**Author details**

Tommaso Bocci1,2, Elisa Giorli1,2, Lucia Briscese1 , Silvia Tognazzi3 , Fabio Giannini2 and Ferdinando Sartucci1,3,4\*

\*Address all correspondence to: f.sartucci@neuro.med.unipi.it

1 Department of Neuroscience, Unit of Neurology, Pisa University Medical School, Pisa, Italy

2 Department of Neuroscience, Neurology and Clinical Neurophysiology Section, Siena University Medical School, Siena, Italy

3 Department of Neuroscience, Cisanello Neurology Unit, Azienda Ospedaliera Universita‐ ria Pisana, Pisa, Italy

4 CNR Neuroscience Institute, Pisa, Italy

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toxicity in vitro [71, 72] could not delay both the early retraction of nerve terminals from neuromuscular end-plates and the dying-back of axons during asymptomatic phase in vivo.

**Figure 3.** Histogram highlighting MUNE values in both BB (left) and ADM (right) muscles at every time of follow-up, in males (gray columns) and females (black columns); the top row shows the evolution of motor unit loss in the familiar form, whereas the bottom one the trend in sporadic cases. The lack of significant differences between males and fe‐ males, in sporadic as well as in familiar forms, is consistent with results recently reported in recent literature [71, 72].

Although our preliminary results cannot be directly compared with those found in animals, these data could expand current knowledges about morphological and functional differences

We speculate that overbranching occurs not only in dendrites but also in the few surviving axons. This increased complexity of axonal arborization, compared both with healthy and sALS subjects, is still largely undervalued and whether that represents a pointless neuropro‐ tective response of nervous system or a disease mechanism is an intriguing matter of debate. However, as suggested in animal models [73], our Macro-EMG data seem to suggest that overbranching might be one way to mitigate loss of function along corticospinal pathways. These evidences highlight a novel hypothesis for the adult onset of fALS symptoms, namely

**5. Conclusions and future directions**

(modified from Bocci et al., *Int J Mol Sci* 2011: \*p<0.05; \*\*p<0.01).

236 Current Advances in Amyotrophic Lateral Sclerosis

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**Chapter 9**

**Eye-Gaze Input System Suitable for Use under Natural**

Recently, eye-gaze input systems have been developed as novel human–machine interfaces [1-10]. Their operation requires only eye movements by the user. Based upon such systems, many communication aids have been developed for people with severe physical disabilities, such as amyotrophic lateral sclerosis (ALS). Eye-gaze input systems commonly employ noncontact eye-gaze detection for which an incandescent, fluorescent, or LED lamp can be used as the source of infrared or natural light. Detection based on infrared light can detect eye gaze with a high degree of accuracy [1-3] but requires an expensive device. Detection based on natural light uses ordinary devices and is therefore cost-effective [4,5]. However, an eye-gaze

We have previously developed an eye-gaze input system for people with severe physical disabilities [8-10]. This system uses a personal computer (PC) and a home video camera to detect eye gaze under natural light. The camera (e.g., a DV camera) can easily be connected to a PC through an IEEE 1394 interface. The frames taken by the camera can be analyzed in real time using the DirectShow library by Microsoft. We developed image analysis software to detect eye gaze. Our eye-gaze input system runs the software on Windows. This system does not require any special devices and is easily customizable. Therefore, this system is not only cost-effective but also versatile. Moreover, it can be operated under natural light and thus is

and reproduction in any medium, provided the original work is properly cited.

© 2013 Kiyohiko et al.; licensee InTech. This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

© 2013 The Author(s). Licensee InTech. This chapter is distributed under the terms of the Creative Commons Attribution License http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution,

**Light and Its Applications Toward a Support for ALS**

**Patients**

Ohyama Minoru

**1. Introduction**

suitable for personal use.

Abe Kiyohiko, Ohi Shoichi and

http://dx.doi.org/10.5772/56560

Additional information is available at the end of the chapter

input system for natural light has a low degree of accuracy.

