ESS - NEU - Comunicações em eventos científicos
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- Technology, Sleep and Rest: what effects do they have on the brain?Publication . Borges, Daniel FilipeThis lecture dealt with various topics relating to technology, neurobiology and the function of sleep as well as the characteristics of rest. In a pragmatic way, an original approach was taken by trying to answer several story-related questions, such as: - When we talk about technology, we inevitably think about access to and use of the internet. How can we measure the impact of technology today in Portugal and in the world? - Should we be concerned about the exponential growth in the use of social networks and e-commerce? - Can the reported statistical data be the ground truth, or is there a certain subjectivity that must be taken into account when analysing it? - Today there are smartwatches and a variety of technologies that allow us to track our sleep. There is a lot of talk about "quantity versus quality". Do we know how to interpret the results? - How can we tell if our sleep was effective without needing a detailed diagnosis? - Are we sufficiently informed about what sleep is and what it does to us? How would you explain in a simple way how this element, which is so important for our health, works? - We often wake up with the feeling that we haven’t rested enough and take it for granted – it’s the “new normal”. Is that dangerous? - Will the overuse of technology that is directly related to light exposure render the sleep cycle ineffective? - There is a lot of talk about blue light. It's often associated with sleep and falling asleep. What are the consequences of exposure to this light? - We are used to only talking about the negative effects of using technology on the brain. But are there also benefits? - The exponential growth in the use of technology can now even be seen in schools. Teenagers are the most affected by this technological phenomenon. What tips would be helpful to protect yourself from the surge we are experiencing? - How can this decline in emotional intelligence affect the critical minds of young people? - What does the future of sleep health look like?
- Reading epilepsy and hyperexcitability of the visual word form areaPublication . Borges, Daniel Filipe; Leal, AlbertoReading epilepsy recruits critical language-related areas, with synchronization and subsequent spreading of excitation in response to the epileptogenic stimulus. The mechanism by which possible generalized discharges result in the expression of bilateral or unilateral clinical symptoms remains controversial. The cortical and subcortical areas involved may constitute part of the normal reading network, such as the visual word form area (VWFA). A right-handed, 59-year-old man was diagnosed with epilepsy at the age of 15 after tonic-clonic seizures. Later, the patient described myoclonic jerks of the masticatory and perioral muscles while reading. A multimodal approach with magnetic resonance imaging and ambulatory and video-electroencephalogram was used for seizure characterization and source analysis. A left hemisphere spontaneous occipitotemporal epileptic focus, activated by reading, was observed, spreading broadly throughout frontal and temporal language networks. There was an abnormally increased cortical response to visual word presentation in comparison to pseudowords. Spatial localization of spike sources suggested a close association between the primary epileptic focus and the VWFA. This epileptiform activity seems to be selectively triggered at an early stage of lexical processing, with a functional connection between the epileptic network and the VWFA. This multimodal and functional connectivity approach could be helpful in determining the epileptic network in reading epilepsy.
- Is a hypothalamic hamartoma always a suspect in gelastic seizures? A source functional connectivity studyPublication . Borges, Daniel Filipe; Leal, AlbertoGelastic seizures are rare manifestations of epilepsy that are often associated with hypothalamic hamartomas (HH). In the absence of HH, location of the origin is more difficult and there are several less well-established possibilities. Non-invasive assessment is often complicated by the deep localization of the epileptogenic area and the complex dynamics of spike activity. Robust neurophysiological methods and careful validation of intrinsically epileptogenic lesions detected by RM can improve the validity of scalp EEG analysis. This presentation will discuss a case report analysing the dynamics of epileptic activity in gelastic seizures associated with cortical dysplasia. The clinical case was a 26-year-old girl with daily refractory gelastic seizures since the age of 6 who underwent neurophysiological examination with long-term EEG recordings and MRI of the brain. She had previously been rejected in an epilepsy surgery programme because no structural brain lesion had been found and the EEG information was not conclusive enough. A recent 3T MRI showed cortical dysplasia in the cingulate gyrus, which was highly suspicious as an epileptogenic focus. We analysed the 31-channel EEG (ictal and interictal) using source and functional connectivity methods to obtain a solid computer model of the origin and dynamics of the epileptic activity and correlate it with the anatomical information of the MRI. Source analysis of the interictal activity revealed multiple sources that dominated at different time points, suggesting considerable dynamics that prevented clear identification of the source. The ictal recordings showed little late rhythmic activity over the frontal areas, but no early focalization. Connectivity analysis, which revealed the flow of information between cortical sources, showed a consistent origin of epileptic activity near the cortical dysplasia for both interictal and ictal activity. EEG connectivity analysis significantly improves the performance of non-invasive methods for determining the intracranial dynamics of epileptic activity and correlation with structural lesions.
