How To Help Als Patients – Doctoral student Bahram Borgheai and Assistant Professor Yalda Shahriari (right) adjusting a hat used to monitor ALS patient Doug Sawyer’s brain activity. photo by Michael Salerno
KINGSTON, R.I. – June 25, 2020 – Doug Sawyer was diagnosed with amyotrophic lateral sclerosis (ALS), also known as Lou Gehrig’s disease, 11 years ago. The only muscles that still work are those that control eye movement.
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Despite his disability, Sawyer still works as an engineer from home, designing electronics for Hayward Industries. Using only his eyes, the 57-year-old writes reports and other papers, draws and schematics, talks on the phone, sends text messages and emails, and attends online meetings several times a week.
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However, Sawyer’s eyesight weakens when he is tired, rendering the technology he is currently using ineffective. That’s why the Seekonk, Massachusetts resident was eager to work with Rhode Island University Assistant Professor Yalda Shahriari to develop a new way for ALS patients to communicate.
Shahriari and a team of student researchers in the College of Engineering are developing ways for those with severe motor deficits such as ALS to communicate using brain signals, eliminating the need for patients to maintain fine visual control of their eyes.
His project, funded by a National Science Foundation (NSF) grant, has two main goals. The first is to develop a personalized multimodal algorithm to increase the robustness of the brain-computer interface (BCI) system for patients with severe motor deficits. The second is developing an autonomic hybrid system for non-communicative patients who have no residual motor control, such as those who lose fine eye control in the late stages of ALS.
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Through longitudinal recordings taken from several ALS patients who undertook this and previous projects, Shahriari and his group noticed significant day-to-day variations in the performance of the brain-computer interface.
“This variation is thought to be related to several factors, including cognitive variations and environmental factors,” said Shahriari. “Developing custom algorithms will allow us to predict these variations and optimize performance based on each patient’s specifications and needs.”
To ensure a more accurate reading of brain activity, two non-invasive techniques are applied simultaneously: electroencephalogram (EEG) signaling and Functional Near Infrared Spectroscopy (fNIRS).
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An EEG detects electrical activity in the brain using tiny metal discs called electrodes. Functional Near Infrared Spectroscopy is an optical imaging technique in which the emitter transmits near infrared light and the detector detects the light reflected from the surface of the brain. This technique measures changes in the oxygen concentration of hemoglobin in the brain. The higher the concentration, the more activity occurs.
“We will use a hybrid of EEG and fNIRS signals to compensate for the deficiencies of each neuroimaging modality and use the complementary features obtained from each modality to enhance our system,” said Shahriari.
For patients with advanced ALS who experience cognitive dysfunction, such as memory loss and inability to maintain eye sight, Near Infrared Functional Spectroscopy has proven to be a more accurate measurement method.
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Shahriari and his students developed a visual-mental dual task paradigm that relies on conventional eccentric-based protocols, but requires the subject to perform several mental arithmetic tasks. This BCI approach is carried out by displaying a grid of letters and numbers and periodically displaying an image (number matrix) in each row and column.
“By giving patients a higher demanding task to focus on, we can stimulate a variety of cognitive functions and extract associated signatures or neural biomarkers,” said doctoral student Bahram Borghai. The computer can then decode the pattern of neural activity seen after the patient performs the task. Models can be used for diagnostic and communication purposes.”
Shahriari has been collaborating with the National Center for Adaptive Neurotechnologies on various projects since 2012. With support from the national center, the Rhode Island Branch of the ALS Association and the Rhode Island Hospital, the professor is looking to add more patients to the study.
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“Our data analysis becomes much more powerful if we can significantly increase the number of patients in this study,” said Shahriari.
Patients will be asked to wear caps with sensors attached that can record brain activity in the comfort of their homes or at treatment centers. Registration of those who are of sound mind will take place at the Shahriari Neural Processing and Control Laboratory at the Fascitelli Center for Advanced Engineering. All data processing and analysis will be carried out in the laboratory.
Once enough patients voluntarily participate in the research project, Shahriari plans to partner with more local hospitals and medical schools to leverage their clinical expertise.
Amyotrophic Lateral Sclerosis (als) Disorder Info
“Participating in studies of brain activity is very beneficial,” said Sawyer. “I like to learn new things and keep up with the latest technological developments. Dr. Shahriari and his team are willing to share their progress. They make me feel like part of their team and not just a test number.”
