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Table of Abbreviation
AD = Alzheimer Disease
BOLD = Blood Oxygenation Level Dependent
Cl = Confident Level
CytOx = Cytochrome Oxidase
DIAN = Dominantly Inherited Alzheimer Network
FC = Functional Connectivity
FC-NIRS = Functional Connectivity Analysis Tool for Near-Infrared Spectroscopy data
FMRI = Functional Magnetic Resonance Imaging
fNIRS = Functional Near Infrared Spectroscopy
Hb = Haemoglobin
HbO = Oxygenated haemoglobin
HbR = Deoxygenatedhaemoglobin
LED = Light Emitting Diode
Mb = Myoglobin
MMSE = Mini Mental State Examination
Functional Near Infrared Spectroscopy (fNIRS) is a new high-density imaging system that have been used to monitor brain activity and measure changes in the concentration of oxygenated haemoglobin (02Hb) and deoxygenatedhaemoglobin (HHb) of the cerebral cortex in brain imaging technology.
Stated by (Williams etal., 2010) the number of individuals with mild cognitive impairment exceeds in number and these individuals have mild impairment in cognition or daily functions that does not meet the threshold for a diagnosis of dementia. Shah etal., (2011) in their study revealed that the relation between concentration of haemoglobin and incident to have Alzheimer’s disease were significant.
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They revealed that even in elderly who do not have dementia, with lower or higher level of haemoglobin were probably increase symptoms in developing AD. Since FNIRS is one of the equipment that used to monitor the changes in blood volume and blood oxygenation related to human brain function, this equipment was utilized in this study.
A basic FNIRS instrumentation dedicated for brain consists of three parts which is the headpiece, a host server and an electronic system hosted by the data acquisition board. The headpiece act as a main component with combination of LED light and optodes as a detector which located at the forehead of the participants.
Every FNIRS system were shipped with a high capacity isolation transformer. It is very flexible where integrates with other physiological and neurobehavioral measures that assess human brain activity, including eye tracking, pupil reflex, respiration and electrodermal activity; easily syncs port with third party stimuli presentation systems.
In this globalisation, every developing country emerged a world experienced higher productivity in elderly where the growth of the youth was declined compared to the number of elderly (Peterson, 1999). But, as stated by Miyoshi (2009) almost all the patients who were diagnosed with dementia were having senile dementia with early onset mostly before 65 years. It can be proved that the neurological disease not only affect towards elderly, even the younger age also prone to have degenerative neurological disease if there is no early detection and do not have a cure yet.
As mentioned by Alzheimer’s Disease International (2014), Malaysia is one of the countries with high incidence rate of developing Alzheimer’s disease (AD) where it was reported as 123,000 people in 2015. The rate was projected to be 261,00 people in 2030 and keep increasing to 590,000 people by 2050. Thus, there is a need to create an intervention for early detection and preventing Alzheimer’s disease progressed since there is no cure yet to treat the disease. Since Alzheimer’s disease is irreversible, proactive measures to delay or prevent the progression of the disease is essential. Therefore, a robust, simple and mobile technique such as FNIRS were needed for early detection to that the intervention could be planned.
The utilization of fNIRS instrumentation were more widely used in other countries because it is more portable compared to functional magnetic resonance imaging (fMRI) where it is flexible, small, wearable and portable brings to anywhere due to battery-operated and wireless. fMRI is most limited where it is expensive, strictly restricted to motions, produce a noisy scanner and physiological noise to surrounding compared to fNIRS (Gefen, Ayaz, & Onaral, 2014). Therefore, we used fNIRS because it has advantages to cover up the limitation of fMRI which is portable and less restriction on motion so that this equipment was needed for our research to accomplish the objective to measure the brain activity during physical performance.
Physical activity may moderate effect the way of brain in deleting the neural connections that are no longer necessary and strengthening the important one. According to Frith & Loprinzi (2018), exercise is thought to induce neurological changes but at the same time it may increase in brain-derived neurotropic factor in cerebral structures. Furthermore, they said that exercise may increase the brain’s neural synapses and pathways that commonly altered by other factors like environment or even a sedentary routine. In other hand, (Frith & Loprinzi, 2018) stated that physical activity is one of the factor that strongly associated in reducing amyloid beta levels for those with a predisposition to Alzheimer disease that’s why it is important to create awareness about the importance of physical activity especially among adults who reach the age of early 40 as an early prevention of Alzheimer’s disease.
