesions (Wisconsin score < or = 6) and normal acuity had a lower mean amplitude (47% loss, P < 0.05) than that of control eyes. CONCLUSIONS: The results indicate that, in NE-AMD, the FERG is altered in parallel with the extent and severity of fundus lesions. However, a functional impairment of outer macular layers, which is detected by FERG losses, could precede morphological changes typical of more advanced disease.

Aged↗

The fundamental and second harmonic of the photopic flicker electroretinogram: temporal frequency-dependent abnormalities in retinitis pigmentosa.

OBJECTIVES: The flicker electroretinogram (FERG) consists mainly of a linear (fundamental, 1F) and a non linear (second harmonic, 2F) component. Previous results indicate that 2F originates more proximally in the retina than 1F, and that retinitis pigmentosa (RP) may affect 2F to a greater extent than 1F. The aim of this study was to evaluate FERG 1F and 2F abnormalities in RP as a function of the stimulus temporal frequency (TF). METHODS: Twelve patients with typical RP and 10 age-matched controls were examined. FERGs were recorded in response to uniform fields (18 degrees) presented in the macula on a light-adapting background. Stimuli were flickered sinusoidally at different, closely spaced TFs between 3.7 and 52 Hz. Amplitudes and phases of the Fourier analysed 1F and 2F components were measured. Components' apparent latencies were estimated from the rate at which phase lagged with TF. RESULTS: When compared to controls, mean 1F amplitudes of patients were reduced at both low (3.7-12.6 Hz) and high (14-52 Hz) TFs, with greatest losses (0.5 log units) around the peaks (3.7 and 41 Hz) of the normal TF function. Mean 2F amplitudes were reduced mainly at low TFs, with greatest losses (0.5 log units) at 5-8 Hz. On average, the shape of the 2F, but not 1F amplitude versus TF function, differed between patients and controls, showing a selective attenuation at low TFs. Mean 1F apparent latencies were delayed at both low and high TFs, with greater delays at low (85 ms) than at high (33 ms) TFs. Mean 2F apparent latencies were delayed only at low TFs (58 ms). CONCLUSIONS: In RP, 1F and 2F phase delays as well as 2F amplitude losses are dependent on TF, suggesting that FERG generators' subpopulations in both distal and proximal retina are differentially affected. Analysis of the FERG TF response is potentially useful to characterize cone system dysfunction in different genetic subtypes of RP.

Adolescent↗

The spatial tuning of steady state pattern electroretinogram in multiple sclerosis.

In normal subjects, the steady-state electroretinogram in response to contrast reversing gratings (PERG), is spatially band-pass tuned in amplitude, with a maximum at intermediate spatial frequencies and an attenuation at lower and higher ones. The amplitude attenuation at low spatial frequencies is believed to reflect centre-surround antagonistic interactions in the receptive fields of inner retinal neurons. The aim of this study was to evaluate the PERG spatial tuning in multiple sclerosis (MS) patients without a previous optic neuritis history. Steady- state PERGs in response to counterphase-modulated (8 Hz) sinusoidal gratings of variable spatial frequency (0.6, 1.0, 1.4, 2.2 and 4.8 c/deg), were recorded from 18 patients with definite or probable MS and no history of optic neuritis (ON-). Nine of them had no signs of subclinical optic nerve demyelination (asymptomatic) in either eye, while nine had symptoms or signs of optic pathways involvement (symptomatic) in one or both eyes. Results were compared with those obtained from 10 MS patients with a previous history of optic neuritis (ON+) in one or both eyes, as well as from 21 age-matched controls. The amplitudes and phases of the responses' 2nd harmonics were measured. Compared with the controls, asymptomatic ON- patients showed selective losses in mean PERG amplitudes at medium and high (1.0-4.8 c/deg) spatial frequencies. Symptomatic ON- patients and ON+ patients had reductions in mean PERG amplitudes, with respect to controls, involving the whole spatial frequency range, but with greater losses at medium-high (1.0-4.8 c/deg) than at lower spatial frequencies. In all patients' groups, the average PERG spatial tuning function differed significantly from that of the controls, assuming a low-pass instead of the normal band-pass shape. The PERG phase was delayed in ON+ but not in ON- patients, as compared to controls. However, the phase delay was independent of spatial frequency. In both ON- and ON+ patients, losses in PERG amplitude and spatial tuning tended to be associated with corresponding abnormalities in perimetric sensitivity, visual acuity, colour vision and transient visual evoked potential (VEP) latency. The results indicate that abnormalities of the spatial tuning of steady-state PERG can be found in MS patients without either optic neuritis or signs of subclinical optic nerve demyelination. These changes may reflect a retinal dysfunction, developing early in the course of MS, due to a loss of specific subpopulations of inner neurons, changes in lateral interactions of their receptive fields, or both.

