[ARTICLE] Effects of somatosensory electrical stimulation on motor function and cortical oscillations – Full Text

Abstract

Background

Few patients recover full hand dexterity after an acquired brain injury such as stroke. Repetitive somatosensory electrical stimulation (SES) is a promising method to promote recovery of hand function. However, studies using SES have largely focused on gross motor function; it remains unclear if it can modulate distal hand functions such as finger individuation.

Objective

The specific goal of this study was to monitor the effects of SES on individuation as well as on cortical oscillations measured using EEG, with the additional goal of identifying neurophysiological biomarkers.

Methods

Eight participants with a history of acquired brain injury and distal upper limb motor impairments received a single two-hour session of SES using transcutaneous electrical nerve stimulation. Pre- and post-intervention assessments consisted of the Action Research Arm Test (ARAT), finger fractionation, pinch force, and the modified Ashworth scale (MAS), along with resting-state EEG monitoring.

Results

SES was associated with significant improvements in ARAT, MAS and finger fractionation. Moreover, SES was associated with a decrease in low frequency (0.9-4 Hz delta) ipsilesional parietomotor EEG power. Interestingly, changes in ipsilesional motor theta (4.8–7.9 Hz) and alpha (8.8–11.7 Hz) power were significantly correlated with finger fractionation improvements when using a multivariate model.

Conclusions

We show the positive effects of SES on finger individuation and identify cortical oscillations that may be important electrophysiological biomarkers of individual responsiveness to SES. These biomarkers can be potential targets when customizing SES parameters to individuals with hand dexterity deficits. Trial registration: NCT03176550; retrospectively registered.

Background

Despite recent advances in rehabilitation, a substantial fraction of stroke patients continue to experience persistent upper-limb deficits [1]. At best, up to 1 out of 5 patients will recover full arm function, while 50% will not recover any functional use of the affected arm. [2] Improvement in upper limb function specifically depends on sensorimotor recovery of the paretic hand [3]. Yet, there remains a lack of effective therapies readily available to the patient with acquired brain injury for recovery of hand and finger function; a systematic review found that conventional repetitive task training may not be consistently effective for the upper extremity [4]. It is thus critical to explore inexpensive and scalable approaches to restore hand and finger dexterity, reduce disability and increase participation after stroke and other acquired brain injuries.

Sensory threshold somatosensory electrical stimulation (SES) is a promising therapeutic modality for targeting hand motor recovery [5]. It is known to be a powerful tool to focally modulate sensorimotor cortices in both healthy and chronic stroke participants [5, 6, 7, 8]. Devices such as transcutaneous nerve stimulation (TENS) units can deliver SES and are commercially available, inexpensive, low risk, and easily applied in the home setting [9]. Previous studies have demonstrated short-term and long-term improvements in hand function after SES [5, 10, 11, 12, 13, 14, 15]. However, the effect of SES on regaining the ability to selectively move a given digit independently from other digits (i.e. finger fractionation) has not been investigated. Poor finger individualization is an important therapeutic target because it is commonly present even after substantial recovery and may account for chronic hand dysfunction [16]. Further, it is unclear if SES is associated with compensatory or restorative mechanisms. Prior studies have largely relied on relatively subjective clinical evaluations of impairment, such as the Fugl-Meyer Assessment, or timed and task-based assessments, such as the Jebson-Taylor Hand Function Test. Biomechanical analyses, on the other hand, can provide important objective and quantitative evidence of improvement in neurologic function and normative motor control [17, 18]. Therefore, we aimed to determine not only the functional effects, but also the kinematic effects, of SES on chronic hand dysfunction.

