\r\n\t \r\n\tThis book is intended to discuss and address the issues and challenges of anomaly detection. The book is focused on, but not limited to chapters that address different aspects of anomaly detection consisting of novel strategies and development of services over different computing models. Moreover, the book intends to investigate how anomaly detection is impacted by cutting edge innovations.
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Venkata Krishna is currently a Professor of Computer Science and a Director at Sri Padmavati Mahila University, Tirupati, India. He received his B. Tech in Electronics and Communication Engineering from Sri Venkateswara University, Tirupathi, India, M. Tech in Computer Science & Engineering from REC, Calicut, India, and he received his Ph.D. from VIT University, Vellore, India. Dr. Krishna has several years of experience working in academia, research, teaching, consultancy, academic administration and project management roles. His current research interests include Mobile and wireless systems, cross-layer wireless network design, QoS, and Cloud Computing. He was the recipient of several academic and research awards such as the Cognizant Best Faculty Award for the year 2009-2010 and the VIT Most Active Researcher Award for the year 2009-2010. 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1. Introduction
The aim of this chapter is to clearly identify the usefulness of audiological investigations, both for hearing and for vestibular function, in positive diagnosis of Menière’s disease and in staging the lesion. This is important for counselling the patients regarding the disease long-term evolution and also for appropriate management of the disease.
Inner ear spaces of the anterior and posterior labyrinth communicate in between and endolymphatic hydrops present in the Menière’s disease usually affects both auditory and vestibular sensorial structures located in the two parts of the inner ear.
In this chapter, hearing and vestibular testing will be presented, as tests are recommended for positive and differential diagnosis of the Menière’s disease. Regarding Menière’s disease diagnostic, audiological and vestibular testing plays an important role in diagnosis of the disease per se and for staging diagnosis. Besides medical importance, accurate diagnosis is also important for counselling the patients regarding the disease long-term evolution and also for appropriate management of the disease.
2. Audiological evaluation
Audiological testing includes pure tone audiometry, with highlights of bone conduction especially in acute episodes of this disease, glycerol test when hearing loss is documented, auditory brainstem response (ABR) and electrocochleography.
2.1. Pure tone audiometry
Pure tone audiometry is a subjective method of hearing evaluation. Patient must signalize the faintest sound he/she hears. Pure tone with specific frequencies is used (125, 250, 500, 1000, 2000, 4000, and 8000 Hz), based on the human normal hearing frequency range (20–20,000 Hz).
Sounds are presented both in air and bone conduction in order to have an accurate image of the hearing.
The result of the test is shown in a graph, a Cartesian system with frequency tested (in Hz) on horizontal axis and intensity (in dB HL) on the vertical one. Frequency varies between 125 and 8000 Hz and intensity between −10 and 120 dB (the latest represents the painful sensation, not an audible one = uncomfortable level). Based on patient’s response, the least audible intensity (threshold) on each tested frequency is plotted.
Threshold notation is standardized internationally (ISO system) and colors as well: red for the right ear and blue for the left ear (Figure 1):
Figure 1.
Standardized notation for hearing thresholds.
Air conduction: “circle” for the right ear and “X” for the left ear
Nose-opened brackets for bone conduction: “<” and “>” in unmasked condition and “[“ and “]” in masked condition
Normative for hearing thresholds (THR) were established based on nonotological history teenagers’ responses decades ago and normal hearing stands for hearing thresholds between −10 and +20 dB on all frequencies, without differences between air and bone conduction (Figure 2).
Figure 2.
Pure tone audiometry—normal hearing in both ears.
Pure tone audiometry is the method of choice for hearing evaluation also in Menière’s disease patients in [1, 2]. When hearing loss (HL) is permanent, Menière’s disease patients experience sensorineural hearing loss (average of hearing THR on 0.5, 1, and 2 kHz greater than 20 dB), with pathological thresholds on low frequencies (Figure 3).
Figure 3.
Low frequency sensorineural hearing loss in left ear.
Cochlear sensorineural hearing loss (SNHL) is accompanied by recruitment, a phenomenon of increased loudness perception—above an increase threshold, higher intensity sounds are as loud to the hearing impaired person as for a normal hearing one and thus disturbing.
Some authors describe in Menière’s disease patients a particular type of recruitment—hyper- or overrecruitment: loudness in the affected ear overtakes the normal ear at high intensities in [3–5].
When differences between air conduction thresholds in both ears exceed 40dB for supra-aural earphones or 55 dB when insert earphones are used, air conduction masking is mandatory for that specific frequency where this difference exists. For bone conduction, masking is mandatory whenever more than 10dB difference between bone and air conduction thresholds is present on that specific frequency. Bone conduction masking is essential in differentiating conductive and sensorineural hearing loss.
It is not unusual to have a conductive component of the hearing loss in Menière’s disease acute phase—disturbances in endolymph metabolism lead to pressure variations at the round and oval window with secondary increases of impedances. High impedances diminish air transmission of the sounds, with consecutive cochlear conductive hearing loss (Figure 4). In these cases, middle ear test (tympanometry and acoustically evoked stapedius reflex) shows no impairment of the middle ear as cause of the conductive component of the hearing loss.
Figure 4.
Conductive (a) or mixed (b) hearing loss due to cochlear conductive hearing loss.
2.2. Speech audiometry
Besides pure tone audiometry, speech audiometry complements auditory evaluation. It is a more complex test, since evaluates the entire auditory pathway as hearing is a cortical process. Speech audiometry is also a subjective audiological test where the tested person has to repeat the heard stimuli—numbers, monosyllabic, disyllabic words, or sentences.
The result of the test is a Cartesian graphic with percentage of correct repeated stimuli on the vertical axis for each intensity tested and with intensity of the stimulus on the horizontal axis. For each intensity, a phonemic-balanced list of 10 stimuli (numbers, monosyllabic, disyllabic words, or sentences) is presented. These percentages draw a curve which crosses the 50% line at some specific intensity. This crossing represents the threshold of speech audiometry. For normal hearing, conductive or cochlear sensorial sensorineural hearing loss, this threshold must correlate with pure tone average ±7 dB (Figure 5).
Figure 5.
Speech audiometry.
If in cochlear sensorineural hearing loss of other etiology there is a good correlation (±7 dB) between pure tone and speech audiometry THR, in prolonged Menière’s disease, some differences may appear.
Another parameter used in interpretation of the speech audiometry is the maxim of intelligibility/discrimination. It represents the highest percentage of correct repeated stimuli the patient obtains. For normal hearing or conductive hearing loss persons, 100% intelligibility is reached.
Sensorineural hearing loss induced distortions in audition which can limit the maximum of discrimination. Speech audiometry can draw attention on the estimated site of hearing loss, cochlear, or retrocochlear: in cochlear lesions, once the maximum score of discrimination is reached, it remains constant as higher intensities are tested. In retrocochlear sensorineural hearing loss an odd phenomenon occurs—as intensity increases, the patient understands less word (roll-over phenomenon).
2.3. Glycerol test
In patients with Menière’s disease and permanent sensorineural HL, if low frequencies THR are greater than 40 dB, glycerol test is recommended. Since endolymphatic hydrops is the pathophysiological mechanism of the Menière’s disease, oral administration of a hypertonic solution will extract liquids from tissues, including from the endolymphatic space. Thus, the endolymphatic pressure is diminished and hearing and vestibular sensorial epithelium recovers from increased pressure. The clinical effect of this restoration is improvement of both auditory and vestibular system function 2 h and 30 min after the ingestion, when both pure tone audiometry and speech audiometry are repeated.
Hearing improvement can be documented by pure tone audiometry and speech audiometry. An improvement of the THR on at least 10dB on three consecutive frequencies in pure tone audiometry and/or a more than 12% improvement of speech audiometry THR is considered a positive glycerol test (Figure 6). Some authors consider this as an indication for diuretic treatment, since the endolymphatic system has the capacity to modify its pressure after oral administration of a hyperosmolar solution.
ABR—is an objective electrophysiological audiological method that allows recording of the electrical activity evoked by neural activity in the auditory pathways, from the cochlea to the brainstem (lateral lemniscus) in Refs. [6, 7]. Surface electrodes are used in this far-field technique. Most commonly used acoustic stimulus is the click—a brief (0.1 ms) rectangular stimulus. Click-evoked ABR reflects hearing sensitivity in the frequency range of 1–4 kHz with a high correlation with pure tone audiometry threshold in this frequency domain, especially at 4 kHz where the stimulus’ energy is maximum.
ABR is the first evoked potentials, with seven characteristic waves in the first 10 ms after click stimulation at high intensities: 70–90 dB normal hearing level (nHL). These waves were first described by Jewett, as response of different auditory pathway structures after acoustic stimulation:
wave I: proximal auditory nerve
wave II: distal auditory nerve
wave III: cochlear nuclei
wave IV: superior olivar complex
wave V: lateral lemniscus
wave VI: medial geniculate body (thalamus)—probable
wave VII: medial geniculate body (thalamus)—probable
First five are mostly used in interpretation of the BERA recordings. In Menière’s disease patients, BERA is mandatory in order to rule out a retrocochlear etiology of the sensorineural hearing loss. Latencies, interpeak intervals and interaural differences of the latencies and interpeak intervals are the parameters used for this differential diagnosis (Figure 7).
Figure 7.
Parameters used in ABR interpretation.
In general, ABR exhibits a sensitivity of over 90% and a specificity of approximately 70–90%. Findings suggestive of retrocochlear pathology may include any one or more of the following:
Absolute latency interaural difference wave V (IT5)—prolonged as compared with normative data.
I–V interpeak interval interaural difference (IPI1-5)—prolonged as compared with normative data; greater than 0.2 ms in unilateral or symmetrical hearing loss, or greater than 0.3 ms in patients with asymmetrical or with noise-induced hearing loss. Interaural IPI difference criterion requires no correction for audiogram differences.
