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Biomedical subjects

Sun I Kim

Publications and source records attributed to Sun I Kim.

At least 55 records · Page 3Linked to original sources

Evaluation of automated and semi-automated skull-stripping algorithms using similarity index and segmentation error.

The skull-stripping in the MR brain image appears to be a key issue in neuroimage analysis. In this paper, we evaluated the accuracy and efficiency of both automated and semi-automated skull-stripping methods. The evaluation was performed on both simulated and real data with the ground truth in skull-stripping. Although automated method showed better efficient results, it should require additional intervention. In contrast to that, semi-automated method showed better accurate results, but it was time consuming and prone to operator bias. Therefore, it might be practical that the semi-automated method was used as the post-processing of the automated one.

Algorithms↗

Experimental application of virtual reality for nicotine craving through cue exposure.

Research has shown that many smokers experience an increase in the desire to smoke when exposed to smoking-related cues. Cue exposure treatment (CET) refers to the manualized, repeated exposure to smoking-related cues, aimed at the reducing cue reactivity by extinction. In this study, we constructed a virtual reality system for evoking a desire of nicotine, which was based on the results of a Questionnaire of Nicotine-craving. And we investigated the effectiveness of the virtual reality system as compared to classical device (pictures). As a result, we reached the conclusion that virtual reality elicits more craving symptoms than the classical devices.

Adult↗

Exploring the use of computer games and virtual reality in exposure therapy for fear of driving following a motor vehicle accident.

Specific phobia, situational type-driving, induced by accident (accident phobia) occurs in 18-38% of those involved in a vehicular accident of sufficient severity to warrant referral to the emergency departments of a general hospital. The objective is to investigate, in an open study, the effectiveness of the combined use of computer generated environments involving driving games (game reality [GR]) and a virtual reality (VR) driving environment in exposure therapy for the treatment of driving phobia following a motor vehicle accident (MVA) program. Fourteen subjects who met DSM-IV criteria for Simple Phobia/Accident Phobia and were referred from the emergency department of a general hospital were exposed to a Virtual Driving Environment (Hanyang University Driving Phobia Environment) and computer driving games (London Racer/Midtown Madness/Rally Championship). Patients who experienced "immersion" (i.e., a sense of presence with heightened anxiety) in one of the driving simulations (defined as an increase in SUD ratings of 3 and/or an increase of heart rate > 15 BPM in a 1-h trial session of computer simulation driving) were exposed to a cognitive behavioral program of up to 12 1-h sessions involving graded driving simulation tasks with self-monitoring, physiological feedback, diaphragmatic breathing and cognitive reappraisal. Subjects were assessed at the beginning and end of therapy with measurements of: physiological responsivity (heart rate), subjective ratings of distress (SUD), rating scales for severity of fear of driving (FDI), Posttraumatic Stress Disorder (CAPS) and depression (HAM-D) and achievement of target behaviors. Of all patients 7/14 (50%) became immersed in the driving environments. This immersed group (n = 7) completed the exposure program. Pre- and post-treatment comparisons showed significant post treatment reductions on all measures SUDS (p = 0.008), FDI (p = 0.008), CAPS (p = 0.008), HR (p = 0.008), CAPS (p = 0.008), HAM-D (p = 0.031). Further analysis of the FDI showed significant reductions in all three subscales: travel distress (p = 0.008), travel avoidance (p = 0.008), and maladaptive driving strategies (p = 0.016). The findings of this study suggest that VR and GR may have a useful role in the treatment of driving phobia post-accident even when co-morbid conditions such as post-traumatic stress disorder and depression are present.

Accidents, Traffic↗

A virtual reality system for the assessment and rehabilitation of the activities of daily living.

Successful rehabilitation with respect to the activities of daily living (ADL) requires accurate and effective assessment and training. A number of studies have emphasized the requirement for rehabilitation methods that are both relevant to the patient's real world environment, and that can also be transferred to other daily living tasks. Virtual reality (VR) has many advantages over other ADL rehabilitation techniques, and offers the potential to develop a human performance testing and training environment. Therefore, in this study, the virtual supermarket was developed and the possibility of using a VR system to assess and train cognitive ability in ADL investigated. This study demonstrates that VR technology offers great promise in the field of ADL training.

