Brain-controlled cycling system for rehabilitation following paraplegia with delay-time prediction

Objective: Robotic rehabilitation systems have been investigated to assist with motor dysfunction recovery in patients with lower-extremity paralysis caused by central nervous system lesions. These systems are intended to provide appropriate sensory feedback associated with locomotion. Appropriate feedback is thought to cause synchronous neuron firing, resulting in the recovery of function. Approach: In this study, we designed and evaluated an ergometric cycling wheelchair, with a brain-machine interface (BMI), that can force the legs to move by including normal stepping speeds and quick responses. Experiments were conducted in five healthy subjects and one patient with spinal cord injury (SCI), who experienced the complete paralysis of the lower limbs. Event-related desynchronization (ERD) in the β band (18‐28 Hz) was used to detect lower-limb motor images. Main results: An ergometer-based BMI system was able to safely and easily force patients to perform leg movements, at a rate of approximately 1.6 seconds/step (19 rpm), with an online accuracy rate of 73.1% for the SCI participant. Mean detection time from the cue to pedaling onset was 0.83±0.31 s Significance: This system can easily and safely maintain a normal walking speed during the experiment and be designed to accommodate the expected delay between the intentional onset and physical movement, to achieve rehabilitation effects for each participant. Similar BMI systems, implemented with rehabilitation systems, may be applicable to a wide range of patients

Slow Potentials of the Sensorimotor Cortex during Rhythmic Movements of the Ankle

The objective of this dissertation was to more fully understand the role of the human brain in the production of lower extremity rhythmic movements. Throughout the last century, evidence from animal models has demonstrated that spinal reflexes and networks alone are sufficient to propagate ambulation. However, observations after neural trauma, such as a spinal cord injury, demonstrate that humans require supraspinal drive to facilitate locomotion. To investigate the unique nature of lower extremity rhythmic movements, electroencephalography was used to record neural signals from the sensorimotor cortex during three cyclic ankle movement experiments. First, we characterized the differences in slow movement-related cortical potentials during rhythmic and discrete movements. During the experiment, motion analysis and electromyography were used characterize lower leg kinematics and muscle activation patterns. Second, a custom robotic device was built to assist in passive and active ankle movements. These movement conditions were used to examine the sensory and motor cortical contributions to rhythmic ankle movement. Lastly, we explored the differences in sensory and motor contributions to bilateral, rhythmic ankle movements. Experimental results from all three studies suggest that the brain is continuously involved in rhythmic movements of the lower extremities. We observed temporal characteristics of the cortical slow potentials that were time-locked to the movement. The amplitude of these potentials, localized over the sensorimotor cortex, revealed a reduction in neural activity during rhythmic movements when compared to discrete movements. Moreover, unilateral ankle movements produced unique sensory potentials that tracked the position of the movement and motor potentials that were only present during active dorsiflexion. In addition, the spatiotemporal patterns of slow potentials during bilateral ankle movements suggest similar cortical mechanisms for both unilateral and bilateral movement. Lastly, beta frequency modulations were correlated to the movement-related slow potentials within medial sensorimotor cortex, which may indicate they are of similar cortical origin. From these results, we concluded that the brain is continuously involved in the production of lower extremity rhythmic movements, and that the sensory and motor cortices provide unique contributions to both unilateral and bilateral movemen

Sensor Approach for Brain Pathophysiology of Freezing of Gait in Parkinson\u27s Disease Patients

Parkinson\u27s Disease (PD) affects over 1% of the population over 60 years of age and is expected to reach 1 million in the USA by the year 2020, growing by 60 thousand each year. It is well understood that PD is characterized by dopaminergic loss, leading to decreased executive function causing motor symptoms such as tremors, bradykinesia, dyskinesia, and freezing of gait (FoG) as well as non-motor symptoms such as loss of smell, depression, and sleep abnormalities. A PD diagnosis is difficult to make since there is no worldwide approved test and difficult to manage since its manifestations are widely heterogeneous among subjects. Thus, understanding the patient subsets and the neural biomarkers that set them apart will lead to improved personalized care. To explore the physiological alternations caused by PD on neurological pathways and their effect on motor control, it is necessary to detect the neural activity and its dissociation with healthy physiological function. To this effect, this study presents a custom ultra-wearable sensor solution, consisting of electroencephalograph, electromyograph, ground reaction force, and symptom measurement sensors for the exploration of neural biomarkers during active gait paradigms. Additionally, this study employed novel de-noising techniques for dealing with the motion artifacts associated with active gait EEG recordings and compared time-frequency features between a group of PD with FoG and a group of age-matched controls and found significant differences between several EEG frequency bands during start and end of normal walking (with a p\u3c0.05)