Absolute latency of wave V—prolonged as compared with normative data.
Absolute latencies and interpeak intervals latencies I–III, I–V, III–V—prolonged as compared with normative data.
Absence of the later waves.
Absent auditory brainstem response in the involved ear even though hearing is normal or mildly impaired.
ABR traces not replicable.
Abnormally low V:I amplitude ratio (less than 1.0)—less sensitivity than latency measurements.
2.5. Electrocochleography
Electrocochleography (ECochG) is an objective audiological test that measures the electrical potentials derived from the cochlear hair cells and the auditory nerve in [8–10]. These potentials are produced between an electrode on the cochlear promontory and an earlobe electrode, within a time frame of 5 ms after stimulation with alternative repetitive very short acoustic signals (click). Averaging of a large number of potentials (1000 sweeps) is needed in order to record the ECochG characteristic wave. Click is the most common stimuli used in ECochG due to its effect of very good synchronization of a large number of cochlear nerve fibers, mandatory for eliciting a measurable action potential. Click has an abrupt onset, very short duration and broad frequency spectra, thus stimulating a very large number of hair cells in the basal turn of the cochlea, where the speed of the travelling wave is the fastest.
Magnitude and quality of the response depends on the electrode type—transtympanic electrode fixed directly on the promontory gives the best recordings, but it is an invasive audiological investigation. Alternatively, with good clinical results are used extratympanic electrodes, place in the external auditory canal, as close as possible to the eardrum or on the eardrum itself.
Synchronization of the auditory nerve fibers after above-mentioned stimulation gives birth to global action potential. Its origin lies into the inner ear hair cells and cochlear nerve.
Global action potential consists of presynaptic and postsynaptic potentials (Figure 8).
Figure 8.
Global action potential.
The first one includes cochlear microphonic (CM) that originates in the outer cochlear hair cells and summating potential (SP) arising from the inner cochlear hair cells. Postsynaptic potentials, known as global action potential of the cochlear nerve, is generated by all cochlear nerve fibers, fired in synchrony by the acoustic stimulus.
In endolymphatic hydrops, due to the increased pressure in scala media, basilar membrane vibrates asymmetrical. These changes of the traveling wave lead to several dysfunctions: distorted cochlear microphonics, enlargement of the summating potential and broadening of the action potential. Magnitude of the AP compared with SP (SP/AP ratio) is increased in endolymphatic hydrops (>30%). The SP/AP amplitude ratio has 50–60% sensitivity in Ménière’s disease diagnosis and 95% specificity in Refs. [11, 12] (Figure 9).
Figure 9.
SP/AP amplitude ratio.
Recently, an area ratio (Figure 10) seems to be a more sensitive parameter for detecting endolymphatic hydrops [13]. An increase of more than 2 of SP/AP area together with the increase of SP/AP amplitude ratio increases sensitivity and specificity in Menière’s disease diagnosis to 92 and 83.9%, respectively [14]. Some EP machines enabled automatically measurement of the area ratio.
Figure 10.
SP/AP area ratio (www.nervecenter.natus.com).
3. Vestibular evaluation
Vestibular investigations are also recommended in Menière’s disease patients not only as a recommended battery test for positive diagnosis, but also in order to evaluate the degree of vestibular lesion which is present from the beginning of the Menière’s disease.
Both vestibulo-ocular reflex (VOR) and vestibulospinal reflex (VSR) should be evaluated. Besides bed-side evaluation, objective vestibular tests are performed for a quantitative measure of these two vestibular reflexes useful in understanding the vestibular deficits as the disease proceeds.
Electro- or videonystagmography allows quantification of the nystagmus, as specific sign of vestibule-ocular reflex dysfunction. Nystagmus, as a conjugate movement of eyes with a slow and a fast phase provoked by vestibular asymmetry, reflects variations of the corneo-retinian potential during eyes movement (Figure 11). The slow phase is the effect of vestibular stimulation and its amplitude is proportional to the intensity of vestibular stimulation. The fast phase is central in origin and reflects only the reflex movement of the eyes to return to their normal position in the orbit. The fast phase direction gives the nystagmus direction.
Figure 11.
Nystagmus recording = variations of the corneo-retinian potential.
The corneo-retinian potential can be measured by surface electrodes fixed around the eyes, horizontal and vertical or registered with infrared camera (Figure 12) in Refs. [15–17]. Conventionally, for horizontal electrodes, the upward fast phase is considered right beating nystagmus, while the downward fast phase is considered left beating nystagmus. For vertical electrodes, the upward fast phase is considered superior beating nystagmus, while the downward fast phase is considered inferior beating nystagmus.
Figure 12.
Calculation of nystagmus slow phase velocity.
Quantification of the nystagmus is based on several parameters:
Direction of the nystagmus—linear, vertical, rotatory; right-, left-, superior- or inferior-beating nystagmus.
Velocity of the slow phase, vestibular in origin (Figure 12).
Several tests are included in the electro-/videonystagmography (ENG/VNG): spontaneous nystagmus, positional, and positioning nystagmus, as well as provoked nystagmus (post or perrotatory nystagmus and caloric nystagmus). The provoked test is recommended only if patient is not in an acute vertigo phase.
Rotatory and caloric testing evaluates semicircular canal function in response to rotation or irrigation with warm and cold water/air of the external ear canal. Bithermal irrigation causes convective movement of endolymph in the ipsilateral horizontal semicircular canal, caloric test being the only available test that gives information regarding each horizontal semicircular canal. The movement of the endolymph provoked by variation of temperature and, secondary, endolymph density results in deflection of the cupula of the irrigated semicircular canal. Motion of the cupula leads to vestibular hair cell excitation or inhibition with consecutive change of the discharge rate in the superior vestibular nerve fibers. The difference between the excitatory and inhibitory discharge rates of the two superior vestibular nerves reaches the vestibular nuclei. From here compensatory eye movements are elicited (slow phase of nystagmus), followed by rapid corrective saccades (fast phase of nystagmus).
In Menière’s disease patients, results in ENG/VNG differ depending on the phase (acute, subacute, or chronic) and the duration of the disease.
At the beginning of an acute phase, due to the minor ruptures in the Reissner’s membrane and an increase of potassium concentration in the endolymph, the vestibular sensorial epithelium in the affected ear is stimulated and the spontaneous nystagmus beats toward the Menière’s ear (Figure 13). Soon after, due to constantly increasing of the potassium concentration, the vestibular hair cells are intoxicated and their function decrease. In this stage, spontaneous nystagmus changes its direction toward the healthy ear.
Figure 13.
Spontaneous nystagmus: A—initial phase of the spell (towards the affected ear); B—end of the spell (towards the non-affected ear).
In the next days after the acute spell of the Menière’s disease results in rotatory and caloric test varies—either hypofunction in the affected ear (Figure 14), or symmetric functionality of the inner ears. The absence of a fixed vestibular lesion is the case in most of patients. In prolonged Menière’s disease (long-term/chronic effect) usually patients’ express caloric hypofunction of the affected ear (1/2—2/3 of patients) as VOR reflects the decreased input from the damaged ear. Caloric stimulation can be done sequential with warm and cold water, respectively, for each ear, or simultaneously. Bilateral cold water (30°C) irrigation shows rapidly the affected ear—the ear toward the nystagmus appears.
Figure 14.
Left ear caloric hyporeflexia-hypofunction index > 30%.
In rotatory chair test, results are usually normal. Directional preponderance is rarely seen, usually in long-duration Menière’s disease, when vestibular lesion is stable at some extent (Figure 15). But immediately after an acute attack, VOR gain is increased in rotation toward the affected ear [18].
Figure 15.
Symmetrical VOR response in rotatory test.
In between the acute spells, Menière’s disease patients can experience positional vertigo, usually due to benign paroxysmal positional vertigo (BPPV). Disturbances in endolymph metabolism affect the function of the stria vascularis with secondary negative effects on the otolithic membrane. Still, BPPV is more frequently associated with vestibular migraine than Menière’s disease.
3.1.2. Video head impulse test
The video head impulse test (HIT) evaluates as well semicircular canal function. Integrity of the VOR allows the tested subject to maintain sight fixed during high-acceleration high-velocity head rotations in space (gain values close to 1.0, as the ratio between eye and head velocity). Rotation is performed in each plane with an excitatory effect on each of the six semicircular canals.
A positive HIT stands for complete lesion of the fibers connected with the tested semicircular canal. In comparison with caloric testing, video HIT is abnormal in much more small numbers of Menière’s disease patients, maybe because vestibular lesion is not complete.
3.2. Vestibulospinal reflex (VSR)
Equilibrium is a complex process, essential in human well-being and daily activities. It allows standing on different supports as well as walking and other movements without falling or disequilibrium.
Body and head position in space, related to gravity and environment landmarks (of verticality for example), is based on normal and correlated information’s form sensorimotor, visual and vestibular systems. The most important, for sure until adult life, is the sensorimotor system—proprioceptors from feet and neck contribute mostly in equilibrium as we move in space.
As long as the child grows, visual information becomes more important in equilibrium, especially when visual surroundings are difficult.
A vestibular system develops in function in the first year of life and contributes progressively more to equilibrium. Its contribution increases in the case of a lesion in either of the other two systems [15–17]. Besides this, a severe unilateral vestibular deficit or bilateral vestibular lesion has a huge impact on equilibrium, at least for several weeks until a unilateral vestibular deficit is compensated by the other ear.
In Menière’s disease, pathophysiology of the disease explains the fluctuating vestibular function of the affected ear. So, we do not have a stable deficit, at least not a complete one, or from the very beginning of the disease. For this reason, vestibular investigations have different results, from patient to patient, as we discussed in the ENG section.
3.2.1. Computerized dynamic posturography
Computerized dynamic posturography (CDP) contributes with specific parameters in monitoring patients with Menière’s disease—for appropriate diagnostic and management. CDP is based on a force plate system capable of measuring the antero-posterior balance of the center of gravity of the tested subject and automatically compare this balance with normal values for patient’s group of age.