Research Objectives
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Specific objective:
Research Hypothesis
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Scope of Study
Significance of the Study
This study will help to measure the haemoglobin concentration changes in cerebral cortex and figure out the prevention for AD progression which will be significance as:
Functional Near-Infrared Spectroscopy (fNIRS) is one of the new inventions that has several conveniences compared to others neuroimaging technique such as magnetic resonance imaging and positron emission tomography. FNIRS have been used to explore homeostatic changes of the body responds towards cognitive task or even for physical activities that cannot be measured within FMRI scanner (Scarapicchiaetal., 2017).
Special features of FNIRS compared to others are portable size and it is adjustable to brain sizes from new-born baby to adult range of age where it can be carried and easily wear in all condition practically in term of mobility. As mentioned by Gefenetal., in 2014 that FNIRS have alternative to use near infrared light that is more attracted to haemoglobin molecules by tracking their concentration changes and blood oxygen level dependent (BOLD).
Near-infrared light utilized a light with a wavelength that is generally from 700 to 1300 nm. The most wavelength of near-infrared light, especially between 700 and 900 nm can simply pass through brain tissue because light in certain part of brain is less scattered and it is absorbed by only a few biological chromophores such as haemoglobin (Hb), myoglobin (Mb) and cytochrome oxidase (CytOx) by optical methods (Ciftcietal., 2005). In other hand, the main component in FNIRS that plays a vital function in measuring the sample which is light emitting diode (LED) and arrange together with detectors also known as an optodes (Gefenetal., 2014). Rubber bands were used to surround and protect the optodes detector and LED sources in the sensor pad that will be placed to subject’s forehead. The results obtained from LED light will be affected with the presence from other source of light, so when using FNIRS all the lights in the room should be off to avoid from getting invalid results (M.R. Bhuttaetal., 2017).
As studied by Ciftcietal., 2005, level of HbO from physiological activities to the resting time were rise and fall irregularly into small amount that were originate from arterial pulse oscillations and respiration from small artery oscillations. Thus, during resting time should not affect the measurement of haemoglobin to indicate that they were free from cognitive impairments.
Mini Mental State Examination (MMSE) is a tool that can be used to assess cognitive function which was first made known by Folsteinetal in 1975. As MMSE can assess the cognitive function of a patient thoroughly, quick where it takes only an average of 5 to 7 minutes and easy to be done, it was invented to distinguish patients with cognitive impairment during psychiatric problem (Folstein, 1975).
According to Dick etal. 1984, MMSE assessment has been proven to be consistent, valuable and a quick technique for bedside regimen evaluation of cognitive impairment. MMSE measures cognitive skills for instance language, orientation, calculation, memory including quick and short-term recall and the skills to execute easy verbal instructions. It is quite simple to be done and can be completed immediately. The significance of using MMSE to evaluate patient’s cognitive function is undeniable, specifically in a neurology health care facility where most of the diseases to be faced with involve cognitive impairment as one of their symptoms.
Alzheimer’s disease is a neurodegenerative disorder that pathologically caused by accumulation of Amyloid β peptide along with neurofibrillary tangles then caused an implementation of amyloid plaque in the brain. It is one of the hallmarks of the AD where the fragments accumulate in the site of brain’s cells and blocking messages between the brain’s cells. Besides the genetic predisposition, (Frith & Loprinzi, 2018) emphasized from the previous research that lifestyle also one of the risk factors contributed to development of AD such as obesity, depression, hypertension, smoking and sedentary lifestyle.
It was proved that sedentary lifestyle is one of the factors constituting a lifestyle that will affect the brain progressively to be more difficult to do ordinary things like simple movement, or even doing a daily routine. Based on (Frith & Loprinzi, 2018), other than hereditary factor, scientific evidence demonstrated that physical activity remodels brain where it may improve the health and functions of the synapses between the neurons. It is positively associated with cognitive performance and lower risk for developing AD.
World Health Organization and the America College of Sports Medicine recommends for most elderly to get at least 150 minutes of moderate activities per week may give beneficial effects on cognitive decline, functional status and AD markers in the brain of suspected AD patients. However, they were highly recommended for those having AD symptoms to increase their physical activity into ≥150 minutes per week which it was associated with significant by better cognitive performance and less AD pathology. From a public health perspective, the recommendation for individuals to perform a physical activity was achieved by 70% to participate the Dominantly Inheritance Alzheimer Network (DIAN) study. The purpose of DIAN study is to identify potential biomarkers that may predict the development of Alzheimer’s patients who carry Alzheimer’s mutation and supported that physically active lifestyle were achievable in plays an important role in delaying the development and progression of AD (S. Muller etal., 2018).