Sawyer hopes his participation will help Shahriari develop ways for ALS patients to work and communicate after their motor functions have ceased.
“I don’t consider myself a victim of ALS and I don’t consider myself disabled,” Sawyer said. “I need help sometimes. There are people out there much worse off than me. Hopefully the time I gave Dr. Shahriari will one day be able to improve their lives.” Stay informed about the latest medical research on the use of stem cell therapy in the treatment of ALS. Learn how this innovative treatment approach has the potential to slow motor neuron degeneration and improve the quality of life for ALS patients.
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Mesenchymal stem cell therapy has demonstrated strong therapeutic potential in various clinical fields. In particular, mesenchymal stem cells (MSCs) can exert their action by differentiating towards a particular cell type or by releasing more growth and trophic factors. Clinical models have demonstrated evidence that mesenchymal stem cells (MSCs) may represent a promising approach for the treatment of ALS; MSC transplantation can delay disease onset and progression and hence increase life expectancy.
In addition, the loss of motor neurons can also be reduced resulting in a delay in the loss of motor function. The results obtained from preclinical studies encourage the administration of mesenchymal stem cells (MSCs) in ALS patients. (3)
Stem cell therapy for ALS is a treatment approach that involves using stem cells, undifferentiated cells that can develop into a variety of specialized cells, to replace or repair damaged or lost cells in the brain associated with ALS. Stem cells are administered into the body via intravenous injection and will find areas of inflammation and damage through a homing mechanism.
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The main mechanisms of stem cells are reducing inflammation (including neuroinflammation) and modulating the immune system. Stem cell therapy aims to prevent disease development for a long time through immune modulation. A secondary benefit of stem cell treatment for ALS is that it helps prevent further loss of neurons to slow development and improve motor symptoms, tremors, stiffness, and movement difficulties.
Stem cells adopt a support role by providing a microenvironment that nourishes and protects nerves which increases the hazardous conditions for diseased motor neurons, thereby reducing neuronal degeneration and neuronal death. The transplanted stem cells, in this capacity, secrete neurotrophic factor and differentiate into non-diseased non-neural cells, such as astrocytes and microglia, or modulator neurons that synapse with diseased motor neurons (MN). Preclinical studies are encouraging and have demonstrated the potential application of stem cells for the treatment of ALS.
Despite numerous clinical trials, there is no cure for ALS, which is known as Lou Gehrig’s Disease; current therapy is palliative and prolongs survival by only a few months. Stem cell therapy is of interest to ALS because it addresses complex disease development through multiple mechanisms.
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The premise of stem cell therapy for Amyotrophic Lateral Sclerosis (ALS) is based on improving the diseased microenvironment. Transplanted stem cells secrete neurotrophic factor and differentiate into supporting cells, such as astrocytes and microglia, which generate a neuroprotective environment that can reduce motor neuron degeneration. (4)
Stem cell therapy may be a viable treatment option for ALS. Stem cells may be viable for supporting and maintaining diseased motor neurons. (1)
“The premise of stem cell therapy for ALS is improving the diseased microenvironment. While stem cells cannot replace diseased motor neurons directly, transplanted stem cells secrete neurotrophic factors and differentiate into supporting cells, such as astrocytes and microglia, which generate a neuroprotective environment that can slow motor neuron degeneration. (1)
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A study conducted by Panayiota Petrou et al. in 2016 found stem cell therapy to be safe and well tolerated by ALS patients.
“Among the 26 patients, 87% were defined as responders to the ALS Revised Functional Classification Scale or forced vital capacity, which had at least a 25% increase at six months post-treatment in the in-progression slope.” (2)
Researchers hope such treatments could eventually slow the progression of ALS, greatly increasing the yield of drugs currently on the market.
Caring For Someone With Als
Amyotrophic Lateral Sclerosis, often called Lou Gehrig’s disease, is difficult to understand and treat. It affects about one to two per 100,000 people in the United States each year. Nearly 95% of ALS cases are caused by unknown factors, with only about 5% being passed down genetically from parents. Although ALS usually strikes around the ages of 50-60, it can affect people of any age.
Amyotrophic Lateral Sclerosis (ALS) occurs when the body begins to experience the death of the neurons that control voluntary muscles. ALS affects both the upper and lower extremities
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