Sensory organization test (SOT) is the most common test of CDP. It allows a selective use of each of the three systems involved in equilibrium during six different conditions of testing (Figure 16) in [19] and thus a global and selective evaluation of equilibrium, based on the system used for maintaining the standing position during testing in [20].
As long as projection of the center of gravity (COG) during testing is inside the base support area and no external support is used for stabilize, patient is able to maintain his/her equilibrium and normal result will be displayed at the end of the test (Figure 17). When patient cannot voluntary control its balance within the parameters described, he will obtain a pathological score of equilibrium, displayed at glance with colors convention and also with numeric values (Figure 18).
Figure 17.
CDP—normal result.
Figure 18.
CDP—pathological result: vestibular deficit.
In Menière’s disease patients, CDP usually display normal results, since in between the spells patient has no equilibrium problems and the acute vestibular deficit of the affected ear was compensated already. Immediately after the acute phase, vestibular scores can be abnormal, mainly in vestibular condition.
3.2.2. Vestibular evoked miogenic potentials
Vestibular evoked miogenic potentials (VEMPs) area relatively new objective test designed to measure otolithic function in [21]. In response to loud sound stimulation (95–97dB nHL), saccular vestibular sensorial epithelium generates activity in the inferior vestibular nerve and further in the vestibulospinal and vestibule-ocular pathway.
Action potential transmitted through the vestibulospinal pathway generates muscular responses in the effectors of the vestibulospinal (cervical muscles—cervical vestibular evoked myogenic potential: cVEMP) or vestibule-ocular reflex (extraocular muscles—ocular vestibular evoked myogenic potential: oVEMP).
3.2.2.1. Cervical VEMP
cVEMP represents an inhibitory biphasic response in the ipsilateral sternocleidomastoid muscle after loud sound stimulation of the sacculae, which can be recorded by surface electrodes. A positive-negative P13-N23 potential is recorded with normal latencies of 13 and 23 ms, respectively (Figure 19). The greatest sensitivity of sacculocolic reflex is for 200–1000 Hz stimuli in Refs. [22, 23], a frequency range highly correlated with saccular function and resonance properties as well (which are correlated with saccular size).
Figure 19.
Montage and cVEMP biphasic potential.
Late N34-P44 potentials are not saccular in origins. The amplitude of the response varies with contraction level of the muscle (Figure 20).
Figure 20.
Amplitude variation in relation with muscle contraction.
A clinical value of cVEMP is based on comparison of cVEMP amplitude in response to each saccular stimulation. For this reason, contraction level should be measure as well and rectified traces are evaluated. A difference of more than 30% between cVEMP amplitudes is considered abnormal, in result either to saccular hypofunction or hyperfunction depending on the pathology.
In Menière’s disease, endolymphatic hydrops involves the sacculae from the very initial stages of the disease with secondary variations in sacculae’s mechanical properties. Since cervical VEMP depends on the physical characteristics of the sacculae, cVEMP is included in the vestibular battery test for Menière’s disease diagnosis. In more than 50% of Menière’s disease patients, click-evoked cVEMP is abnormal or absent in Refs. [24, 25].
It also has been studied frequency tuning of cVEMP in endolymphatic hydrops and it appears that VEMP is recorded at higher frequencies and across broader frequency ranges than in normal inner ears due to changes in saccular resonance characteristics [26].
These two changes (blunting and frequency shift of cVEMP) are greater as the Menière’s disease has a longer evolution and greater severity in [27]. Additionally, over 20% of Menière’s disease patients have abnormal cVEMP results in the non-affected ear in Ref. [28], recommending VEMP as a predictor test for bilateral Menière’s disease.
Another study revealed a correlation between cVEMP threshold variations in between affected and nonaffected ear and the severity of Menière’s disease in Ref. [29].
In a small series of Menière’s disease patients, VEMP increased in amplitude, even three times at the end of positive glycerol test (Figure 21) as an argument of presence of the endolymphatic hydrops in the sacculae in Ref. [30].
Figure 21.
VEMP amplitude variation in positive glycerol test.
3.2.2.2. Ocular VEMP
Ocular VEMP (oVEMP) is a newer variant of VEMP which measures saccular function in response to very loud sound stimulation (about 120–130 dB SPL) or utricular function in response to vibrations applied to the cochlea. Electrodes placed below the orbit record excitatory response in the contralateral inferior oblique muscle when in a flexed state by looking upward in Ref. [31].
The first negative (excitatory) component of the oVEMP at a latency of about 10 ms is called n10. This n10 component most likely indicates the myogenic potentials of inferior oblique muscle.
Additionally, in patients with early Menière’s disease tested at attack, the contralateral oVEMP n10 is enhanced compared to measures in the same patients at quiescence. We speculate that this enhancement by Menière’s disease attack could be due to mechanical changes in the labyrinth that enhance the sensitive response of utricular receptors to bone conduction vibrator stimulation. It seems that alterations in frequency tuning discussed in cVEMP are also present in sound-evoked oVEMP in Menière’s disease patients in Ref. [32].
\n',keywords:"pure tone audiometry, glycerol test, auditory brainstem response, vestibular evoked myogenic potentials",chapterPDFUrl:"https://cdn.intechopen.com/pdfs/53473.pdf",chapterXML:"https://mts.intechopen.com/source/xml/53473.xml",downloadPdfUrl:"/chapter/pdf-download/53473",previewPdfUrl:"/chapter/pdf-preview/53473",totalDownloads:1085,totalViews:821,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,dateSubmitted:"April 14th 2016",dateReviewed:"October 18th 2016",datePrePublished:null,datePublished:"October 4th 2017",dateFinished:null,readingETA:"0",abstract:"Audiological and vestibular testing plays an important role in diagnosis of Menière’s disease,as disease per se and as staging diagnosis. A battery of tests are recommended in order to have a better evaluation of the disease. Audiological testing includes pure tone audiometry, with highlights of bone conduction especially in acute episodes of Menière’s disease, speech audiometry and glycerol test when hearing loss is documented, ABR and electrocochleography. Besides these investigations, vestibular investigations are also recommended in order to evaluate the degree of vestibular lesion present from the beginning of Menière’s disease—electro- and videonystagmography, head impulse test, vestibular evoked myogenic potentials and computerized dynamic posturography.",reviewType:"peer-reviewed",bibtexUrl:"/chapter/bibtex/53473",risUrl:"/chapter/ris/53473",book:{slug:"up-to-date-on-meniere-s-disease"},signatures:"Madalina Gabriela Georgescu",authors:[{id:"189076",title:"Associate Prof.",name:"Madalina",middleName:null,surname:"Georgescu",fullName:"Madalina Georgescu",slug:"madalina-georgescu",email:"madalina.georgescu@gecad.com",position:null,institution:{name:"University of Bucharest",institutionURL:null,country:{name:"Romania"}}}],sections:[{id:"sec_1",title:"1. Introduction",level:"1"},{id:"sec_2",title:"2. Audiological evaluation",level:"1"},{id:"sec_2_2",title:"2.1. Pure tone audiometry",level:"2"},{id:"sec_3_2",title:"2.2. Speech audiometry",level:"2"},{id:"sec_4_2",title:"2.3. Glycerol test",level:"2"},{id:"sec_5_2",title:"2.4. Brainstem evoked response audiometry (BERA)/auditory brainstem response (ABR)",level:"2"},{id:"sec_6_2",title:"2.5. Electrocochleography",level:"2"},{id:"sec_8",title:"3. Vestibular evaluation",level:"1"},{id:"sec_8_2",title:"3.1. Vestibulo-ocular reflex",level:"2"},{id:"sec_8_3",title:"3.1.1. Electronystagmography (ENG)/videonystagmography (VNG)",level:"3"},{id:"sec_9_3",title:"3.1.2. Video head impulse test",level:"3"},{id:"sec_11_2",title:"3.2. Vestibulospinal reflex (VSR)",level:"2"},{id:"sec_11_3",title:"3.2.1. Computerized dynamic posturography",level:"3"},{id:"sec_12_3",title:"3.2.2. Vestibular evoked miogenic potentials",level:"3"},{id:"sec_12_4",title:"3.2.2.1. Cervical VEMP",level:"4"},{id:"sec_13_4",title:"3.2.2.2. Ocular VEMP",level:"4"}],chapterReferences:[{id:"B1",body:'Hulshof JH, Baarsma EA. Vestibular investigations in Menière’s disease. 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Arch Otolaryngol Head Neck Surg 2003;129(5):547-551.'},{id:"B14",body:'Al-Momani M, Ferraro J, Ator G, Gajewski B. Improved sensitivity of ECochG in the diagnosis of Menière’s disease. Int J Audiol 2009;48:811-819.'},{id:"B15",body:'Fluur E, Mellström A. Dynamic body stabilization: EquiTest system in patients with bilateral vestibular caloric areflexia. In: Woollacott M, Horak F, (eds.), Posture and Gait: Control Mechanisms vol. I, Eugene, OR: Eugene University of Oregon Books, ; 1992, pp. 292-295.'},{id:"B16",body:'Georgescu M. Evaluation of the dizzy patient (Romanian language). Bucharest: Mayko ed.; 2005, 351 p.'},{id:"B17",body:'Goebel JA, Paige GD. Dynamic posturography and caloric test results in patients with and without vertigo. Otolaryngol Head Neck Surg 1989;100:553-558.'