- EEG CLÍNICO: como descrever, interpretar e relatar em 10 passosPublication . Borges, Daniel Filipe
- Neurophysiology in the WildPublication . Borges, Daniel Filipe; Leal, AlbertoIntroduction: The acquisition of bioelectrical signals from the nervous system is traditionally complex, prone to artifacts and technically demanding. Currently, there are signs that research in this field is saturated and confined to institutional walls due to the cost-effectiveness profile of the methods used. Therefore, the demand for portable technology has grown exponentially to significantly increase the amount of data collected. Therefore, epilepsy, specifically regarding long-term electroencephalography (EEG), and sleep medicine are two of the best examples of the clinical utility of wearables for real-world (Level IV) studies. Objective: Development of clinical and translational research based on the development, application and clinical validation of neurophysiological wearable technology to study neural networks in different clinical contexts. Methods: Using a tailor-made 2-channel EEG wearable device and a customized single-channel EEG sensor inserted into the external auditory canal, we conducted three clinical validation studies in patients' homes. We detected and sonified typical absence seizures in pediatric epilepsy patients, studied patients with clinically suspected temporal lobe epilepsy, and recorded and staged 30-second epochs from sleep studies of healthy and pathological subjects. Results: The wearable devices employed showed neurophysiological data with consistently strong positive correlations, consistent performance and high reliability compared to gold standard methods, as well as near perfect inter-observer agreement. Conclusions: Clinical neuroscientists require large amounts of data, so these developments, driven largely by the influx of gadgets in the consumer market, are enabling more do-it-yourself and quantified-self methods. These neurophysiological signals from wearables hold great promise for advancing neuroscience through real-world data.
- Sleep stage detection: a clinical validation study of a custom-built single-channel in-ear EEG sensorPublication . Borges, Daniel Filipe; Soares, Joana I.; Silva, Heloísa; Felgueiras, João; Batista, Carla; Ferreira, Simão; Rocha, Nuno; Leal, AlbertoIntroduction:Sleep is vital for health. It has regenerative and protective functions, and its disruption reduces the quality of life and increases susceptibility to disease. During sleep, there is a cyclicity of distinct phases that are studied using polysomnography (PSG), a costly and technically demanding method that compromises the quality of natural sleep. The search for simpler devices for recording biological signals at home addresses some of these issues. Objective: To clinically validate a custom-built single-channel in-ear EEG sensor for sleep classification by assessing various sleep metrics and staging decisions with simultaneously recorded PSG. Methods: Prospective cross-sectional study with 28 participants, divided into two groups: healthy volunteers and clinical patients. In both groups, PSG, individual in-ear EEG- with two different electrode configurations- and actigraphic recordings (only in the healthy group) were performed simultaneously for a whole night. Statistical analysis focussed on the four main sleep metrics: TRT (total recording time), TST (total sleep time), SE (sleep efficiency), SL (sleep latency) and the 5-class classifications (wakefulness, N1, N2, N3 and REM sleep). This included correlation analyses between methods and Bland-Altman plots, Cohen’s K coefficient, and confusion matrices aiming 30-second epoch-wise agreement with an automatic sleep classification algorithm using visual sleep classification by an ERSR-certified human expert as the gold standard according to current AASM guidelines. Results: The analysed sleep data comprised 30960 epochs. The correlation analysis revealed strong positive correlations (0.90) for all variables for the in-ear sensor. The Bland-Altman plots show a high level of agreement and consistency (+- 1.87 SD), with minimal bias between methods. The average kappa values (0.75) and the confusion matrices with each method's sensitivity and specificity also show a very high level of concordance.Conclusions: In both groups, the in-ear EEG sensor showed strong correlation, agreement and reliability with the gold standard, supporting accurate sleep classification.
