Rehabilitative devices for a top-down approach

In recent years, neurorehabilitation has moved from a "bottom-up" to a "top down" approach. This change has also involved the technological devices developed for motor and cognitive rehabilitation. It implies that during a task or during therapeutic exercises, new "top-down" approaches are being used to stimulate the brain in a more direct way to elicit plasticity-mediated motor re-learning. This is opposed to "Bottom up" approaches, which act at the physical level and attempt to bring about changes at the level of the central neural system. Areas covered: In the present unsystematic review, we present the most promising innovative technological devices that can effectively support rehabilitation based on a top-down approach, according to the most recent neuroscientific and neurocognitive findings. In particular, we explore if and how the use of new technological devices comprising serious exergames, virtual reality, robots, brain computer interfaces, rhythmic music and biofeedback devices might provide a top-down based approach. Expert commentary: Motor and cognitive systems are strongly harnessed in humans and thus cannot be separated in neurorehabilitation. Recently developed technologies in motor-cognitive rehabilitation might have a greater positive effect than conventional therapies

Paving the Way for Motor Imagery-Based Tele-Rehabilitation through a Fully Wearable BCI System

The present study introduces a brain–computer interface designed and prototyped to be wearable and usable in daily life. Eight dry electroencephalographic sensors were adopted to acquire the brain activity associated with motor imagery. Multimodal feedback in extended reality was exploited to improve the online detection of neurological phenomena. Twenty-seven healthy subjects used the proposed system in five sessions to investigate the effects of feedback on motor imagery. The sample was divided into two equal-sized groups: a “neurofeedback” group, which performed motor imagery while receiving feedback, and a “control” group, which performed motor imagery with no feedback. Questionnaires were administered to participants aiming to investigate the usability of the proposed system and an individual’s ability to imagine movements. The highest mean classification accuracy across the subjects of the control group was about 62% with 3% associated type A uncertainty, and it was 69% with 3% uncertainty for the neurofeedback group. Moreover, the results in some cases were significantly higher for the neurofeedback group. The perceived usability by all participants was high. Overall, the study aimed at highlighting the advantages and the pitfalls of using a wearable brain–computer interface with dry sensors. Notably, this technology can be adopted for safe and economically viable tele-rehabilitation

Multimodal Feedback in Assisting a Wearable Brain-Computer Interface Based on Motor Imagery

A multimodal sensory feedback was exploited in the present study to improve the detection of neurological phenomena associated with motor imagery. At this aim, visual and haptic feedback were simultaneously delivered to the user of a brain-computer interface. The motor imagery-based brain-computer interface was built by using a wearable and portable electroencephalograph with only eight dry electrodes, a haptic suit, and a purposely implemented virtual reality application. Preliminary experiments were carried out with six subjects participating in five sessions on different days. The subjects were randomly divided into “control group” and “neurofeedback group”. The former performed pure motor imagery without receiving any feedback, while the latter received multimodal feedback as a response to their imaginative act. Results of a cross validation showed that at most 61% of classification accuracy was achieved in performing the pure motor imagination. On the contrary, subjects of the “neurofeedback group” achieved up to 82% mean accuracy, with a peak of 91% in one of the sessions. However, no improvement in pure motor imagery was observed, either when practicing with pure motor imagery or with feedback

Study of soft materials, flexible electronics, and machine learning for fully portable and wireless brain-machine interfaces

Over 300,000 individuals in the United States are afflicted with some form of limited motor function from brainstem or spinal-cord related injury resulting in quadriplegia or some form of locked-in syndrome. Conventional brain-machine interfaces used to allow for communication or movement require heavy, rigid components, uncomfortable headgear, excessive numbers of electrodes, and bulky electronics with long wires that result in greater data artifacts and generally inadequate performance. Wireless, wearable electroencephalograms, along with dry non-invasive electrodes can be utilized to allow recording of brain activity on a mobile subject to allow for unrestricted movement. Additionally, multilayer microfabricated flexible circuits, when combined with a soft materials platform allows for imperceptible wearable data acquisition electronics for long term recording. This dissertation aims to introduce new electronics and training paradigms for brain-machine interfaces to provide remedies in the form of communication and movement for these individuals. Here, training is optimized by generating a virtual environment from which a subject can achieve immersion using a VR headset in order to train and familiarize with the system. Advances in hardware and implementation of convolutional neural networks allow for rapid classification and low-latency target control. Integration of materials, mechanics, circuit and electrode design results in an optimized brain-machine interface allowing for rehabilitation and overall improved quality of life.Ph.D