},{id:"B18",body:'Alpert JN, Coats AC, Perusquia E. Saccadic nystagmus in cortical cerebellar atrophy. Neurology 1975;25:276-280.'},{id:"B19",body:'WWW–www.nervecenter.natus.com'},{id:"B20",body:'Brodal A. 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Diagnostic value of prolonged latencies in the vestibular myogenic potential. Arch Otolaryngol Head Neck Surg 2001;127(9):1069-1072.'},{id:"B26",body:'Rauch SD, Zhou G, Kujawa SG, Guinan JJ, Herrmann BS. Vestibular evoked myogenic potentials show altered tuning in patients with Meniere’s disease. Otol Neurotol 2004;25(3):333-338.'},{id:"B27",body:'Timmer FC, Zhou G, Guinan JJ, Kujawa SG, Herrmann BS, Rauch SD. Vestibular evoked myogenic potential (VEMP) in patients with Meniere’s disease with drop attacks. Laryngoscope 2006;116(5):776-779.'},{id:"B28",body:'Lin MY, Timmer FC, Oriel BS, et al. Vestibular evoked myogenic potentials (VEMP) can detect asymptomatic saccular hydrops. Laryngoscope 2006;116(6):987-992.'},{id:"B29",body:'Young YH, Huang TW, Cheng PW. Assessing the stage of Meniere’s disease using vestibular evoked myogenic potentials. Arch Otolaryngol Head Neck Surg 2003;129(8):815-818.'},{id:"B30",body:'Georgescu M, Cernea M. Clinical value of VEMP in Meniere’s disease diagnosis (Romanian language). ORL.ro 2014;6(23):14-26.'},{id:"B31",body:'Rosengren SM, Todd NM, Colebatch JG. Vestibularevoked extraocular potentials produced by stimulation with bone-conducted sound. Clin Neurophysiol 2005;116(8):1938-1948.'},{id:"B32",body:'Winters SM, Berg IT, Grolman W, Klis SF. Ocular vestibular evoked myogenic potentials: Frequency tuning to airconducted acoustic stimuli in healthy subjects and Meniere’s disease. Audiol Neurotol 2012;17(1):12-19.'}],footnotes:[],contributors:[{corresp:"yes",contributorFullName:"Madalina Gabriela Georgescu",address:"madalina.georgescu@gecad.com",affiliation:'
“Carol Davila” University of Medicine and Pharmacy,, Bucharest, Romania
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Pandey",authors:[{id:"68725",title:"Dr.",name:"Sidheshwar",middleName:null,surname:"Pandey",fullName:"Sidheshwar Pandey",slug:"sidheshwar-pandey"},{id:"175648",title:"Dr.",name:"Mukeshwar",middleName:null,surname:"Pandey",fullName:"Mukeshwar Pandey",slug:"mukeshwar-pandey"}]},{id:"49486",title:"Hearing Loss in Infectious and Contagious Diseases",slug:"hearing-loss-in-infectious-and-contagious-diseases",signatures:"Luiz Alberto Alves Mota, Paula Cristina Alves Leitão, Paulo Marcelo\nFreitas de Barros and Ana Maria dos Anjos Carneiro Leão",authors:[{id:"88874",title:"Prof.",name:"Luiz",middleName:"Alberto Alves",surname:"Mota",fullName:"Luiz Mota",slug:"luiz-mota"},{id:"172369",title:"Dr.",name:"Ana Maria",middleName:"Dos Anjos",surname:"Carneiro-Leão",fullName:"Ana Maria Carneiro-Leão",slug:"ana-maria-carneiro-leao"},{id:"172496",title:"Ms.",name:"Paula",middleName:null,surname:"Leitão",fullName:"Paula Leitão",slug:"paula-leitao"},{id:"176446",title:"Prof.",name:"Paulo",middleName:null,surname:"Barros",fullName:"Paulo Barros",slug:"paulo-barros"}]},{id:"49108",title:"Hearing Loss and the Voice",slug:"hearing-loss-and-the-voice",signatures:"Ana Cristina Coelho, Daniela Malta Medved and Alcione Ghedini\nBrasolotto",authors:[{id:"174260",title:"M.Sc.",name:"Ana Cristina",middleName:null,surname:"Coelho",fullName:"Ana Cristina Coelho",slug:"ana-cristina-coelho"},{id:"174643",title:"Dr.",name:"Alcione",middleName:null,surname:"Brasolotto",fullName:"Alcione Brasolotto",slug:"alcione-brasolotto"},{id:"174644",title:"MSc.",name:"Daniela",middleName:null,surname:"Medved",fullName:"Daniela Medved",slug:"daniela-medved"}]},{id:"49067",title:"Hearing Impairment in Professional Musicians and Industrial Workers — Profession-Specific Auditory Stimuli Used to Evoke Event-Related Brain Potentials and to Show Different Auditory Perception and Processing",slug:"hearing-impairment-in-professional-musicians-and-industrial-workers-profession-specific-auditory-sti",signatures:"Edeltraut Emmerich, Marcus Engelmann, Melanie Rohmann and\nFrank Richter",authors:[{id:"174481",title:"Prof.",name:"Frank",middleName:null,surname:"Richter",fullName:"Frank Richter",slug:"frank-richter"},{id:"174483",title:"Dr.",name:"Edeltraut",middleName:null,surname:"Emmerich",fullName:"Edeltraut Emmerich",slug:"edeltraut-emmerich"},{id:"175607",title:"Dr.",name:"Marcus",middleName:null,surname:"Engelmann",fullName:"Marcus Engelmann",slug:"marcus-engelmann"},{id:"175608",title:"Dr.",name:"Melanie",middleName:null,surname:"Rohmann",fullName:"Melanie Rohmann",slug:"melanie-rohmann"}]},{id:"49476",title:"A Combination of EGb 761 and Soft Laser Therapy in Chronic Tinnitus",slug:"a-combination-of-egb-761-and-soft-laser-therapy-in-chronic-tinnitus",signatures:"Klára Procházková, Ivan Šejna, Petr Schalek, Jozef Rosina and Aleš\nHahn",authors:[{id:"174678",title:"Dr.",name:"Klára",middleName:null,surname:"Procházková",fullName:"Klára Procházková",slug:"klara-prochazkova"},{id:"174740",title:"Dr.",name:"Aleš",middleName:null,surname:"Hahn",fullName:"Aleš Hahn",slug:"ales-hahn"},{id:"174741",title:"Dr.",name:"Ivan",middleName:null,surname:"Šejna",fullName:"Ivan Šejna",slug:"ivan-sejna"},{id:"175639",title:"Dr.",name:"Petr",middleName:null,surname:"Schalek",fullName:"Petr Schalek",slug:"petr-schalek"},{id:"175640",title:"Prof.",name:"Jozef",middleName:null,surname:"Rosina",fullName:"Jozef Rosina",slug:"jozef-rosina"}]},{id:"48992",title:"Technological Advances in Universal Neonatal Hearing Screening (UNHS)",slug:"technological-advances-in-universal-neonatal-hearing-screening-unhs-",signatures:"Stavros Hatzopoulos, Henryk Skarzynski and Piotr H Skarzynski",authors:[{id:"174266",title:"Prof.",name:"Stavros",middleName:null,surname:"Hatzopoulos",fullName:"Stavros Hatzopoulos",slug:"stavros-hatzopoulos"},{id:"175661",title:"Prof.",name:"Henryk",middleName:null,surname:"Skarzynski",fullName:"Henryk Skarzynski",slug:"henryk-skarzynski"},{id:"175662",title:"Dr.",name:"Piotr H",middleName:null,surname:"Skarzynski",fullName:"Piotr H Skarzynski",slug:"piotr-h-skarzynski"}]},{id:"49167",title:"Bilateral Cochlear Implants, Minimizing Auditory Rehabilitation",slug:"bilateral-cochlear-implants-minimizing-auditory-rehabilitation",signatures:"Miguel A. Hyppolito and Eduardo T. Massuda",authors:[{id:"88917",title:"Prof.",name:"Miguel",middleName:null,surname:"Hyppolito",fullName:"Miguel Hyppolito",slug:"miguel-hyppolito"},{id:"174645",title:"Prof.",name:"Eduardo",middleName:null,surname:"Massuda",fullName:"Eduardo Massuda",slug:"eduardo-massuda"}]}]}]},onlineFirst:{chapter:{type:"chapter",id:"70956",title:"Design of Three-Term Controller Using a PIC18F452 Microcontroller",doi:"10.5772/intechopen.89815",slug:"design-of-three-term-controller-using-a-pic18f452-microcontroller",body:'
1. Introduction
The PID (Proportional Integral Differential) algorithm is the most popular feedback controller used within the process industries. It has been successfully used for over 50 years. It is a robust easily understood algorithm that can provide excellent control performance despite the varied dynamic characteristics of process plant. It is designed to generate an output that causes some corrective effort to be applied to a process so as to drive a measurable process variable towards a desired value, known as the set point. The concept is based (as shown in Figure 1) on the re-input of the system own output according to certain laws (hence the name “feedback”). It is desired for the system output to follow the set point. All feedback controllers determine their output by observing the difference, called error, between the set point and the actual process variable measurement. The PID looks at (a) the current value of the error, (b) the integral of the error over a recent time interval, and (c) the current derivative of the error signal to determine not only how much of a correction to apply, but for how long. Each of those three quantities are multiplied by a (tuning constant) and added together. Thus the PID output is a weighted sum. Depending on the application one may want a faster convergence speed or a lower overshoot. By adjusting the weighting constants, Kp, Ki, and Kd, the PID is set to give the most desired performance.
Figure 1.
Typical closed loop control system.
As a result of enormous development in microcomputer technology, analog controllers have been replaced by digital controllers either in small or large industry. It is now a common practice to implement PID controllers in its digital version, which means that they operate in discrete time domain and deal with analog signals quantized in a limited number of levels. The trend toward digital rather than analog control is mainly due to: (1) versatility where programs can be easily modified or completely changed, (2) sophistication where advanced control laws could be implemented, (3) cost effectiveness where microcontrollers are available at very low costs compared to PLCs, industrial computers, RTUs or DCS. A typical digital feedback control system is shown in Figure 2. In digital feedback systems, the controller input and output are digital (sampled) rather than continuous signals. Thus, the continuous signal from the measurement device (sensor/transmitter) is sampled and converted periodically to a digital signal by an analog-to-digital converter (ADC). A digital control algorithm is then used to calculate the controller output as a digital signal. Because most final control elements are analog devices, the digital output signal is usually converted to a corresponding analog signal by a digital-to-analog converter (DAC).
