Seizure prediction and control in epilepsy

The first part of my thesis presents an overview of the different approaches used in the past two decades in the attempt to forecast epileptic seizure on the basis of intracranial and scalp EEG. Past research could reveal some value of linear and nonlinear algorithms to detect EEG features changing over different phases of the epileptic cycle. However, their exact value for seizure prediction, in terms of sensitivity and specificity, is still discussed and has to be evaluated. In particular, the monitored EEG features may fluctuate with the vigilance state and lead to false alarms. Recently, such a dependency on vigilance states has been reported for some seizure prediction methods, suggesting a reduced reliability. An additional factor limiting application and validation of most seizure-prediction techniques is their computational load. For the first time, the reliability of permutation entropy [PE] was verified in seizure prediction on scalp EEG data, contemporarily controlling for its dependency on different vigilance states. PE was recently introduced as an extremely fast and robust complexity measure for chaotic time series and thus suitable for online application even in portable systems. The capability of PE to distinguish between preictal and interictal state has been demonstrated using Receiver Operating Characteristics (ROC) analysis. Correlation analysis was used to assess dependency of PE on vigilance states. Scalp EEG-Data from two right temporal epileptic lobe (RTLE) patients and from one patient with right frontal lobe epilepsy were analysed. The last patient was included only in the correlation analysis, since no datasets including seizures have been available for him. The ROC analysis showed a good separability of interictal and preictal phases for both RTLE patients, suggesting that PE could be sensitive to EEG modifications, not visible on visual inspection, that might occur well in advance respect to the EEG and clinical onset of seizures. However, the simultaneous assessment of the changes in vigilance showed that: a) all seizures occurred in association with the transition of vigilance states; b) PE was sensitive in detecting different vigilance states, independently of seizure occurrences. Due to the limitations of the datasets, these results cannot rule out the capability of PE to detect preictal states. However, the good separability between pre- and interictal phases might depend exclusively on the coincidence of epileptic seizure onset with a transition from a state of low vigilance to a state of increased vigilance. The finding of a dependency of PE on vigilance state is an original finding, not reported in literature, and suggesting the possibility to classify vigilance states by means of PE in an authomatic and objectic way. The second part of my thesis provides the description of a novel behavioral task based on motor imagery skills, firstly introduced (Bruzzo et al. 2007), in order to study mental simulation of biological and non-biological movement in paranoid schizophrenics (PS). Immediately after the presentation of a real movement, participants had to imagine or re-enact the very same movement. By key release and key press respectively, participants had to indicate when they started and ended the mental simulation or the re-enactment, making it feasible to measure the duration of the simulated or re-enacted movements. The proportional error between duration of the re-enacted/simulated movement and the template movement were compared between different conditions, as well as between PS and healthy subjects. Results revealed a double dissociation between the mechanisms of mental simulation involved in biological and non-biologial movement simulation. While for PS were found large errors for simulation of biological movements, while being more acurate than healthy subjects during simulation of non-biological movements. Healthy subjects showed the opposite relationship, making errors during simulation of non-biological movements, but being most accurate during simulation of non-biological movements. However, the good timing precision during re-enactment of the movements in all conditions and in both groups of participants suggests that perception, memory and attention, as well as motor control processes were not affected. Based upon a long history of literature reporting the existence of psychotic episodes in epileptic patients, a longitudinal study, using a slightly modified behavioral paradigm, was carried out with two RTLE patients, one patient with idiopathic generalized epilepsy and one patient with extratemporal lobe epilepsy. Results provide strong evidence for a possibility to predict upcoming seizures in RTLE patients behaviorally. In the last part of the thesis it has been validated a behavioural strategy based on neurobiofeedback training, to voluntarily control seizures and to reduce there frequency. Three epileptic patients were included in this study. The biofeedback was based on monitoring of slow cortical potentials (SCPs) extracted online from scalp EEG. Patients were trained to produce positive shifts of SCPs. After a training phase patients were monitored for 6 months in order to validate the ability of the learned strategy to reduce seizure frequency. Two of the three refractory epileptic patients recruited for this study showed improvements in self-management and reduction of ictal episodes, even six months after the last training session.