Simultaneously, it should be noted that although SES can potentially be an effective therapy, not all individuals who are administered SES experience positive effects. While improvement levels as high as 31–36% compared to baseline function have been reported, [11, 19] about half of one cohort demonstrated minimal or no motor performance improvement after a single session of SES [15]. One method to shed more light on this discrepancy is to identify neurophysiological biomarkers associated with motor responses to SES. Neurophysiological biomarkers are increasingly used to predict treatment effects [20, 21]. Although some studies have examined biomarkers associated with treatment-induced motor recovery, to our knowledge none have been performed for SES [22, 23]. A recent study using electroencephalography (EEG) found that changes in patterns of connectivity predicted motor recovery after stroke [24]. At present, little is known about the effect of peripheral neuromodulation on EEG activity, how existing neural dynamics interacts with peripheral stimulation, and whether this interaction is associated with improvements in motor function. Associating EEG activity with treatment response may also provide mechanistic insight regarding the effects of SES on neural plasticity. EEG activity can also potentially be used as a cost-effective real-time metric of the time-varying efficacy of SES. This novel application of EEG information may help tailor treatment efforts while reducing the variability in outcome.

The main goal of this pilot study was to evaluate both changes in finger fractionation in response to SES and identify the associated neural biomarkers through analyses of EEG dynamics. Outcomes from this study have potential in designing targeted SES therapy based on neural biomarkers to modulate and improve hand function after acquired brain injury such as stroke (e.g. enrollment in long-term studies of the efficacy of SES).

 

Continue —>  Effects of somatosensory electrical stimulation on motor function and cortical oscillations | Journal of NeuroEngineering and Rehabilitation | Full Text

Fig. 1a Schematic representation of the method used for calculating the FCI. The participant is instructed to flex only the index finger as much as possible without flexing the other digits. b FCI is defined mathematically as the angle traversed by the middle finger (digit A) divided by the angle tranversed by the index finger (digit B) relative to the horizontal starting position. c Statistically significant change in mean fractionation from baseline to immediately after peripheral nerve stimulation. Fractionation improvement is indicated by a decrease in finger coupling index (FCI)

 

[ARTICLE] Robotic Arm with Brain – Computer Interfacing – Full Text PDF

Abstract

Brain Computer Interfaces (BCI), is a modern technology which is currently revolutionizing the field of signal processing. BCI helped in the evolution of a new world where man and computer had never been so close. Advancements in cognitive neuro-sciences facilitated us with better brain imaging techniques and thus interfaces between machines and the human brain became a reality. Electroencephalography (EEG), which is the measurement and recording of electric signals using sensors arrayed across the scalp can be used for applications like prosthetic devices, applications in warfare, gaming, virtual reality and robotics upon signal conditioning and processing.

This paper is entirely based on Brain-Computer Interface with an objective of actuating a robotic arm with the help of device commands derived from EEG signals. This system unlike any other existing technology is purely non-invasive in nature, cost effective and is one of its kinds that can serve various requirements such as prosthesis. This paper suggests a low cost system implementation that can even serve as a reliable substitute for the existing technologies of prosthesis like BIONICS. […]

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via Robotic Arm with Brain – Computer Interfacing – ScienceDirect

[Abstract] Focal onset seizure prediction using convolutional networks

Abstract:

Objective: This work investigates the hypothesis that focal seizures can be predicted using scalp electroencephalogram (EEG) data. Our first aim is to learn features that distinguish between the interictal and preictal regions. The second aim is to define a prediction horizon in which the prediction is as accurate and as early as possible, clearly two competing objectives.

Methods: Convolutional filters on the wavelet transformation of the EEG signal are used to define and learn quantitative signatures for each period: interictal, preictal, and ictal. The optimal seizure prediction horizon is also learned from the data as opposed to making an a priori assumption.

Results: Computational solutions to the optimization problem indicate a ten-minute seizure prediction horizon. This result is verified by measuring Kullback-Leibler divergence on the distributions of the automatically extracted features.

Conclusions: The results on the EEG database of 204 recordings demonstrate that

1. the preictal phase transition occurs approximately ten minutes before seizure onset, and
2. (the prediction results on the test set are promising, with a sensitivity of 87.8% and a low false prediction rate of 0.142 FP/h.

Our results significantly outperform a random predictor and other seizure prediction algorithms.