Adolescent↗

Precision LED-based stimulator for focal electroretinography.

The authors discuss the technical problems commonly encountered in the design of devices used in the functional analysis of the central retina (macula) and its neuronal elements. They present a simple effective solution for introducing some of the most recent and interesting results of neurophysiological and psychophysical research into the eye clinic.

Electroretinography↗

The first and second harmonics of the macular flicker electroretinogram: differential effects of retinal diseases.

We evaluated the effects of retinal diseases on the macular electroretinogram first and second harmonic components, which are dominated by outer and inner retinal activity, respectively. Macular electroretinograms in response to a uniform field (9 degrees x 9 degrees) flickering sinusoidally at either 32 or 8 Hz (peak frequencies of the first and second harmonics, respectively) were recorded in 14 patients with maculopathies involving photoreceptors (e.g., age-related macular degeneration), in 16 patients with postreceptoral macular diseases (e.g., branch occlusion of central retinal artery), and in 38 normal controls. Amplitude and phase of the first and second harmonic response components were evaluated by Fourier analysis. When compared to controls, patients with photoreceptor diseases had reduction in both first and second harmonic mean amplitudes and second harmonic phase delay; patients with postreceptoral diseases had normal first harmonic components but reduced and delayed second harmonic components. A discriminant analysis, by using first and second harmonic values, correctly classified 13 of 14 patients with photoreceptor diseases and 14 of 16 patients with postreceptoral disorders. These results indicate that combined evaluation of the macular electroretinogram first and second harmonic components is a useful test for identifying the site(s) of retinal dysfunction in patients with macular diseases.

Adolescent↗

[Measurement of the magnetic field dispersed in places with installed magnetic resonance equipment. Characteristics of the control instrumentation].

Among the various controls prescribed by the standards for NMR equipment installations, the measurement of dispersed magnetic field values is of utmost technical importance. The paper deals with scope, strategy and practical execution of the measurements. It also analyzes the question of measurement errors and their effect on the strategy to be adopted and on the final accuracy of isomagnetic tracings.

Electromagnetic Fields↗

[Radiofrequency magnetic fields and SAR in magnetic resonance for clinical use].

The exposure to radiofrequency (RF) electromagnetic fields is one of the main aspects to be controlled in order to ensure the safety of patients in an NMR environment. Starting from the description of the main physical characteristics of RF fields active in imaging instrumentation, a simple model is obtained which accounts for the experimental interdependence between the parameters of the stimulus and SAR values deposited on the patients. This model can yield a preliminary/approximate prediction of exposure levels for a given test. Some NMR equipment admit the estimation of the actual SAR values during the test on the basis of electrical measurements. The paper illustrates the basic principles of these measurements. The biological effects associated with the absorption of RF energy are discussed with particular attention to the physical and biological factors which may result in local heating on the body, a danger which may not be prevented by simply observing the prescribed thresholds of mean exposure.

Biophysical Phenomena↗

Postreceptoral contribution to macular dysfunction in retinitis pigmentosa.

PURPOSE: To understand the sites of macular dysfunction in retinitis pigmentosa by evaluating focal electroretinogram (FERG) fundamental and second harmonic components, which are dominated by the activity of the outer and inner retina, respectively. METHODS: FERGs were recorded in response to a uniform field (9 degrees x 9 degrees) flickered sinusoidally at either 8 Hz or 32 Hz. The fundamental components of the responses to both the 8-Hz and 32-Hz stimuli and the second harmonic of the response to the 8-Hz stimulus were measured in their amplitudes and phases. Normal subjects (n = 17), as well as patients with typical retinitis pigmentosa (n = 22), cone dystrophy (CD, n = 7) and X-linked congenital retinoschisis (XLR, n = 5) served as subjects. The fundamental (32-Hz)-second harmonic (8 Hz) amplitude ratio was taken as an index of the relative function of outer-inner layers of the macula. RESULTS: Compared to controls, patients with retinitis pigmentosa showed losses of both FERG fundamental and second harmonic and an increase of the fundamental-second harmonic ratio. Patients with CD also showed losses of both fundamental and second harmonic, but the fundamental-second harmonic ratio was normal. Patients with XLR had a selective loss of the second harmonic, resulting in an increased fundamental-second harmonic ratio. On average, the fundamental-second harmonic ratio of patients with retinitis pigmentosa tended to increase with age. CONCLUSIONS: The results suggest that in retinitis pigmentosa, both receptoral and postreceptoral sites contribute to macular dysfunction. This differs from CD and XLR, where losses appear more selective for the outer and the inner retina. Postreceptoral losses in retinitis pigmentosa may become larger with increasing age.