Figure 2.
Digital closed loop based on a microcontroller.
In feedback control, the objective is to reduce the error signal to zero where
et=yspt−ymtE1
where et = error signal, yspt = set point and ymt = measured value of the controlled variable. For the PID controller, the three terms (proportional, integral, and derivative) are combined to minimize the error as much as possible. The most common combination of these three terms is in parallel as shown in Figure 3. The PID equation [1, 2] is given by:
A straightforward way of deriving a digital version of the parallel form of the PID controller is to replace the integral and derivative terms by finite difference approximations,
∫0tetdt≈∑j=1kejTSE3
dedt≈ek−ek−1TSE4
where TS = the sampling time (the time between successive measurements of the controlled variable); and ek = error at the kth sampling instant for k = 1, 2, 3, …
There are two alternative forms of the digital PID control equation, the position form and the velocity form. Substituting Eqs. (3) and (4) into (2) gives the position form:
Pk=P¯+KCek+TSτI∑j=1kej+τDTSek−ek−1E5
where Pk is the controller output at the Kth sampling instant. Eq. (5) is referred to as the position form of the PID control algorithm because the actual value of the controller output is calculated [3, 4].
In the velocity form, the change in controller output is calculated. The velocity form can be derived by writing the position form of Eq. (5) for the (k − 1) sampling instant:
Pk−1=P¯+KCek−1+TSτI∑j=1k−1ej+τDTSek−1−ek−2E6
Note that the summation still begins at j = 1 because it is assumed that the process is at the desired steady state for j ≤ 0, and thus ej = 0 for j ≤ 0. Subtracting Eq. (6) from (5) gives the velocity form of the digital PID algorithm:
ΔPk=Pk−Pk−1=KCek−ek−1+TSτIek+τDTSek−2ek−1+ek−2E7
Pk=Pk−1+KCek−ek−1+TSτIek+τDTSek−2ek−1+ek−2E8
In this study, velocity form is chosen because of the following advantages:
It does not need initialization. The position form requires the initial value of the controller output P¯, which is not normally known in practice. For example, an operator keeps the control loop in the manual mode until a desired steady state operation has been reached. At this point the error is zero and the position of the control valve would correspond to the P¯ value. Therefore, if the operator would like to transfer the control from manual to automatic, he or she should enter in the position control algorithm the value of P¯ which is not normally known. This difficulty can be bypassed with the velocity form of the control algorithms, which do not need initialization.
It is protected against integral windup. The integral mode of a controller causes its output to continue changing as long as there is a nonzero error. Often the errors cannot be eliminated quickly enough and given enough time they produce larger and larger values for the integral term, which in turn keeps increasing the control action until it is “saturated” (e.g., the valve completely opens or closes). This condition is called integral windup. Then, even if the error returns to zero, the control action will remain saturated. The position form with its continuous summation of errors will produce integral windup and special attention will be required. The velocity form, on the other hand, is protected from integral windup for the following reason: The control action changes continuously until it becomes saturated. But then as soon as the error changes sign, the control action can return within the control range in one sampling period.
It protects the process against computer failure. With the velocity algorithm one can send out a signal which is used to drive an integrating amplifier or a stepper motor. These devices will retain the last calculated position of the control valve (or other final control element) in case the computer fails, thus avoiding total loss of control of the process.
2. PIC18F452 background
As mentioned earlier, the implementation is based on a Microchip PIC18F452 microcontroller, where the controller plays the role of the brain of the control system [5]. The right choice of the microcontroller is essential, as it will be the core of the final design. The PIC18F452 from Microchip has been chosen for the following advantages:
Speed: with its maximum internal clock rate of 20 MHz and its 16-bit-wide instruction bus, the CPU can execute most of its instructions at a single machine cycle of four clocks which is equivalent to a 0.2 μs.
Math support: unlike classical microprocessors, the controller in hand has got a hardware multiplier and divider for multiple-bytes, fixed-point numbers and for floating-point numbers so multiplication is carried out in a single instruction.
Flexible timer resources: four independent timers modules support timing measurements and output interval control with a timing resolution as fine as 0.1 μs. Those timers could be used to produce up to three pulse width modulations which could be used for electrical motor control.
Free software tools: Microchip’s Development Package MPLAB® (consisting of assembler, simulator, and user interface) as well as all manuals and application notes are available at no cost from their Web site (www.microchip.com).
Development tool versatility: it supports in-circuit debugger which permits the loading and execution of a user program as well as the use of breakpoints, memory/ register modification, and single stepping.
Build-in ADCs: it has analogue-to-digital converters with 10 bits resolution.
Built-in serial peripheral interface: it has a variety of serial bus interfaces like USART, I2C & SPI.
C programmable: it could be programmed using C language with the use of a variety of built in C libraries developed by microchip.
The PIC18F452 microcontroller is a 40 or 44-pin depending on the package, where in the 40 pins configuration, a dual inline package is used; whereas in the 44 pins configuration, either thin quad flat package or dual flat no leads package is used. Its design is based on Harvard technology where the program and data have different buses. This type of microcontrollers is very cheap, small in size, and could be customized. It could be easily programmed on-line using either assembly language, BASIC or C language. In fact, it is ideal for small application such as the one in hand. The controller has a 24 kbytes of flash memory and 2048 bytes of SDRAM. It also has a 8 × 10 bits analog to digital channels. It also has 5 bidirectional digital ports with 33 inputs/outputs, configured as follows: 3 × 8 digital I/O ports (PORTB, PORTC and PORTD), one six digital I/O port (PORTA) and one three digital I/O port (PORTE). Unfortunately, one of the drawbacks of microcontrollers, it is very seldom to find one with a digital to analog converter. Luckily, they are few manufacturers around including microchip, which make serial DACs which could be programmed through Serial Port Interface (SPI) using only three wires. The PIC18F452 has four timer/counters which could be programmed either as 8 or 16 bit timers/counters. It also has two ports which could be configured either as capture, compare or pulse width modulation (PWM). It has two serial peripheral interfaces: (SPI) and an inter-integrated circuit (I2C). An asynchronous port (USART) is also provided. For the microcontroller to output analogue data, an MCP4921 device is used. The device is a 12-bit buffered single voltage output Digital-to-Analog Converter (DAC). The device operates from a single 2.7 V to 5.5 V supply with an SPI compatible Serial Peripheral Interface. The user can configure the full-scale range of the device to be VREF or 2*VREF by setting the gain selection option bit (gain of 1 of 2). The user can shut down the device by setting the Configuration Register bit. In Shutdown mode, most of the internal circuits are turned off for power savings, and the output amplifier is configured to present a known high resistance output load (500 kΩ, typical). The device includes double-buffered registers, allowing synchronous updates of the DAC output using the LDAC pin. The device also incorporates a Power-on Reset (POR) circuit to ensure reliable powerup. The device utilizes a resistive string architecture, with its inherent advantages of low Differential Non-Linearity (DNL) error and fast settling time. The device is specified over the extended temperature range (+125°C). It provides high accuracy and low noise performance for consumer and industrial applications where calibration or compensation of signals (such as temperature, pressure and humidity) is required. The MCP4921 device is available in the PDIP, SOIC, MSOP and DFN packages. Figure 4 shows the chip pin configuration. The MCP4921 device is designed to interface directly with the Serial Peripheral Interface (SPI) port, which is available on the PIC18F452 microcontroller and supports Mode 0,0 and Mode 1,1. Commands and data are sent to the device via the SDI pin, with data being clocked-in on the rising edge of SCK. The communication is unidirectional; this means the data cannot be read out of the MCP4921. The CS (chip select active low) pin must be held low for the duration of a write command. The write command consists of 16 bits and is used to configure the DAC’s control and data latches. Register shown in Figure 5, details the write command which is loaded into the input register that is used to configure and load the DAC register [6].
Figure 4.
MCP4921 pin configuration.
Figure 5.
Write command register for MCP4921 (12-bit DAC).
The write command is initiated by driving the CS pin low, followed by clocking the four Configuration bits and the 12 data bits into the SDI pin on the rising edge of SCK. The CS pin is then raised, causing the data to be latched into the DAC’s input register. The MCP4921 utilizes a double-buffered latch structure to allow the analog output to be synchronized with the LDAC pin, if desired. By bringing the LDAC pin down to a low state, the content stored in the DAC’s input register is transferred into the DAC’s output register (VOUT), and VOUT is updated. The write to the MCP4921 device is 16-bit words. Any clocks past the 16th clock will be ignored. The Most Significant 4 bits are Configuration bits. The remaining 12 bits are data bits. No data can be transferred into the device with CS high. This transfer will only occur if 16 clocks have been transferred into the device. If the rising edge of CS occurs prior to that, shifting of data into the input register will be aborted. The most four significant bits are defined as follows:
bit 15 0 = Write to DAC register
1 = Ignore this command
bit 14 BUF: VREF Input Buffer Control bit
1 = Buffered
0 = Unbuffered
bit 13 : Output Gain Selection bit
1 = 1x (VOUT = VREF * D/4096)
0 = 2x (VOUT = 2 * VREF * D/4096)
bit 12 : Output Shutdown Control bit
1= Active mode operation. VOUT is available.
0 = Shutdown the device. Analog output is not available.
VOUT pin is connected to 500 kΩ (typical).
3. Liquid crystal display (LCD)
This module is designed to display the value of the temperature detected by the temperature sensor and to guide the user in changing the parameters of the controller. The LCD is a 16 × 2 alphanumeric display with the built-in Hitachi 44780 controller and LED backlighting. It works with an 8-bit data bus, which means it will require a total of 11 data lines. Three control lines (connected to port E) plus the 8 lines for the data bus (connected to port D) [7].