Based on the previous study, the researchers found that physical performance indicate the reduction towards potential cognitive declines in brain activity by using mice. As studied by (Scarmeasetal., 2009), they suggested that physical activity may promote synaptic plasticity, angiogenesis, learning process, neurogenesis and resistance to brain insults. This factor also helps in enhancing the growth and survival potential of neuron at the same time assist in expression of genes that could benefit to plasticity. High physical performance also has been related to depletion of inflammation, elevated the concentration of neurotransmitters while it also helps in increasing insulin growth factor. Furthermore, (Scarmeasetal., 2009) in their study revealed that pathological changes occur in exercised mice that has been shown the result in declined the cortical amyloid burden and mediated in the processing of amyloid precursor protein.
Functional near-infrared spectroscopy (fNIRS), a non-invasive and relatively new imaging method, has become a popular instrument in studies of resting-state brain functional connectivity (FC). However, the corresponding software packages for data analysis of FC still need improvement. Thus, on 2015, Xuetal. developed a MATLAB software package called “functional connectivity analysis tool for near-infrared spectroscopy data” (FC-NIRS) in order to aid in human functional connectome studies by means of fNIRS. This Matlab software packages have four main functions of fNIRS which are network analysis, FC calculation, data pre-processing and quality control.
As this software has a friendly graphical user interface (GUI), FC-NIRS aids investigators to analyse data in a simple, quick and flexible way. Moreover, FC-NIRS can manage batch processing during data processing and analysis. These features can reduce the time needed in processing more datasets. Progressive experimental studies using real human brain method have confirmed the capability of the toolbox. This novel toolbox is presumed to significantly aid in fNIRS-data-based human functional connectome studies.
Alzheimer’s disease (AD) is a progressive dementia that may cause loss of neurons in frontal and temporal cortex and leads to memory loss, functional decline and decline in cognitive performance. It caused pathologically by accumulation of extracellular amyloid plaques and intracellularneurofibrillary tangles that were form from the main component of Aβ and tau regularly. According to Selkoe 1991, he indicated that the accumulation of amyloid filaments was commonly consist of either normal or mutant gene products of proteolytic fragments. Specifically, it was occurring due to accumulate of 4-KD protein together with beta pleated sheet configuration that known as βA4 which arranged in a radial fashion and covered by a corona of abnormally formed neurites (P. Perl, 2010).
Moreover, development of AD also affects the release of neurotransmitter which associate together in a reduction of acetylcholine, serotonin, dopamine and noradrenaline production (Selkoe, 1991). In addition, a small amount of acetylcholine released in neurons will contribute to the reduction of cholineacetyltransferase and may affect a cognitive performance at the same time cause a neuropathological finding. Thus, the reduction of this neurotransmitter was involved in the shrinkage of projection neurons in hippocampal and cortical that due to progressive of AD symptoms as well as changes in personality and behaviour.
This study is an experimental study to determine the cerebral hemoglobin concentration changes in healthy subjects by using functional near-infrared spectroscopy (fNIRS). The fNIRS is used to measure cerebral oxygenated hemoglobin (HbO) and deoxygenated hemoglobin (HbR) concentrations changes during resting time (lying supine and sitting), during coordination activity and between the resting time and coordination activity in a period of time for healthy subjects.
Few subjects from UniKLMestech who volunteering themselves to be as a subject had an initial screening. The inclusion and exclusion criteria are applied. The subjects behavioral and physical ability is observed by investigators before subjects selected to answer the MMSE. The subjects answered the question based on MMSE and the marks are calculated in instance. The marks are given based on score and healthy subject are selected to followed investigator for further testing with fNIRS. In total, 30 subjects have completed the MMSE (Malay Version) but only 12 subjects were selected to go for further test with fNIRS.
The source population of this study is 12 subjects, comes from 6 male and 6 female which the study population is from the UniKLMestech students. The source population will be all undergraduate Healthcare Science students from UniKLMestech students, and the study population sampled students were who fulfill the exclusion and inclusion criteria.
Inclusion criteria
Exclusion criteria
All the data from all the three different position will be measured for cerebral haemoglobin changes and be recorded, and then will be inserted into statistical software which is the SPSS version 24. Descriptive statistics will be calculated, then percentage, mean, standard deviation, and frequency distribution will be obtained. After that, we can utilise the Chi-square Test and Regression then be applied to assess the association between haemoglobin changes and three different position which is lying supine and sitting, during coordination activity and at rest of healthy subjects using fNIRS. The confidence level (Cl) of 95% with a margin error of 5% will be used. Also, the P value of 0.05 or less (p < 0.05) will be considered as statistically significant.
Complexcity Analysis of Functional Near Infrared Spectroscopy (Fnirs) During Coordination Test in Healthy Subjects. (2024, Feb 21). Retrieved from https://studymoose.com/document/complexcity-analysis-of-functional-near-infrared-spectroscopy-fnirs-during-coordination-test-in-healthy-subjects
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