Significance: We demonstrate that a robust set of features can be learned from scalp EEG that characterize the preictal state of focal seizures.

via Focal onset seizure prediction using convolutional networks – IEEE Journals & Magazine

[Abstract+References] Longitudinal Structural and Functional Differences Between Proportional and Poor Motor Recovery After Stroke

Abstract

Background. Evolution of motor function during the first months after stroke is stereotypically bifurcated, consisting of either recovery to about 70% of maximum possible improvement (“proportional recovery, PROP”) or in little to no improvement (“poor recovery, POOR”). There is currently no evidence that any rehabilitation treatment will prevent POOR and favor PROP. Objective. To perform a longitudinal and multimodal assessment of functional and structural changes in brain organization associated with PROP. Methods. Fugl-Meyer Assessments of the upper extremity and high-density electroencephalography (EEG) were obtained from 63 patients, diffusion tensor imaging from 46 patients, at 2 and 4 weeks (T0) and at 3 months (T1) after stroke onset. Results. We confirmed the presence of 2 distinct recovery patterns (PROP and POOR) in our sample. At T0, PROP patients had greater integrity of the corticospinal tract (CST) and greater EEG functional connectivity (FC) between the affected hemisphere and rest of the brain, in particular between the ventral premotor and the primary motor cortex. POOR patients suffered from degradation of corticocortical and corticofugal fiber tracts in the affected hemisphere between T0 and T1, which was not observed in PROP patients. Better initial CST integrity correlated with greater initial global FC, which was in turn associated with less white matter degradation between T0 and T1. Conclusions. These findings suggest links between initial CST integrity, systems-level cortical network plasticity, reduction of white matter atrophy, and clinical motor recovery after stroke. This identifies candidate treatment targets.

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via Longitudinal Structural and Functional Differences Between Proportional and Poor Motor Recovery After StrokeNeurorehabilitation and Neural Repair – Adrian G. Guggisberg, Pierre Nicolo, Leonardo G. Cohen, Armin Schnider, Ethan R. Buch, 2017

[BLOG POST] Study: Transcranial e-stim beneficial in mild traumatic brain injury

Researchers from the University of California San Diego and from the Veterans Affairs San Diego Healthcare System have improved neural function in a group of people with mild traumatic brain injury using low-impulse electrical stimulation to the brain, according to a study published in Brain Injury.

Although little is understood about the pathology of mild TBI, the team of researchers noted that previous work has shown that passive neuro-feedback, low-intensity pulses applied to the brain through transcranial electrical stimulation, has promise as a potential treatment.

The team’s pilot study enrolled six people with mild TBI who were experiencing post-concussion symptoms. Researchers used a form of LIP-tES combined with concurrent electroencephalography monitoring and assessed the treatment’s effect using a non-invasive functional imaging technique, magnetoencephalography, before and after treatment.

“Our previous publications have shown that MEG detection of abnormal brain slow-waves is one of the most sensitive biomarkers for mild traumatic brain injury (concussions), with about 85 percent sensitivity in detecting concussions and, essentially, no false-positives in normal patients,” senior author Dr. Roland Lee said in prepared remarks. “This makes it an ideal technique to monitor the effects of concussion treatments such as LIP-tES.”

Researchers reported that the brains in all six patients had abnormal slow-waves at the time of initial scans. After treatment, MEG scans showed reduced abnormal slow-waves and the study participants reported a significant reduction in post-concussion scores.

“For the first time, we’ve been able to document with neuroimaging the effects of LIP-tES treatment on brain functioning in mild TBI,” first author Ming-Xiong Huang added. “It’s a small study, which certainly must be expanded, but it suggests new potential for effectively speeding the healing process in mild traumatic brain injuries.”

Source: Study: Transcranial e-stim beneficial in mild traumatic brain injury – MassDevice

[Abstract] EEG-guided robotic mirror therapy system for lower limb rehabilitation – IEEE Conference Publication

Abstract:

Lower extremity function recovery is one of the most important goals in stroke rehabilitation. Many paradigms and technologies have been introduced for the lower limb rehabilitation over the past decades, but their outcomes indicate a need to develop a complementary approach. One attempt to accomplish a better functional recovery is to combine bottom-up and top-down approaches by means of brain-computer interfaces (BCIs). In this study, a BCI-controlled robotic mirror therapy system is proposed for lower limb recovery following stroke. An experimental paradigm including four states is introduced to combine robotic training (bottom-up) and mirror therapy (top-down) approaches. A BCI system is presented to classify the electroencephalography (EEG) evidence. In addition, a probabilistic model is presented to assist patients in transition across the experiment states based on their intent. To demonstrate the feasibility of the system, both offline and online analyses are performed for five healthy subjects. The experiment results show a promising performance for the system, with average accuracy of 94% in offline and 75% in online sessions.

