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Purpose: The current assessment of patients with craniofacial asymmetries is accomplished by physical examination, anamnesis and radiological imaging. We propose a semi-automated, computer-assisted craniofacial evaluation (SymMetric v 1.0) based on orthogonal photography of the patient's head in 3 positions. The system is simple, low-cost, no-radiation or special resources needed. Although it does not substitute CT in cases of doubt between craniosynostosis and positional plagiocephaly, multiple numeric evaluations indicate regional deformities and severity of the asymmetry, which can help in the clinical decision of indicating or not the orthosis in positional deformities, determining treatment duration or evaluating surgical outcomes after correction. Methods: A Matlab-based tool was developed for digital processing of photographs taken in 3 positions (anterior, superior and lateral). The software guides the user to select visible and reproducible landmarks in each photograph acquisition and calculates multiple indexes and metrics, generating a set of comprehensive plots to offer the user an overview of head and facial symmetry across the orthogonal views. For purposes of demonstration, we evaluated 2 patients (one control and one with non-sinostotic deformity). Results: The results show a clear differentiation of the control and plagiocephalic patient metrics mainly in the superior view, showing potential for diagnosis of the condition, and also detected the clinical improvement during helmet treatment in the follow-up, 3 and 5 months after orthosis' use. Conclusion: We presented a proof-of-concept for a low cost, no radiation evaluation system for craniofacial asymmetries, that can be useful in a clinical context for diagnosis and follow-up of patients. [ABSTRACT FROM AUTHOR]

Introduction Early sensory re-education techniques are important strategies associated with cortical hand area preservation. The aim of this study was to investigate early cortical responses, sensory function outcomes and disability in patients treated with an early protocol of sensory re-education of the hand using an audio-tactile interaction device with a sensor glove model. Methods After surgical repair of median and/or ulnar nerves, participants received either early sensory re-education twice a week with the sensor glove during three months or no specific sensory training. Both groups underwent standard rehabilitation. Patients were assessed at one, three and six months after surgery on training-related cortical responses by functional magnetic resonance imaging, sensory thresholds, discriminative touch and disability using the Disabilities of the Arm, Shoulder and Hand patient-reported questionnaire. Results At six-months, there were no statistically significant differences in sensory function between groups. During functional magnetic resonance imaging, trained patients presented complex cortical responses to auditory stimulation indicating an effective connectivity between the cortical hand map and associative areas. Conclusion Training with the sensor glove model seems to provide some type of early cortical audio-tactile interaction in patients with sensory impairment at the hand after nerve injury. Although no differences were observed between groups related to sensory function and disability at the intermediate phase of peripheral reinnervation, this study suggests that an early sensory intervention by sensory substitution could be an option to enhance the response on cortical reorganization after nerve repair in the hand. Longer follow-up and an adequately powered trial is needed to confirm our findings. [ABSTRACT FROM AUTHOR]

The visual appealing nature of the now popular BOLD fMRI may give the false impression of extreme simplicity, as if the the functional maps could be generated with the press of a single button. However, one can only get plausible maps after long and cautious processing, considering that time and noise come into play during acquisition. One of the most popular ways to account for noise and individual variability in fMRI is the use of a Gaussian spatial filter. Although very robust, this filter may introduce excessive blurring, given the strong dependence of results on the central voxel value. Here, we propose the use of the Isotropic Anomalous Diffusion (IAD) approach, aiming to reduce excessive homogeneity while retaining the natural variability of signal across brain space. We found differences between Gaussian and IAD filters in two parameters gathered from Independent Component maps (ICA), identified on brain areas responsible for auditory processing during rest. Analysis of data gathered from 7 control subjects shows that the IAD filter rendered more localized active areas and higher contrast-to-noise ratios, when compared to equivalent Gaussian filtered data (Student t-test, p<0.05). The results seem promising, since the anomalous filter performs satisfactorily in filtering noise with less distortion of individual localized brain responses.