Activities of Daily Living↗

A virtual environment for investigating schizophrenic patients' characteristics: assessment of cognitive and navigation ability.

Patients with schizophrenia have thinking disorders such as delusions or hallucinations because they have a deficit in the ability to systematize and integrate information. Therefore, they cannot integrate or systematize visual, auditory, and tactile stimuli. The multimodal integration model of the brain can provide a theoretical background from which one can approach multimodal stimulus integration. In this study, we suggest a virtual reality system for the multi-modal assessment of cognitive ability of schizophrenia patients. The virtual reality system can provide multimodal stimuli, such as visual and auditory stimuli, to the patient and can evaluate the patient's multimodal integration and working memory integration abilities by making the patient interpret and react to multimodal stimuli, which must be remembered for a given period of time. The clinical study showed that the virtual reality program developed is comparable to those of the Wisconsin Card Sorting Test (WCST) and the Standard Progressive Matrices (SPM), and it provides some information related to the schizophrenic patients' behavior in 3D virtual environment.

Adult↗

A data glove with tactile feedback for FMRI of virtual reality experiments.

Virtual reality (VR) technology is increasingly recognized as a useful tool for the assessment and rehabilitation of neurologic and psychiatric disorders. The hope that VR can accurately mimic real-life events is also of great interest in basic neuroscience, to identify the brain activity that underlies complex behavior by combining VR with techniques such as functional magnetic resonance imaging (fMRI). Toward these applications, in this study we designed and validated an fMRI-compatible data glove with a built-in vibratory stimulus device for tactile feedback during VR experiments. A simple VR-fMRI experiment was performed at 3.0 Tesla on four young healthy adults involving touching a virtual object with and without tactile feedback. The usefulness of the data glove was subsequently assessed using a series of questionnaires, behavioral performance, and the resulting activation images. Questionnaire scores indicated positive opinions with respect to the data glove, the tactile feedback, and the experimental paradigm. All subjects felt comfortable in the scanner during the VR experiment and were able to perform all aspects of the tasks successfully and with reasonable accuracy. In addition, activation maps showed the anticipated modulations in motor, somatosensory, and parietal cortex. These results support that tactile feedback enhances the realism of virtual hand-object interactions, and that the tactile data glove is suitable for use in other VR-fMRI research applications (e.g., VR physical therapy for stroke recovery).

Adult↗

Modified magnetic resonance image based parcellation method for cerebral cortex using successive fuzzy clustering and boundary detection.

Development of the accurate and reproducible parcellation of the human brain can be used to resolve the complex structure-functional relationships in the brain. We propose a modified parcellation method that provides the reliable and reproducible regions of interest using successive fuzzy c-means (sFCM) and boundary-detection algorithm. This method displays simultaneously both original brain image for identifying the sulcal landmarks and its tissue-classified image for referring to patterns of sulci. The whole cerebral region is extracted by the semiautomated region growing method and then classified to gray matter, white matter, and cerebrospinal fluid by sFCM. Referred to the other previous researches, the volume ratio of gray matter to white matter was shown to find that the efficiency of classification was improved (conventional FCM: 0.80 +/- 0.12 vs. sFCM: 1.57 +/- 0.18). Inter-rater reliability, estimated by the regression analysis, demonstrated that the proposed method was more reliable and reproducible than conventional methods [ANALYZE: correlation coefficient (CC)=0.341, Sig.=0.335 vs. proposed method: CC=0.816, Sig.=0.004]. The volume ratio of the whole cerebrum to the parceled object can be used to investigate structural abnormalities for the pathological detection of the various mental diseases such as schizophrenia, obsessive-compulsive disorder.

