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Publications

Publications by João Paulo Cunha

2022

Gait Characterization and Analysis of Hereditary Amyloidosis Associated with Transthyretin Patients: A Case Series

Authors
Vilas-Boas, MD; Fonseca, PFP; Sousa, IM; Cardoso, MN; Cunha, JPS; Coelho, T;

Publication
JOURNAL OF CLINICAL MEDICINE

Abstract
Hereditary amyloidosis associated with transthyretin (ATTRv), is a rare autosomal dominant disease characterized by length-dependent symmetric polyneuropathy that has gait impairment as one of its consequences. The gait pattern of V30M ATTRv amyloidosis patients has been described as similar to that of diabetic neuropathy, associated with steppage, but has never been quantitatively characterized. In this study we aim to characterize the gait pattern of patients with V30M ATTRv amyloidosis, thus providing information for a better understanding and potential for supporting diagnosis and disease progression evaluation. We present a case series in which we conducted two gait analyses, 18 months apart, of five V30M ATTRv amyloidosis patients using a 12-camera, marker based, optical system as well as six force platforms. Linear kinematics, ground reaction forces, and angular kinematics results are analyzed for all patients. All patients, except one, showed a delayed toe-off in the second assessment, as well as excessive pelvic rotation, hip extension and external transverse rotation and knee flexion (in stance and swing phases), along with reduced vertical and mediolateral ground reaction forces. The described gait anomalies are not clinically quantified; thus, gait analysis may contribute to the assessment of possible disease progression along with the clinical evaluation.

2022

Corrigendum: Clinical 3-D gait assessment of patients with polyneuropathy associated with hereditary transthyretin amyloidosis

Authors
Vilas-Boas, MdC; Rocha, AP; Cardoso, MN; Fernandes, JM; Coelho, T; Cunha, JPS;

Publication
Frontiers in Neurology

Abstract

2022

Portable RGB-D Camera-Based System for Assessing Gait Impairment Progression in ATTRv Amyloidosis

Authors
Vilas Boas, MD; Rocha, AP; Choupina, HMP; Cardoso, MN; Fernandes, JM; Coelho, T; Cunha, JPS;

Publication
APPLIED SCIENCES-BASEL

Abstract
Hereditary Amyloidosis associated with variant Transthyretin (ATTRv Amyloidosis) is a progressive and highly disabling neurological disorder that affects gait. Quantitative motion analysis is useful for assessing motor function, including gait, in diseases affecting movement. A single markerless RGB-D camera enables 3D full-body motion capture in a less expensive and intrusive, and more portable way than multi-camera marker-based systems. In this study, we examine whether a gait analysis system based on an RGB-D camera can be used to detect significant changes in the gait of ATTRv amyloidosis patients over time, when compared with a 12-camera system. We acquired 3D data provided by both systems from six ATTRv amyloidosis patients, while performing a simple gait task, once (T0) and 18 months later (T1). A direct comparison of systems has already been conducted. In this work, however, for each patient, we investigated if the RGB-D camera system detects statistically significant differences between the two different acquisitions in a similar way to the reference system, and whether it is reliable to use during patients' follow-up. The obtained results show that the differences detected between T0 and T1 for both systems follow the same tendency for 65% of the spatiotemporal gait parameters, and for 38% of the kinematic parameters (38%). The most reliable parameters were: stride duration/length, gait speed (and its variability), and arm/foot swing velocity, all with an almost perfect strength of agreement.

2022

Clinical 3-D gait assessment of patients with polyneuropathy associated with hereditary transthyretin amyloidosis (vol 11, 605282, 2020)

Authors
Vilas-Boas, MD; Rocha, AP; Cardoso, MN; Fernandes, JM; Coelho, T; Cunha, JPS;

Publication
FRONTIERS IN NEUROLOGY

Abstract
In the published article, there was an error in Table 2 as published. The units of the Total body center of mass sway in x-axis (TBCMx) and y-axis (TBCMy) were shown in mm when they should be in cm. The corrected Table 2 and its caption appear below. In the published article, there was an error in Table 3 as published. The units of the Total body center of mass sway in x-axis (TBCMx) and y-axis (TBCMy) were shown in mm. The correct unit is cm. The corrected Table 3 and its caption appear below. In the published article, there was an error in Figure 3 as published. The units of the Total body center of mass sway in x-axis were shown in mm in the vertical axis of the plot. The correct unit is cm. The corrected Figure 3 and its caption appear below. In the published article, there was an error in Supplementary Table S.I. The units of the Total body center of mass sway in x-axis (TBCMx) and y-axis (TBCMy) were shown in mm. The correct unit is cm. The correct material statement appears below. In the published article, there was a mistake on the computation description of one of the assessed parameters (total body center of mass). A correction has been made to “Data Processing,” Paragraph 3: “For each gait cycle, we computed the 24 spatiotemporal and kinematic gait parameters listed in Table 2 and defined in (15). The total body center of mass (TBCM) sway was computed as the standard deviation of the distance (in the x/y-axis, i.e., medial-lateral and vertical directions) of the total body center of mass (TBCM), in relation to the RGBD sensor’s coordinate system, for all gait cycle frames. For each frame, TBCM’s position is the mean position of all body segments’ CM, which was obtained according to (21).” The authors apologize for these errors and state that this does not change the scientific conclusions of the article in any way. The original article has been updated. © 2022 Vilas-Boas, Rocha, Cardoso, Fernandes, Coelho and Cunha.

2022

Ictal and interictal features of local field potentials recorded from the anterior thalamic nucleus of epilepsy patients performing deep brain stimulation with the Percept (TM) PC system

Authors
Lopes, E; Caldeiras, C; Rito, M; Chamadoira, C; Santos, A; Cunha, JPS; Rego, R;

Publication
EPILEPSIA

Abstract

2022

Novel 3D video action recognition deep learning approach for near real time epileptic seizure classification

Authors
Karacsony, T; Loesch-Biffar, AM; Vollmar, C; Remi, J; Noachtar, S; Cunha, JPS;

Publication
SCIENTIFIC REPORTS

Abstract
Seizure semiology is a well-established method to classify epileptic seizure types, but requires a significant amount of resources as long-term Video-EEG monitoring needs to be visually analyzed. Therefore, computer vision based diagnosis support tools are a promising approach. In this article, we utilize infrared (IR) and depth (3D) videos to show the feasibility of a 24/7 novel object and action recognition based deep learning (DL) monitoring system to differentiate between epileptic seizures in frontal lobe epilepsy (FLE), temporal lobe epilepsy (TLE) and non-epileptic events. Based on the largest 3Dvideo-EEG database in the world (115 seizures/+680,000 video-frames/427GB), we achieved a promising cross-subject validation f1-score of 0.833 +/- 0.061 for the 2 class (FLE vs. TLE) and 0.763 +/- 0.083 for the 3 class (FLE vs. TLE vs. non-epileptic) case, from 2 s samples, with an automated semi-specialized depth (Acc.95.65%) and Mask R-CNN (Acc.96.52%) based cropping pipeline to pre-process the videos, enabling a near-real-time seizure type detection and classification tool. Our results demonstrate the feasibility of our novel DL approach to support 24/7 epilepsy monitoring, outperforming all previously published methods.

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