4. System design
The system is design around a stand-alone PIC18F452 controller, where the measured variable (MV) is read through channel0 (pin 2). The MV is subtracted from the set point automatically by the controller. The error is treated by the PIC PID and produces a digital control variable. This control variable is outputted through PIC serial data output pin (SDO pin 24) together with serial clock pin (SCK pin 18) to synchronize the conversion process. For the conversion to take place, the serial DAC chip select (CS) has to be pulled low. The CS is connected to pin RC0. The positive reference voltage is connected to +5 V (pin 6) and the negative reference voltage (pin 7) is tied to zero volt. The analog output is read through pin8 (Vout). This voltage is small to drive an electric motor. This voltage is pulled up to +12 V through the non-inverting operational amplifier (LM358). The Darlington transistor 2SD1409 is used to bust the current. The motor is connected to the emitter follower so that the driving current is sufficient enough to drive the motor. Needless to say that the diode 1N4148 is used to protect the Darlington transistor against any spike due to the change of current. Figure 6 shows the schematic of the system. The LCD is used to display the measured temperature. To manipulate the setting of different parameters, six push buttons are used as follows:
Figure 6.
System schematic circuit showing all the connection to the microcontroller, as well as the liquid crystal display and the final control element.
Six push buttons were used in the project to allow the user to change the setting and the controller parameters. Their functions are as follows:
Reset: To reset the microcontroller.
Stop: interrupt the program to allow the user to change the controller settings
Run: To run the program
Mode: To allow the user to change between setting modes.
Increment: To increment the controller variables by 1 or 0.1.
Decrement: To decrement the controller variables by 1 or 0.1.
These switches are connected to PIC PORTB to allow the user to use the internal build-in pull up resistors to prevent floating instead of using external pull-down resistors. The reset has got a separate button connected to MCLR pin. A buzzer is used as an alarm to indicate that the temperature is more than what the user specifies. Three LEDs were used to show the user the status of the microcontroller program. The three colors green, yellow, and orange were used as follows:
Green: means that the PID controller is working properly.
Yellow: means that the program is interrupted by (STOP) push button.
Red: means that the alarm is triggered.
5. Software design
To implement the control program, three major routines are used; the main routine along with the timer and external interrupts. The program starts with the main routine which contains all the configurations of the external pins whether outputs or inputs. It also contains the configurations of timer and external interrupts, so when one of these interrupts is triggered, the microcontroller will stop its current execution and perform another action. The trigger will be caused by either an overflow in timer register or a change on an external pin (RB0/INT0).
Because the time is a crucial element in digital control, the PID algorithm is controlled through a timer interrupt. This choice allows the user the ability to calculate the sampling time accurately. On the other hand, an external interrupt (INT0) is used to interrupt the program in order to allow the user a chance to modify the controller parameters. In the following we discuss in some details about the functions of each routine.
5.1 Main routine
5.1.1 Routine function
This routine, as mentioned earlier, is dedicated to configure the direction of external pins as well as interrupt sources. It also allows the user to choose the measured variable (temperature, flow, level or others). The flow chart of this routine is shown in Figure 7.
Figure 7.
Main routine.
5.1.2 External ports configuration
First PORTA (pin RA0) is configured as an analog input channel0 and PORTB as input digital port which is connected to the push button switches; while all other pins are configured as outputs.
5.1.3 LCD configuration
The configuration of the LCD was performed by separate software from Microchip called Application Maestro [8]. With the aid of this software, a configuration code was produced after modifying the module parameters. It was then incorporated into the project. Once incorporated, the LCD is configured and ready to work. One feature of using Application Maestro is its ability to use the prewritten code that this software provides to initialize or to write to the LCD.
5.1.4 Timer0 configuration
Timer0 can operate as a timer or as a counter. In Timer mode, the Timer0 module will increment with every instruction cycle (without prescaler). It is configured by setting a special function register called T0CON (timer0 control byte). This register is a readable and writable register that controls all the aspects of Timer0, including the prescale selection. In the design in hand, T0CON register is set to 0x85 (0b10000101) as shown below [9, 10].
This value will configure the timer0 as follows:
●Bit7
TMR0ON
= 1
: Timer0 is enabled
●Bit6
T08BIT
= 0
: Timer0 is configured as a 16-bit timer
●Bit5
T0CS
= 0
: Internal instruction cycle clock
●Bit4
T0SE
= 0
: This bit is used only with external clock
●Bit3
PSA
= 0
: Timer0 prescaler is assigned
●Bit2
T0PS2
= 1
: Bit2: T0PS2 =1:
}
1:64 prescaler value
●Bit1
T0PS1
= 0
: Bit1: T0PS1 =0:
●Bit0
T0PS0
= 1
: Bit0: T0PS0 =1:
5.1.5 Interrupt configuration
There are ten registers which are used to control internal and external interrupt operations to accommodate a variety of interrupts [11]. In the project in hand, only two interrupts are required INT0 and timer0 interrupt. To do so, only three control registers are required. These registers are INTCON, INTCON2, and RCON. INTCON register contains various enable bits as well as several interrupt flags. RCON is the Reset Control register which contains flag bits that allow differentiation between the sources RESET. Timer0 interrupt is enabled by setting TMR0IE bit (<5>) while external interrupt is enabled by setting INT0IE (INTCON<4>). Note that the interrupt flags are reset before enabling the interrupt in order to avoid unwanted interruptions.
To start the interrupt, the global interrupt bit GIE/GIEH (INTCON<7>) must be set. If set, it enables all unmasked interrupts, so if more than one interrupt source is used (as in our case) the Interrupt Priority Enable bit IPEN (RCON<7>) must be set and the interrupt sources should be specified either as high or low priority interrupt. The interrupt priority bit TMR0IP (INTCON2<2>) is used to specify the interrupt priority for Timer0. This bit is reset so timer0 interrupt is set to low priority. On the other hand, no need to specify the priority of the external interrupt (INT0), because it is already set to high priority by default.
After configuring the interrupts, the program will enter an infinite loop until one of the interrupt sources is triggered.
5.2 Timer interrupt routine
5.2.1 Routine function
The main purpose of this routine is to calculate the controller output and send it to the DAC serially through the synchronous SPI module [12]. Figure 8 shows the routine function.
Figure 8.
Timer interrupt routine.
5.2.2 Timer reloading
Because of the importance of time in calculating the timed controller output, timer0 is used as an accurate hardware timer. The source clock of the timer is the crystal oscillator which is fed to the clock pin of Timer0 internally. The clock used is a 20 MHz derived from a stable crystal oscillator. This frequency is automatically divided by 4 because the controller machine cycle is 4 clocks to give a 5 MHz which is fed to the timer. The timer is exactly clocked every 0.2 μs and takes 13107.2 μs (16-bit mode) to count from zero to zero again. However, by loading the timer with a suitable value, a smaller time interval could be obtained. For example, by loading the timer with the value 4095 (0xFFF), the overflow would occur after 12288.2 μs. Alternatively, the time period can be extended by using a prescaler as was done in the main routine. If a divide by 64 prescaler is selected, timer0 only overflows after 838.848 ms. This is obtained as follows:
5MHz64=78,125Hz
78125Hz−1=12.8μs
12.8μs×65,535=838.848ms
This time period is less than one second, while a one second sampling time is required for the design in hand. To obtain a one second sampling time, the timer should count 78,125 pulses.
Because timer0 register is only 16 bit wide, it is only limited to count up to 65,535 pulses. The interruption is trigged several times to obtain one second timing, after which the controller computes the control action and sends it to the DAC. By using MPLAP simulator, it was found that 5362 cycles are required to calculate the controller output and send it to the DAC besides 51 extra cycles needed to reload the timer with time constant. If the interruption is required to repeat itself five times before calculating the controller output, one needs 5362 + 51 × 5 = 5617 cycles (1.1234 ms). Thus, in order to get exactly one second sampling time, the timer register (TMR0) has to be reloaded with a value that interrupts the program every 998.8766 ms (1 s–1.1234 ms). The following shows how this value is obtained:
No.of cycles for1s=5×106cycles
Thereforeno.of cycles between interrupts=5×106−5617=4,997,383cycles
By using a timer with 64 prescaler:
No.of counts=4,997,38364=78,084.10938
When we repeat the interrupt for 5 times:
No.of counts=78,084.109385=15,616.82188
But because the timer counts in ascending order (from 0x0000 to 0xFFFF):
Reload value=65,535−15616.82188=49918.17812
repeat=5*sampling_time;
term_1=((repeat)*51.0+5362.0);
term_2=(5000000.0*sampling_time-term_1)/64.0;
term_3=term_2/repeat;
cycle=65535-term_3;
However, the timer register accepts only integer numbers, thus the final value that should be added to the timer register is 49918. Because we omitted the numbers after the decimal point, our error will be ± 1 count which is equal to 64 cycles. Therefore, our error in calculating the sampling time will be:
Timer error=64×0.2μs=12.8μs
This calculation is for getting 1 s sampling time. To expand the calculation in order to enable the user to change the sampling time, one defines two integer variables (repeat and cycle). The first variable repeat is to determine how many times we need to repeat the interrupt, while the second one cycle is the final value that should be added to the timer register. The following pseudo code shows the general formula used to reload the timer register.
5.2.3 Analog to digital converter module
The ADC module normally operates at 10-bits resolution, giving output digital values 0–1024 [13]. It needs a reference voltage to set the maximum and minimum values for the input conversion. This reference can be provided internally as Vdd and Vss (supply values) or externally through Vref+ and Vref− pins. To configure this module, OpenADC function from Microchip C library is used. This function performs a bitwise AND operation (“&”) between its arguments which are defined in the file adc.h. The parameters of this function along with their meaning of each argument are discussed below [1]
A clock divider to allow the minimum specified conversion time (about 20 μs). A 32 prescaler was chosen because the clock source is 20 MHz
ADC_RIGHT_JUST: Right justified.