Algorithms↗

Detrended fluctuation analysis of EEG in sleep apnea using MIT/BIH polysomnography data.

A number of natural time series including electroencephalogram (EEG) show highly non-stationary characteristics in their behavior. We analyzed the EEG in sleep apnea that typically exhibits non-stationarity and long-range correlations by calculating its scaling exponents. Scaling exponents of the EEG dynamics are obtained by analyzing its fluctuation with detrended fluctuation analysis (DFA), which is suitable for non-stationary time series. We found the mean scaling exponents of EEG is discriminated according to Non-REM, REM (Rapid Eye Movement) and waken stage, and gradually increased from stage 1 to stage 2, 3 and 4.

Cerebral Cortex↗

Intensity based affine registration including feature similarity for spatial normalization.

This paper presents a new spatial normalization with affine transformation. The quantitative comparison of brain architecture across different subjects requires a common coordinate system. For the analysis of a specific brain area, it is required to normalize and compare a region of interest and global brain. Intensity based registration method matches the global brain well. But a region of interest may not be locally normalized compared to feature based method. The method of this paper uses feature similarities of local region as well as intensity similarities. The lateral ventricle and the central gray nuclei of brain including the corpus callosum, which is used for features in Schizophrenia detection, is appropriately normalized. In the results section, our method reduces the difference of feature area such as corpus callosum (7.7%, 2.4%) and lateral ventricle (8.2%, 13.5%) compared with mutual information and Talairach methods.

Algorithms↗

Analysis of physiological response to two virtual environments: driving and flying simulation.

As virtual reality technology continues to attract significant attention in clinical psychology, especially in the treatment of phobias, physiological monitoring is increasingly considered as an objective measurement tool for studying participants. There are few studies, however, of the normal physiological response to virtual environments or reactions to different virtual environments. The goal of this study is to analyze nonphobic participants' physiological reactions to two virtual environments: driving and flying. Eleven nonphobic participants were exposed to each virtual environment for 15 min. Heart rate, skin resistance, and skin temperature were measured during physiological monitoring, and the Presence and Simulator Sickness Questionnaire scores were obtained after each exposure. This study found that skin resistance and heart rate variability can be used to show arousal of participants exposed to the virtual environment experience and that such measures generally returned to normal over time. The data suggest that skin resistance and heart rate can be used as objective measures in monitoring the reaction of non-phobic participants to virtual environments. We also noted that heart rate variability could be useful for assessing the emotional states of participants.

Adult↗

Physiological monitoring as an objective tool in virtual reality therapy.

The goals of this study were twofold: (1) to investigate nonphobics' and phobics' physiological response in virtual environments, and (2) to analyze the trend of phobics' physiology during virtual reality (VR) treatment. As a measure of physiology, heart rate, skin resistance, and skin temperature were acquired. The data for two groups of participants were analyzed: 22 nonphobic participants (mean = 32 +/- 9.4 years) and 36 subjects with fear of flying (mean = 40 +/- 12.1 years) who met the DSM-IV criteria for fear of flying. As a result, skin resistance showed significant differences between nonphobics and phobics, T(56) = 2.978 and p < 0.01, respectively. The physiological response of 33 phobic participants, who were able to fly without medicine after VR treatment, showed a gradual trend toward the nonphobics' physiological responses as therapy sessions progressed. In this study, physiological monitoring, in particular skin resistance, appeared to be useful both in understanding the physiological state of phobic individuals and in evaluating the results of treatment in VR psychotherapy.

Adult↗

The effect of virtual reality cognitive training for attention enhancement.

Our main goal in this research was to validate the possibility of virtual reality (VR) for attention enhancement in cognitive training program. Then, we developed some cognitive training tasks using VR technology. Thirty subjects who had little behavioral problems and social problems were randomly assigned into three groups: VR group, non-VR group, and control group. Only the VR group used the head-mounted display (HMD) and position sensor. While the VR group and non-VR group performed cognitive training, the control group received no special treatment. All participants took their eight session tasks over 2 weeks. Participants executed a continuous performance task (CPT) before and after training sessions. We found that immersive VR with cognitive training is effective for attention enhancement. Also, we confirmed that our cognitive training can improve the attention span of children and adolescents with behavioral problems and help them learn to focus on some tasks.