Adolescent↗

Simultaneous foveal and parafoveal electroretinograms in hereditary degeneration of the central retina.

Simultaneous foveal and parafoveal electroretinograms (ERG) in response to two identical checks (6 degrees per side) alternating at constant mean luminance were recorded in 26 patients (52 eyes) affected by central hereditary chorioretinal diseases and in 14 age-matched normal subjects (14 eyes). Patients were divided into four groups according to clinical diagnoses: 1. Stargardt's disease; 2. cone dystrophy; 3. vitelliform degeneration; 4. pattern dystrophy. The amplitude and latency of the foveal ERG and the amplitude ratio between foveal and parafoveal ERG (F:PF ratio) were measured. The mean foveal ERG amplitude was significantly lower than the control mean in all patient groups. The foveal ERG latency showed a trend to a increase in all pathological groups. However, this difference was not statistically significant. The mean value of F:PF ratio was significantly reduced as compared with the control mean in Stargardt's disease and cone dystrophy only. In 46 of 52 affected eyes (88.5%) at least one of the electrophysiological parameters was abnormal. Our results suggest that the simultaneous foveal and parafoveal ERG recording may be a sensitive technique in hereditary degenerations of the central retina. This method may also contribute to a better understanding of cone degeneration pathophysiology.

Adolescent↗

Development of personal computer software for a visual electrophysiology laboratory.

This paper describes the software developed by the authors in order to introduce the flexibility and computing power of a modern personal computer in an existing visual electrophysiology laboratory. The basic problems that a programmer must solve in order to implement the main tasks requested are discussed. Such problems include signal acquisition, signal averaging, artifact rejection, time domain analysis, frequency domain analysis and data management. The software developed following our guidelines makes it possible for a personal computer equipped with a commercial analog-to-digital converter to interface directly with the physiologic amplifiers and visual stimulators commonly used either for classical electroretinography or for pattern and focal electroretinography.

Electroretinography↗

Changes in spatial tuning of the pattern electroretinogram with age.

Experimental and clinical studies have demonstrated that the electroretinogram in response to periodical patterns alternating in contrast at constant mean luminance (pattern reversal ERG, P-ERG), is correlated with ganglion cell activity. Senile functional changes of these neurons might be therefore investigated by the P-ERG technique. Steady-state P-ERGs (8 Hz) in response to sinusoidal gratings of different spatial frequencies (0.6-6.8 c/d) were recorded in normal subjects ranging over 50 year age span. The P-ERG amplitude as a function of stimulus spatial frequency shows a maximum between 1.2-1.7 c/d and attenuation at higher and lower spatial frequencies (spatial tuning). The P-ERGs of the older subjects are reduced in amplitute, as compared to those of the younger ones, over the whole range of spatial frequency. This reduction is more marked at intermediate spatial frequencies resulting in a shallower tuning.

Adult↗

The pattern electroretinogram by skin electrodes: effect of spatial frequency and age.

Steady-state (8 Hz) pattern electroretinograms in response to sinusoidal gratings were recorded from 18 elder subjects (mean age 62.7 years) and 22 young subjects (mean age 27 years) by means of skin electrodes. All subjects were free from ocular pathology and their corrected visual acuity was 1.0 or better. In young subjects the second harmonic amplitude as a function of spatial frequency is spatially tuned, with a maximum at around 1.7 c/deg. The response of elder subjects is significantly (P less than 0.05) reduced over the whole range of spatial frequency as compared with that of younger ones. This decrease is more marked (P less than 0.01) at intermediate spatial frequencies, resulting in a shallower tuning. The response phase is not significantly different between young and elder subjects.

Adult↗