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Functional neuroimaging has contributed new insights in the field of aphasia research. Techniques like repetitive transcortical magnetic stimulation (rTMS), Wada testing, and cortical stimulation during neurosurgery with grid mapping, all of which inhibit distinct areas of the brain, have determined which nodes of the networks visualized in functional neuroimaging are critical for each function. The neurological examination of a patient with aphasia can be broken down into six major categories: naming, fluency, repetition, comprehension, reading, and writing. The classical aphasia syndromes result from the infarction of defined vascular distributions, each typically associated with a specific set of neurological deficits, also caused by damage to that particular region of the brain. Patients who develop aphasia following acute stroke typically recover well with only mild long-term language deficits. Many of the techniques currently employed by speech-language pathologists focus on treatment of the damaged component of the system.
Transcranial Doppler (TCD) utilizes the Doppler principle to determine the direction and velocity of blood flow. Most TCDs use long sample volumes in order to improve the signal-to-noise ratio and ease the detection of the basal cerebral arteries. Most TCDs use the fast Fourier transform (FFT) method of spectral analysis which produces the typical visual representation of blood flow velocity. The FFT method of spectral analysis is used in most TCD systems because it allows almost instantaneous detection and display of information in a form which is understandable to most observers. Pulsatility and resistance indices reflect characteristics of the Doppler shift velocity waveforms, and indicate the degree of pulsatility of the waveform. TCD is able to detect two of the major causes of neurological deficits that are abnormalities in blood flow and cerebral embolization. These have made it a valuable practical tool for treating patients in diverse clinical disciplines.
Translational research: application to human neural injury
Gerald E. Loeb, Department of Biomedical Engineering and the A.E. Mann Institute for Biomedical Engineering, University of Southern California, Los Angeles, CA, USA,
Cesar E. Blanco, Department of Biomedical Engineering and the A.E. Mann Institute for Biomedical Engineering, University of Southern California, Los Angeles, CA, USA
This chapter deals with the neural prosthetic devices that integrate directly with the nervous system. The individual computational elements of the nervous system, neurons, are physically small in diameter, allowing them to be packed together into dense nerve tracts and nuclei. In order to achieve biomimetic function, it is desirable to exchange information with neurons on a similar spatial scale. Improving the biomimetic function of a neural prosthesis generally depends on packing yet more electrodes and signal processing functionality into ever-smaller places in the body from which they are not easily retrieved. The seemingly mundane requirements for packaging are likely to remain limiting factors in the clinical performance of neural prostheses. Many neurological deficits involve loss of function in central rather than peripheral pathways, such as inability to store or access information in various forms of dementia.
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