Adolescent↗

Development and validation of virtual driving simulator for the spinal injury patient.

We developed a virtual reality (VR) driving simulator in order to safely evaluate and improve the driving ability of spinal injury patients. The simulator is composed of an actual car, a beam projector, and a large screen. For the interface of our driving simulator, an actual car was adapted and then connected to a computer. We equipped the car with hand control driving devices especially adapted for spinal injury patients. A beam projector was used so that the subjects could see the virtual scene on a large screen set up in front of them. The virtual environment (VE) consisted of 18 sections (e.g., a speed-limited road, a straight road, a curved road, a left turn) and each section was linked naturally to the next. The subjects selected for this trial were 10 normal drivers with valid driving licenses and 15 patients with thoracic or lumbar cord injuries who had prior driving experience. For evaluation, five driving skills were measured, including average speed, steering stability, centerline violations, traffic signal violations, and driving time in various road conditions such as straight and curved roads. The normal subjects manipulated the gas pedal and the brake with their feet, while the patients manipulated a hand control with their hands. After they finished driving the whole course, the participants answered the questions such as "How realistic did the virtual reality driving simulator seem to you?" and "How much was your fear reduced?" In this study, we found that the difference in manipulation method (i.e., the patient group's hand control versus the normal driver's foot controls) does not seem to influence relative performance in the VR driving simulator, though training to improve the use of hand controls in the VR driving simulator would be useful to reduce the fear that the patients feel while driving.

Adult↗

Virtual reality system for treatment of the fear of public speaking using image-based rendering and moving pictures.

The fear of speaking is often cited as the world's most common social phobia. The rapid growth of computer technology enabled us to use virtual reality (VR) for the treatment of the fear of public speaking. There have been two techniques used to construct a virtual environment for the treatment of the fear of public speaking: model-based and movie-based. Virtual audiences and virtual environments made by model-based technique are unrealistic and unnatural. The movie-based technique has a disadvantage in that each virtual audience cannot be controlled respectively, because all virtual audiences are included in one moving picture file. To address this disadvantage, this paper presents a virtual environment made by using image-based rendering (IBR) and chroma keying simultaneously. IBR enables us to make the virtual environment realistic because the images are stitched panoramically with the photos taken from a digital camera. And the use of chroma keying allows a virtual audience to be controlled individually. In addition, a real-time capture technique was applied in constructing the virtual environment to give the subjects more interaction, in that they can talk with a therapist or another subject.

Desensitization, Psychologic↗

The development of virtual reality therapy (VRT) system for the treatment of acrophobia and therapeutic case.

Virtual reality therapy (VRT), based on this sophisticated technology, has been recently used in the treatment of subjects diagnosed with acrophobia, a disorder that is characterized by marked anxiety upon exposure to heights and avoidance of heights. Conventional VR systems for the treatment of acrophobia have limitations, over-costly devices or somewhat unrealistic graphic scenes. The goal of this study was to develop an inexpensive and more realistic virtual environment (VE) in which to perform exposure therapy for acrophobia. It is based on a personal computer, and a virtual scene of a bunge-jump tower in the middle of a large city. The virtual scenario includes an open lift surrounded by props beside a tower, which allows the patient to feel a sense of heights. The effectiveness of the VE was evaluated through the clinical treatment of a subject who was suffering from the fear of heights. As a result, it was proved that this VR environment was effective and realistic at overcoming acrophobia according not only to the comparison results of a variety of questionnaires before and after treatment but also to the subject's comments that the VE seemed to evoke more fearful feelings than the real situation.

Chronic Disease↗

The treatment of fear of flying: a controlled study of imaginal and virtual reality graded exposure therapy.