Published in: Engineering in Medicine and Biology Society (EMBC), 2017 39th Annual International Conference of the IEEE

Source: EEG-guided robotic mirror therapy system for lower limb rehabilitation – IEEE Conference Publication

[WEB SITE] BrainTrain

 

BRAINTRAIN will improve and adapt the methods of real-time fMRI neurofeedback (fMRI-NF) for clinical use, including the combination with electroencephalography (EEG) and the development of standardised procedures for the mapping of brain networks that can be targeted with neurofeedback.

Its core component will be the exploration of the efficacy of fMRI-NF in selected mental and neurodevelopmental disorders that involve motivational, emotional and social neural systems. The ultimate goals of BRAINTRAIN are therefore to :

• Develop new or optimize existing imaging technologies,
• Validate their application as a therapeutic tool to mental and behavioural disorders by integrating imaging data with complementarity knowledge resulting bioinformatics and clinical data,
• Allow the diagnosis of mental disorders at the pre-symptomatic stage or early during development,
• Better measure disease progression.
• Develop transfer technologies for fMRI-NF through EEG and serious games.

BRAINTRAIN is innovative in the development of new real-time imaging technologies e.g. new sequences, image reconstruction methods and data analysis software. This will also be the first clinical testing of fMRI-NF in a set of disorders with extraordinary socioeconomic and public health impact.

The project started in November 2013 and will last four years. It is coordinated by Cardiff University (Professor David Linden, Wales, UK).

BRAINTRAIN is a European research network (Collaborative Project) supported by the European Commission under the Health Cooperation Work Programme of the 7th Framework Programme, under the Grant Agreement n°602186.

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[Abstract] Digital mirror box: An interactive hand-motor BMI rehabilitation tool for stroke patients

Abstract:

We develop a brain-machine interface for the hand-motor rehabilitation of stroke patients. The interface provides both visual and proprioceptive feedback to the user based upon the successful generation of cortical motor commands. We discuss the details of the proposed system and provide a summary of the preliminary experiment. The experiment investigates the importance of simultaneous visual and proprioceptive feedback to the delivery of motor commands from the affected motor cortex of the patients. We also discuss a case study involving a chronic stroke patient who trained with the system for 14 days to recover functional movement in the hand. The results obtained by this study suggest that the developed system is effective at accelerating the recovery of motor function in stroke patients with hand paralysis.

Published in: Signal and Information Processing Association Annual Summit and Conference (APSIPA), 2016 Asia-Pacific

Date of Conference: 13-16 Dec. 2016

Date Added to IEEE Xplore: 19 January 2017

ISBN Information:

Electronic ISBN: 978-9-8814-7682-1

Print on Demand(PoD) ISBN: 978-1-5090-2401-8

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References Cited:
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DOI: 10.1109/APSIPA.2016.7820761

Publisher: IEEE

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Anticipation- and error-related EEG signals during realistic human-machine interaction: A study on visual and tactile feedback

Ricardo Chavarriaga; Xavier Perrin; Roland Siegwart; Jose del R. Millan

A direct noninvasive brain interface with computer based on steady-state visual-evoked potential (SSVEP) with high transfer rates

Md Kamrul Hasan; Rushdi Zahid Rusho; Mohiuddin Ahmad

Performance analysis of multi-frequency SSVEP-BCI using clear and frosted colour LED stimuli

Surej Mouli; Ramaswamy Palaniappan; Ian P. Sillitoe; John Q. Gan

Compact Wireless EEG system with active electrodes for daily healthcare monitoring

Koji Morikawa; Akinori Matsumoto; Shrishail Patki; Bernard Grundlehner; Auryn Verwegen; Jiawei Xu; Srinjoy Mitra; Julien Fenders