- Perceções de estudantes da área da saúde póspandemia: estudo observacionalPublication . Cruz, Agostinho; Machado, Alberto; Cabral, Ana Paula; Tavares, Diana; Sousa, Helena; Curado, Henrique; Faria, Isabel; Sousa, Maria; Gonçalves, Maria João; Lopes, Paula; Monteiro, PedroO contexto pandémico vivenciado por toda a comunidade portuguesa nestes últimos meses, constituiu indubitavelmente um ambiente e um conjunto de experiências totalmente novas e singulares para todos os cidadãos, mas sobretudo para os jovens adultos. A pandemia e o confinamento, trouxe restrições no acesso a simulações práticas e especializadas assim como a locais de ensino clínico em contexto real e presencial, fundamental para a aquisição de competências clínicas e integração de realidades organizacionais de serviços cuidados de saúde. Neste contexto ao nível da área da saúde os desafios foram ímpares e alteraram a dinâmica profissional e as interações sociais.
- The relevance of an ethics committee in a higher education institution in the health area: The experience of ESS-P.PORTOPublication . Monteiro, Pedro; Tavares, Diana; Cruz, Agostinho; Cabral, Ana Paula; Machado, Alberto; Curado, Henrique; Sousa, Helena; Faria, Isabel; Gonçalves, Maria João; Sousa, Maria; Marques, António; Lopes, Paula; Prudêncio, CristinaEthics Committees arose as consequence of medical-scientific advances made in an eminent demand to extend morality and ethics to the field of biomedicine, to expand and preserve autonomy and dignity of human beings. The Ethics Committee (EC) of Escola Superior de Saúde (ESS) was born in February 2011. The importance for this unit of P.PORTO in having such a committee, for ethical and not legal imperative, came to be corroborated by law (Decree-Law no. 80/2018).
- P300 wave and the right against self-incrimination: Parallel with the evidence obtained by DNAPublication . Sousa, Maria; Tavares, DianaThe right against self-incrimination rests on the nemo tenetur se ipsum accusare principle, derived from the presumption of innocence. The possibility to extract information from a person`s body, based on the theory of passive collaboration, as it happens in DNA collection, means that a person is not self-incriminating but merely admitting an intervention. It is one of the most controversial issues among jurists, who are divided between those who allow some, even minimal, restriction on this right and those who do not allow any restriction. The present work seeks to answer two essential questions. Firstly, on the assumption of passive collaboration theory, to understand if it is open the possibility of using new ways of obtaining the knowledge only the suspect or accused (eventually) has. On the other hand, given the international censorship of the polygraph, to study the basis for the use of P300 Wave, as a new form of cognitive evocation, under the idea that someone is not actively collaborating, but merely tolerating an intervention in the body, as it is already applied in the US and Spain.
- Is there still space for pedagogical and technical-scientific creativity in higher education in health technologies?Publication . Tavares, Diana; Mota, Sandra; Amorim, ManuelaAfter pandemic period, it is urgent to create a facilitating means of internal cogitation and to identify creative strategies that can overcome the less positive aspects of distance learning. There is an increasingly constant problem - the lack of motivation and identity in the academic-scientific environment with a lack of proactivity and resistance of interaction with others. It is necessary to work with traditional teaching-learning methodologies and create out of the box grafts that are attractive and productive. This year we will implemented a set of strategies: clinical cases, health literacy training sessions, cultural tools, escape room and others. We will carry out a diagnostic assessment of knowledge, before and after the intervention; as well as an interview that will allow us to understand the personal evolution and the degree of satisfaction. In this phase, the intention is to share the methodological strategies in a constructive and enriching manner.
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