The goal of this study was to determine if virtual reality graded exposure therapy (VRGET) was equally efficacious, more efficacious, or less efficacious, than imaginal exposure therapy in the treatment of fear of flying. Thirty participants (Age = 39.8 +/- 9.7) with confirmed DSM-IV diagnosis of specific phobia fear of flying were randomly assigned to one of three groups: VRGET with no physiological feedback (VRGETno), VRGET with physiological feedback (VRGETpm), or systematic desensitization with imaginal exposure therapy (IET). Eight sessions were conducted once a week. During each session, physiology was measured to give an objective measurement of improvement over the course of exposure therapy. In addition, self-report questionnaires, subjective ratings of anxiety (SUDs), and behavioral observations (included here as flying behavior before beginning treatment and at a three-month posttreatment followup) were included. In the analysis of results, the Chi-square test of behavioral observations based on a three-month posttreatment followup revealed a statistically significant difference in flying behavior between the groups [chi(2) (4) = 19.41, p < 0.001]. Only one participant (10%) who received IET, eight of the ten participants (80%) who received VRGETno, and ten out of the ten participants (100%) who received VRGETpm reported an ability to fly without medication or alcohol at three-month followup. Although this study included small sample sizes for the three groups, the results showed VRGET was more effective than IET in the treatment of flying. It also suggests that physiological feedback may add to the efficacy of VR treatment.

Adult↗

An investigation of immersiveness in virtual reality exposure using physiological data.

As virtual reality technology is increasingly attracting significant attention in clinical psychology, especially in the treatment of phobias, physiological monitoring is increasingly considered as an objective measuring tool for studying participants. However, there are few studies of the normal individual's physiological response to virtual environments, or their reactions to different virtual environments. The goal of this study is to analyze non-phobic participants' physiological reaction to two virtual environments: driving and flying and to investigate the usefulness of heart rate variability. Eleven non-phobic participants were exposed to each virtual environment for 15 minutes. Heart rate, skin resistance, and skin temperature measurements were taken for physiological monitoring and Presence and Simulator Sickness Questionnaires were obtained after each exposure. This study found that skin resistance and heart rate variability can be used to show arousal of participant exposed to virtual environments experience and that such measures generally returned to normal as time went by. The Study showed that skin resistance and heart rate can be used as objective measures in monitoring the reaction of non-phobic participants to virtual environments. Significantly, heart rate variability analysis in virtual environments showed that it could be useful for assessing the emotional states of participants.

Adult↗

The development and clinical trial of a Driving Simulator for the handicapped.

We developed a Virtual Reality Driving Simulator in order to safely evaluate and improve the driving ability of the handicapped. The Virtual Environment consists of 18 sections (e.g. a speed limited road, a strait road, a curved road, a left turn course, etc) and each section is linked naturally. For the interface of our driving simulator, an actual car was adapted for realism and then connected to a computer. We also equipped it with hand control driving devices especially adapted for the handicapped. A beam projector was used so that the subjects could see the virtual scene on a large screen which was set in front of them. The subjects selected for this trial were 10 normal drivers with valid driving licenses and 15 patients with thoracicor lumber cord injuries who had prior driving experience. For evaluation, 5 driving skills were measured including average speed, steering stability, centerline violations, traffic signal violations, and driving time in various road conditions such as strait and curved roads. The normal subjects manipulated the gas pedal and the brake with their feet while the patients manipulated a hand control with their hands. After they finished driving the whole course, the participants answered the questions such as "How realistic did the Virtual Reality Driving Simulator seeme to you?" and "How much was your fear reduced". The five driving skills measured between the two groups (normal vs. handicapped) did not show any significant differences (p > 0.05). And in the three kinds of road conditions (a speed limited road and roads with a sharp curve and left-hand turn), the average speed of the handicapped group was 45.6 Km, less than 61.2 Km (p<0.05) of the normal group. In all, 11 patients (73%) reported that their fear of driving was reduced. Furthermore, their average score on the degree of realism question was 51.5%.

Adult↗