Visualization of the Short Term Maximum Lyapunov Exponent Topography in the Epileptic Brain

Nadia Mammone; Francesco Carlo Morabito; Jose C. Principe

High-speed noninvasive brain-computer interfaces

A. Materka; P. Poryzala

Toward BCI Wizard – best BCI approach for each user

Ivan Volosyak; Christoph Guger; Axel Graser

Bispectrum analysis of EEG during observation and imagination of hand movement

Adity Saikia; Shyamanta M Hazarika

Source: Digital mirror box: An interactive hand-motor BMI rehabilitation tool for stroke patients – IEEE Xplore Document

[Abstract] Combining a hybrid robotic system with a bain-machine interface for the rehabilitation of reaching movements: A case study with a stroke patient

Abstract:

Reaching and grasping are two of the most affected functions after stroke. Hybrid rehabilitation systems combining Functional Electrical Stimulation with Robotic devices have been proposed in the literature to improve rehabilitation outcomes. In this work, we present the combined use of a hybrid robotic system with an EEG-based Brain-Machine Interface to detect the user’s movement intentions to trigger the assistance. The platform has been tested in a single session with a stroke patient. The results show how the patient could successfully interact with the BMI and command the assistance of the hybrid system with low latencies. Also, the Feedback Error Learning controller implemented in this system could adjust the required FES intensity to perform the task.

I. Introduction

Stroke is a leading cause of adult disability around the world. A large number of stroke survivors are left with a unilateral arm or leg paralysis. After completing conventional rehabilitation therapy, a significant number of stroke survivors are left with limited reaching and grasping capabilities [1].

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Source: Combining a hybrid robotic system with a bain-machine interface for the rehabilitation of reaching movements: A case study with a stroke patient – IEEE Xplore Document

[Abstract] Fatigue detection and estimation using auto-regression analysis in EEG

Abstract:

Estimation of fatigue is a required criteria in the field of physiology. The estimation of muscle fatigue and its development in the brain signals can provide a level of endurance among athletes and limits of a persons in doing physical tasks. In this paper a technique for detecting and estimating the fatigue development using regression parameters for EEG signals is discussed. The study of 14 subjects was undertaken and analysed for the fatigue development using Auto-Regression(AR) model. The behaviour of the error function obtained is analysed for the prediction of the stages and limits of muscle fatigue development.

I. Introduction

Muscle fatigue is a phenomenon associated with the muscle contraction. It is understood as the reduction in the ability of maximal force generation by the muscle with time, during its stressing, as the muscle contraction keeps on increasing. The nervous system’s limitation to generate sustainable signals and the reduction of ability of muscle fiber to contract are two major factors contributing to fatigue development [1]. Fatigue development limits the performance and capability of the individual in sports, long stretch driving conditions and in rigourous day to day activities. Hence a parameter that can estimate the fatigue levels and provide a break point for maximum fatigue can be useful for physiology and in other areas such as labour. People working under mines can be monitored for the fatigue break point and the overall productivity of such areas can be increased by proper analysis. The fatigue development in a person can be analysed via number of methods based on physiological changes. These include Electroencephalogram (EEG), Elec-tromyography(EMG), and Heart Rate Variability(HRV). Zadry et.al. [2] reported the increase in alpha band power level of EEG with time for fatigue development [3]. Ali et.al. also reported increase in RMS values of different bands in EEG [4]. Few studies measure brain activity in light repetitive task using EEG [5] to measure drowsiness or fatigue on drivers [6] [7] and night work [8] [9]. The EEG analysis for overall fatigue has been the focus of research, but research for specific muscle fatigue detection has been limited. The EEG based detection of fatigue has the advantage of quantitative based assessment. But, for real time application perspective faster computational power and signal processing methods are required. One of the challenges based on EEG based approach is the disturbances and contamination of the signal from eyes blinking action, muscle noise by movements and instrumental noises like line noise, electronic interferences [10]. Another problem is imposed by the inter-variability and intra-variability in EEG dynamics accompanying loss of alertness [11].

Source: Fatigue detection and estimation using auto-regression analysis in EEG – IEEE Xplore Document