Because the ADRES register pair (where the converted values are loaded) is 16-bit wide. But the ADC is only 10bit wide. The ADC module could either be configured as right or left justified. In this project, right justified is chosen as shown in Figure 9. This sets the 6 most significant bits of register ADRES to zeros.
ADC_8ANA_0REF: VREF+ = VDD, VREF− = VSS
The supply values are chosen as the voltage references to the ADC.
ADC_CH0: Channel0 (AN0) is selected
ADC_INT_OFF: Interrupts of ADC interrupts are disabled.
Once the A/D conversion is completed, the result is stored in an integer variable called result. After reading the analog value by the ADC module, the result will be compared with the variable alarm-trigger which was previously specified. If the result is greater than this value, the microcontroller triggers the buzzer and lights the red LED.
Figure 9.
Choosing right justified for data input.
5.2.4 Controller calculation
Due to the limitation in the microcontroller’s memory, the PID equation is divided into three terms (term_1, term_2, and term_3) and after calculating each term separately, they are added together along with the previous output to give the controller output which will be sent to the DAC. The following code shows how to calculate the controller output
To send the control variable to the final control element, the serial DAC, which is interfaced to the Serial Peripheral Interface (SPI) port, is used. The SPI is initiated using Microchip C library called OpenSPI. This function also performs a bitwise AND operation between its arguments which are defined in the file SPI.h according to the following formula.
SPI_FOSC_16: Master mode and the clock = FOSC/16
MODE_00: Mode 0,0 (change takes place on the rising edge)
SMPEND: Input data sample at end of data out
OpenSPI(SPI_FOSC_16, MODE_00, SMPEND);
After configuring the module, it is time to write a command to the DAC in order to convert it into analog signal. The write command is initiated by driving the CS pin low, followed by clocking the four configuration bits and the 12 data bits into the SDI pin on the rising edge of SCK. The CS pin is then raised, causing the data to be latched into the DAC’s input registers and when the LDAC pin is pulled down through RC1, the values held in the DAC’s input registers are transferred into the DAC’s output registers to provide the analog signal. It is important to mention here that we wrote the write command in two steps (as shown in the following code) because the SPI module send only 8 bit at a time.
LATCbits.LATC0 = 0; // Chip Select is set
WriteSPI(pid_output_16_high); //4MSB as command + 4LSB as data
WriteSPI(pid_output_16_low); // 8 bit data
LATCbits.LATC0 = 1; // Chip Select is reset
LATCbits.LATC1=0; // enable LDAC for data output to DAC
LATCbits.LATC1=1; // disable LDAC
CloseSPI();
5.2.6 Writing on the LCD
To write characters to the LCD, required prewritten functions are provided by Application Maestro. Some of These functions are listed in following table:
XLCDInit()
It is used to initialize the LCD module according to the Application Maestro options
XLCDPut(data)
It sends the clocking signal and data to be displayed to the LCD
XLCDL1home()
Points to the first address location of line one of the LCD
XLCDL2home()
Points to the first address location of line two of the LCD
XLCDClear()
Clears the DDRAM content of the LCD and points to the 00 address location
XLCDPutRomString(addr)
Displays String in Program memory
XLCDPutRamString(addr)
Displays String in Data memory
XLCDCommand(Command)
It sends clocking signal and instructions to the LCD
For numbers to be displayed, they are first converted into strings (characters) before being sent to the LCD, since the latter only accepts strings. To do so a C function called sprintf is called upon. This function saves the number in an array after converting it into string. The subroutine to do so is shown below [4]:
sprintf (buf,"%d",temp_set);
XLCDPutRamString(buf);
5.3 External interrupt routine
5.3.1 Routine function
The main function of this routine is to allow the user to change the controller parameters. The routine is initiated by pressing the push button (STOP) which is connected to the external interrupt pin (RB0/INT0). Once initiated, the user is able to change all the parameters of the controller (KC, τI, τD, sampling time, alarm trigger and sensitivity) by using three push buttons (MODE, INCREMENT and DECREMENT [11].
To determine which action the microcontroller should take if any push button is pressed, we defined two integer variables (present_button and present_mode) to be used as statuses. That is, each bit of them has specific meaning as described below:
present_button
Np
____
____
____
____
____
____
____
____
____
____
____
____
dec
inc
Mod
bit15
bit0
● bit 15
Np: set if there are no push buttons pressed
● bit 14-3
Unimplemented
● bit 2
dec: set if the DECREMENT push button pressed
● bit 1
inc: set if the INCREMENT push button pressed
● bit 0
mod: set if the MODE push button pressed
present_mode
____
Srt
Spt
KC
TI
TD
Stm
Sen
Alm
Tun
Dp
Tp
Kp
____
____
____
bit15
bit0
● bit 15
Unimplemented
● bit 14
Srt: set in the starting mode
● bit 13
Spt: set in the set point mode
● bit 12
KC: set in the controller gain mode
● bit 11
TI: set in the integral time mode
● bit 10
TD: set in the derivative time mode
● bit 9
Stm: set in the sampling time mode
● bit 8
Sen: set in the sensitivity mode
● bit 7
Alm: set in the alarm mode
● bit 6
Tun: set in the tuning mode
● bit 5
Dp: set in the process delay mode
● bit 4
Tp: set in the process time constant mode
● bit 3
Kp: set in the process gain mode
● bit 2-0
Unimplemented
Initially, before pressing any push button, present_button variable is loaded with 0x8000 (no push button pressed), and present_mode with 0x2000 (starting mode).Then if any push button is pressed, the corresponding bit of that push button will be set, giving a specific value of present_button which indicates the push button that was pressed by the user. So by performing a bitwise OR operation between the two variables (present_button and present_mode) we will come up with a number indicates the push button pressed and the present mode and based on that number we can decide the proper action to be taken by the microcontroller. The following code shows how to perform the OR operation after checking which of the push buttons was pressed. Beside changing the controller variables, this routine has another feature, it gives the user preliminary values of the controller parameters after entering the process variables. The result is derived based on Cohen-Koon tuning method. However, this feature is impractical if the sampling time is big [14].
if (mode_pin==0){
Delay10KTCYx(70);
present_button=mode_pushed;
}
else if (inc_pin==0){
Delay10KTCYx(70);
present_button=inc_pushed;
}
else if (dec_pin==0){
Delay10KTCYx(70);
present_button=dec_pushed;
}
else if(end_pin==0)
return;
action= present_mode | present_button;
6. Testing and verification
To test the system, a first order system given by the equation below was used. To run the control action, the system was converted into a difference equation given by Eq. (10).
Gp=105S+1E9
The process transfer function is first order, thus the discrete transfer function obtained using Zero-Order Hold will be:
HGz=az−11−bz−1E10
where:
a=kp1−exp−Tsτp
b=exp−Tsτp
If kp = 10, τp = 5, and Ts = 1, The discrete transfer function will be:
HGz=1.813z−11−0.8187z−1E11
⇒1−0.8187z−1Yz=1.813z−1Cz
Yz−0.8187z−1Yz=1.813z−1Cz
yn−0.8187yn−1=1.813cn−1
Therefore the difference equation of the output is:
yn=0.8187yn−1+1.813cn−1E12
After getting the difference equation, the control scheme was tested and the output of Figure 10 was obtained with the parameters set to: Kc = 0.2, Ti = 4.0 and Td = 0.0. The parameters were then changed to: Kc = 0.1, Ti = 3.0 and Td = 0.2. The response is shown in Figure 11.
Figure 10.
Controller response with Kc = 0.2, Ti = 4.0 and Td = 0.
Figure 11.
Controller response with Kc = 0.1, Ti = 3.0 and Td = 0.2.
7. Conclusion
By referring to the previous graphs, it could be concluded that the response tracks the set point as expected. In addition, the increase in controller gain (Kc) does speed up the response but at the expense of the overshoot. Based on these results, it could be concluded that the three-term controller is working according to plan. Because of the flexibility of the microcontroller and its programming, any control scheme could be developed and implemented in the manner as described in this chapter. Not only that, the scheme could be transferred to several high range microcontrollers from the same company such as 16 or 32 bits with the use of the benefits those types of controllers offer.