Psychobiological correlates of allostatic load

Introduction: The term Clinimetric was introduced by Feinstein in 1982, who first noticed that despite all the improvements in the assessment methods, a number of clinical phenomena were still unconsidered during the evaluation process. Yet today clinical phenomena, such as stress, relevant in diseases progression and course, are not completely evaluated. Only recently, according to the clinimetric approach, Fava and colleagues have introduced specific criteria for evaluating the allostatic overload in clinical setting. Methods: Participants were 240 blood donors recruited from May 2007 to December 2009 in 4 different blood Centers (AVIS) in Italy. Blood samples from each participant were collected for laboratory test the same day the self-rating instruments were administered (Psychosocial Index, Symptom Questionnaire, Psychological well-being scales, Temperament and Character inventory, Self-Report Altruism scale). The study explore different aspects describing sample characteristics and correlates of stress in the total sample (part I), new selection criteria applied to existing instruments to identify individuals reporting allostatic load (part II), and differences on biological correlates between subjects with vs without AL. Results: Significant differences according to gender and past illnesses have been found in different dimensions of well-being and distress. Further, distress was explained for more than 60% by 4 main factors such as anxiety, somatic symptoms, environmental mastery and persistence. According to the new criteria, 98 donors reported AL. Allostatic load individuals reported to engage in less altruistic behaviours. Also they differ in personality traits and characters from controls. In the last part, results showed significant differences among donors according to allostatic load on diverse biological parameters (RBC, MCV, immune essay). Conclusion: This study presents obvious limitations due to its preliminary nature. Further research are need to confirm that these new criteria may lead to identify high risk individuals reporting not only stressful situations but also vulnerabilities.

La Previsione dei Consumi Elettrici nel Mercato Energetico Italiano : un nuovo modello empirico con struttura triangolare

L'obiettivo principale della tesi è lo sviluppo di un modello empirico previsivo di breve periodo che sia in grado di offrire previsioni precise ed affidabili dei consumi di energia elettrica su base oraria del mercato italiano. Questo modello riassume le conoscenze acquisite e l'esperienza fatta durante la mia attuale attività lavorativa presso il Romagna Energia S.C.p.A., uno dei maggiori player italiani del mercato energetico. Durante l'ultimo ventennio vi sono stati drastici cambiamenti alla struttura del mercato elettrico in tutto il mondo. Nella maggior parte dei paesi industrializzati il settore dell'energia elettrica ha modificato la sua originale conformazione di monopolio in mercato competitivo liberalizzato, dove i consumatori hanno la libertà di scegliere il proprio fornitore. La modellazione e la previsione della serie storica dei consumi di energia elettrica hanno quindi assunto un ruolo molto importante nel mercato, sia per i policy makers che per gli operatori. Basandosi sulla letteratura già esistente, sfruttando le conoscenze acquisite 'sul campo' ed alcune intuizioni, si è analizzata e sviluppata una struttura modellistica di tipo triangolare, del tutto innovativa in questo ambito di ricerca, suggerita proprio dal meccanismo fisico attraverso il quale l'energia elettrica viene prodotta e consumata nell'arco delle 24 ore. Questo schema triangolare può essere visto come un particolare modello VARMA e possiede una duplice utilità, dal punto di vista interpretativo del fenomeno da una parte, e previsivo dall'altra. Vengono inoltre introdotti nuovi leading indicators legati a fattori meteorologici, con l'intento di migliorare le performance previsive dello stesso. Utilizzando quindi la serie storica dei consumi di energia elettrica italiana, dall'1 Marzo 2010 al 30 Marzo 2012, sono stati stimati i parametri del modello dello schema previsivo proposto e valutati i risultati previsivi per il periodo dall'1 Aprile 2012 al 30 Aprile 2012, confrontandoli con quelli forniti da fonti ufficiali.

Evaluation of slope stability under water and seismic load through the Minimum Lithostatic Deviation method

The main objective of this thesis is to obtain a better understanding of the methods to assess the stability of a slope. We have illustrated the principal variants of the Limit Equilibrium (LE) method found in literature, focalizing our attention on the Minimum Lithostatic Deviation (MLD) method, developed by Prof. Tinti and his collaborators (e.g. Tinti and Manucci, 2006, 2008). We had two main goals: the first was to test the MLD method on some real cases. We have selected the case of the Vajont landslide with the objective to reconstruct the conditions that caused the destabilization of Mount Toc, and two sites in the Norwegian margin, where failures has not occurred recently, with the aim to evaluate the present stability state and to assess under which conditions they might be mobilized. The second goal was to study the stability charts by Taylor and by Michalowski, and to use the MLD method to investigate the correctness and adequacy of this engineering tool.