\n',keywords:"PIC microcontroller, PID, timer, Digital to analog converter, serial digital to converter, liquid crystal display",chapterPDFUrl:"https://cdn.intechopen.com/pdfs/70956.pdf",chapterXML:"https://mts.intechopen.com/source/xml/70956.xml",downloadPdfUrl:"/chapter/pdf-download/70956",previewPdfUrl:"/chapter/pdf-preview/70956",totalDownloads:179,totalViews:0,totalCrossrefCites:0,dateSubmitted:"April 19th 2019",dateReviewed:"September 19th 2019",datePrePublished:"January 31st 2020",datePublished:null,dateFinished:null,readingETA:"0",abstract:"Microcontrollers are used in almost any applications that come across one’s mind, from small control applications such as home appliances to aerospace. Microcontroller-based controllers are cost-effective and flexible to modify the design to meet the requirement for any control of any industrial plant. Microcontrollers do not require external hardware interface, memories, counter/timers, and ADCs, because they are all integrated inside the chip. Those controllers could be programmed online and do not require any backup memories except for big applications. This chapter presents the implementation of the three-term PID controller using a Microchip PIC18F452 microcontroller. To read data into the controller, a 10-bit integrated ADC is used; and to read data out of the machine, an external 12-bit serial DAC is used. Before programming the PIC microcontroller, the task to be tested could be off-line using a software simulator to make sure that it is working according. When that is the case, it could be then fired into the controller on-line in a mater seconds. Not only that, if the user decides to use different algorithm, he only programs the controller again online.",reviewType:"peer-reviewed",bibtexUrl:"/chapter/bibtex/70956",risUrl:"/chapter/ris/70956",signatures:"Mostefa Ghassoul",book:{id:"9385",title:"Renewable Energy",subtitle:null,fullTitle:"Renewable Energy",slug:null,publishedDate:null,bookSignature:"Associate Prof. Tolga Taner",coverURL:"https://cdn.intechopen.com/books/images_new/9385.jpg",licenceType:"CC BY 3.0",editedByType:null,editors:[{id:"197240",title:"Associate Prof.",name:"Tolga",middleName:null,surname:"Taner",slug:"tolga-taner",fullName:"Tolga Taner"}],productType:{id:"1",title:"Edited Volume",chapterContentType:"chapter",authoredCaption:"Edited by"}},authors:[{id:"146702",title:"Dr.",name:"Mostefa",middleName:null,surname:"Ghassoul",fullName:"Mostefa Ghassoul",slug:"mostefa-ghassoul",email:"mghassoul@uob.edu.bh",position:null,institution:{name:"University of Bahrain",institutionURL:null,country:{name:"Bahrain"}}}],sections:[{id:"sec_1",title:"1. Introduction",level:"1"},{id:"sec_2",title:"2. PIC18F452 background",level:"1"},{id:"sec_3",title:"3. Liquid crystal display (LCD)",level:"1"},{id:"sec_4",title:"4. System design",level:"1"},{id:"sec_5",title:"5. Software design",level:"1"},{id:"sec_5_2",title:"5.1 Main routine",level:"2"},{id:"sec_5_3",title:"5.1.1 Routine function",level:"3"},{id:"sec_6_3",title:"5.1.2 External ports configuration",level:"3"},{id:"sec_7_3",title:"5.1.3 LCD configuration",level:"3"},{id:"sec_8_3",title:"5.1.4 Timer0 configuration",level:"3"},{id:"sec_9_3",title:"5.1.5 Interrupt configuration",level:"3"},{id:"sec_11_2",title:"5.2 Timer interrupt routine",level:"2"},{id:"sec_11_3",title:"5.2.1 Routine function",level:"3"},{id:"sec_12_3",title:"5.2.2 Timer reloading",level:"3"},{id:"sec_13_3",title:"5.2.3 Analog to digital converter module",level:"3"},{id:"sec_14_3",title:"5.2.4 Controller calculation",level:"3"},{id:"sec_15_3",title:"5.2.5 SPI module",level:"3"},{id:"sec_16_3",title:"5.2.6 Writing on the LCD",level:"3"},{id:"sec_18_2",title:"5.3 External interrupt routine",level:"2"},{id:"sec_18_3",title:"5.3.1 Routine function",level:"3"},{id:"sec_21",title:"6. Testing and verification",level:"1"},{id:"sec_22",title:"7. Conclusion",level:"1"}],chapterReferences:[{id:"B1",body:'Ogunnaike BA, Ray WH. Process Dynamics, Modeling, and Control. 1st ed. USA: Oxford University Press; 1994'},{id:"B2",body:'Stephanopoulos G. Chemical Process Control: An Introduction to Theory and Practice. USA: Prentice Hall; 1983'},{id:"B3",body:'Seborg DE, Edgar TF, Mellichamp DA, Doyle FJ. Process Dynamics and Control. 4th ed. New York, USA: John Wiley and Son; 2017. pp. 115-117'},{id:"B4",body:'Phillips CL, Nagle HT, Chakrabortty A. Digital Control System Analysis and Design. UK: Pearson; 2015. pp. 279-335'},{id:"B5",body:'Microchip PIC18FXX2 Data Sheet “High-Performance, Enhanced Flash Microcontrollers” Microchip 2006 (DS39564C)'},{id:"B6",body:'Microchip MCP4921/4922 datasheet “12-Bit DAC with SPI™ Interface” Microchip 2007'},{id:"B7",body:'HD44780 LCD starter guide. 2001'},{id:"B8",body:'Microchip application maestro software user’s guide. 2003'},{id:"B9",body:'Microchip PIC18FXX2 Data Sheet “High-Performance, Enhanced Flash Microcontrollers: Timers” Microchip 2006 (DS39564C). pp. 103-115'},{id:"B10",body:'Bates M. PIC Microcontrollers: An Introduction to Microelectronics. Newnes; 2011'},{id:"B11",body:'Microchip PIC18FXX2 Data Sheet “High-Performance, Enhanced Flash Microcontrollers: External interrupts” Microchip 2006 (DS39564C). pp. 73-85'},{id:"B12",body:'Microchip PIC18FXX2 Data Sheet “High-Performance, Enhanced Flash Microcontrollers: Timer0 interrupt” Microchip 2006 (DS39564C). p. 85'},{id:"B13",body:'Microchip PIC18FXX2 Data Sheet “High-Performance, Enhanced Flash Microcontrollers: 10 bit ADC” Microchip 2006 (DS39564C). Chandler, Arizona USA; pp. 181-188'},{id:"B14",body:'Deitel PJ, Deitel HM. C How to Program. 6th ed. New Jersey USA: Pearson Prentice Hall; 2010'}],footnotes:[],contributors:[{corresp:"yes",contributorFullName:"Mostefa Ghassoul",address:"mghassoul@uob.edu.bh",affiliation:'
Chemical Engineering, University of Bahrain, Bahrain
'}],corrections:null},book:{id:"9385",title:"Renewable Energy",subtitle:null,fullTitle:"Renewable Energy",slug:null,publishedDate:null,bookSignature:"Associate Prof. Tolga Taner",coverURL:"https://cdn.intechopen.com/books/images_new/9385.jpg",licenceType:"CC BY 3.0",editedByType:null,editors:[{id:"197240",title:"Associate Prof.",name:"Tolga",middleName:null,surname:"Taner",slug:"tolga-taner",fullName:"Tolga Taner"}],productType:{id:"1",title:"Edited Volume",chapterContentType:"chapter",authoredCaption:"Edited by"}}},profile:{item:{id:"249046",title:"Dr.",name:"Johann",middleName:null,surname:"Alex Ebenezer",email:"johannebenezer@gmail.com",fullName:"Johann Alex Ebenezer",slug:"johann-alex-ebenezer",position:null,biography:null,institutionString:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",totalCites:0,totalChapterViews:"0",outsideEditionCount:0,totalAuthoredChapters:"1",totalEditedBooks:"0",personalWebsiteURL:null,twitterURL:null,linkedinURL:null,institution:null},booksEdited:[],chaptersAuthored:[{title:"Insight in Psychosis: An Integrated Perspective",slug:"insight-in-psychosis-an-integrated-perspective",abstract:"Insight in psychosis is a multidimensional concept with each component being influenced by various biological, individual and cultural factors. The study and understanding of such a concept needs to be done at various levels and with needed emphasis on the personal and interpersonal aspects of the people suffering with psychotic disorders, as this is routinely neglected in the clinical discourse in favor of reductionist biological models. An adequate understanding of the nature of human person should undergird a complex effort like the inquiry into the higher concepts of human experience such as delusion and insight into illness, which in turn should guide the therapeutic, administrative and legal management of people with psychotic illness.",signatures:"Starlin Vijay Mythri and Johann Alex Ebenezer",authors:[{id:"246230",title:"Dr.",name:"Starlin",surname:"Vijay Mythri",fullName:"Starlin Vijay Mythri",slug:"starlin-vijay-mythri",email:"starlinvijay@yahoo.co.in"},{id:"249046",title:"Dr.",name:"Johann",surname:"Alex Ebenezer",fullName:"Johann Alex Ebenezer",slug:"johann-alex-ebenezer",email:"johannebenezer@gmail.com"}],book:{title:"Psychosis",slug:"psychosis-biopsychosocial-and-relational-perspectives",productType:{id:"1",title:"Edited Volume"}}}],collaborators:[{id:"200124",title:"Dr.",name:"Fatai Oladunni",surname:"Balogun",slug:"fatai-oladunni-balogun",fullName:"Fatai Oladunni Balogun",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/no_image.jpg",biography:null,institutionString:null,institution:null},{id:"245870",title:"Ph.D. Student",name:"Lui",surname:"Unterrassner",slug:"lui-unterrassner",fullName:"Lui Unterrassner",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:null},{id:"245937",title:"Ph.D.",name:"Eduardo",surname:"García-Laredo",slug:"eduardo-garcia-laredo",fullName:"Eduardo García-Laredo",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:null},{id:"246230",title:"Dr.",name:"Starlin",surname:"Vijay Mythri",slug:"starlin-vijay-mythri",fullName:"Starlin Vijay Mythri",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:null},{id:"247063",title:"Ph.D.",name:"Oya",surname:"Mortan Sevi",slug:"oya-mortan-sevi",fullName:"Oya Mortan Sevi",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/247063/images/7861_n.jpg",biography:null,institutionString:null,institution:{name:"Bahçeşehir University",institutionURL:null,country:{name:"Turkey"}}},{id:"248272",title:"Dr.",name:"Abdulwakeel",surname:"Ayokun-nun Ajao",slug:"abdulwakeel-ayokun-nun-ajao",fullName:"Abdulwakeel Ayokun-nun Ajao",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Obafemi Awolowo University",institutionURL:null,country:{name:"Nigeria"}}},{id:"259661",title:"Dr.",name:"Damilare",surname:"Adedayo Adekomi",slug:"damilare-adedayo-adekomi",fullName:"Damilare Adedayo Adekomi",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:null},{id:"259663",title:"Dr.",name:"Sefiu",surname:"Adekilekun Saheed",slug:"sefiu-adekilekun-saheed",fullName:"Sefiu Adekilekun Saheed",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:null},{id:"300406",title:"Dr.",name:"Saheed",surname:"Sabiu",slug:"saheed-sabiu",fullName:"Saheed Sabiu",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/300406/images/system/300406.jpeg",biography:null,institutionString:"Durban University of Technology",institution:{name:"University of the Free State",institutionURL:null,country:{name:"South Africa"}}}]},generic:{page:{slug:"open-access-funding",title:"Open Access Funding",intro:"
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