A comprehensive review of endogenous EEG-based BCIs for dynamic device control

Electroencephalogram (EEG)-based brain–computer interfaces (BCIs) provide a novel approach for controlling external devices. BCI technologies can be important enabling technologies for people with severe mobility impairment. Endogenous paradigms, which depend on user-generated commands and do not need external stimuli, can provide intuitive control of external devices. This paper discusses BCIs to control various physical devices such as exoskeletons, wheelchairs, mobile robots, and robotic arms. These technologies must be able to navigate complex environments or execute fine motor movements. Brain control of these devices presents an intricate research problem that merges signal processing and classification techniques with control theory. In particular, obtaining strong classification performance for endogenous BCIs is challenging, and EEG decoder output signals can be unstable. These issues present myriad research questions that are discussed in this review paper. This review covers papers published until the end of 2021 that presented BCI-controlled dynamic devices. It discusses the devices controlled, EEG paradigms, shared control, stabilization of the EEG signal, traditional machine learning and deep learning techniques, and user experience. The paper concludes with a discussion of open questions and avenues for future work.peer-reviewe

Enhancement of Robot-Assisted Rehabilitation Outcomes of Post-Stroke Patients Using Movement-Related Cortical Potential

Post-stroke rehabilitation is essential for stroke survivors to help them regain independence and to improve their quality of life. Among various rehabilitation strategies, robot-assisted rehabilitation is an efficient method that is utilized more and more in clinical practice for motor recovery of post-stroke patients. However, excessive assistance from robotic devices during rehabilitation sessions can make patients perform motor training passively with minimal outcome. Towards the development of an efficient rehabilitation strategy, it is necessary to ensure the active participation of subjects during training sessions. This thesis uses the Electroencephalography (EEG) signal to extract the Movement-Related Cortical Potential (MRCP) pattern to be used as an indicator of the active engagement of stroke patients during rehabilitation training sessions. The MRCP pattern is also utilized in designing an adaptive rehabilitation training strategy that maximizes patients’ engagement. This project focuses on the hand motor recovery of post-stroke patients using the AMADEO rehabilitation device (Tyromotion GmbH, Austria). AMADEO is specifically developed for patients with fingers and hand motor deficits. The variations in brain activity are analyzed by extracting the MRCP pattern from the acquired EEG data during training sessions. Whereas, physical improvement in hand motor abilities is determined by two methods. One is clinical tests namely Fugl-Meyer Assessment (FMA) and Motor Assessment Scale (MAS) which include FMA-wrist, FMA-hand, MAS-hand movements, and MAS-advanced hand movements’ tests. The other method is the measurement of hand-kinematic parameters using the AMADEO assessment tool which contains hand strength measurements during flexion (force-flexion), and extension (force-extension), and Hand Range of Movement (HROM)

Improving Real-Time Lower Limb Motor Imagery Detection Using tDCS and an Exoskeleton

The aim of this work was to test if a novel transcranial direct current stimulation (tDCS) montage boosts the accuracy of lower limb motor imagery (MI) detection by using a real-time brain-machine interface (BMI) based on electroencephalographic (EEG) signals. The tDCS montage designed was composed of two anodes and one cathode: one anode over the right cerebrocerebellum, the other over the motor cortex in Cz, and the cathode over FC2 (using the International 10–10 system). The BMI was designed to detect two MI states: relax and gait MI; and was based on finding the power at the frequency which attained the maximum power difference between the two mental states at each selected EEG electrode. Two different single-blind experiments were conducted, E1 and a pilot test E2. E1 was based on visual cues and feedback and E2 was based on auditory cues and a lower limb exoskeleton as feedback. Twelve subjects participated in E1, while four did so in E2. For both experiments, subjects were separated into two equally-sized groups: sham and active tDCS. The active tDCS group achieved 12.6 and 8.2% higher detection accuracy than the sham group in E1 and E2, respectively, reaching 65 and 81.6% mean detection accuracy in each experiment. The limited results suggest that the exoskeleton (E2) enhanced the detection of the MI tasks with respect to the visual feedback (E1), increasing the accuracy obtained in 16.7 and 21.2% for the active tDCS and sham groups, respectively. Thus, the small pilot study E2 indicates that using an exoskeleton in real-time has the potential of improving the rehabilitation process of cerebrovascular accident (CVA) patients, but larger studies are needed in order to further confirm this claim

Neuroergonomics applications of electroencephalography in physical activities : a systematic review

Recent years have seen increased interest in neuroergonomics, which investigates the brain activities of people engaged in diverse physical and cognitive activities at work and in everyday life. The present work extends upon prior assessments of the state of this art. However, here we narrow our focus specifically to studies that use electroencephalography (EEG) to measure brain activity, correlates, and effects during physical activity. The review uses systematically selected, openly published works derived from a guided search through peer-reviewed journals and conference proceedings. Identified studies were then categorized by the type of physical activity and evaluated considering methodological and chronological aspects via statistical and content-based analyses. From the identified works (n = 110), a specific number (n = 38) focused on less mobile muscular activities, while an additional group (n = 22) featured both physical and cognitive tasks. The remainder (n = 50) investigated various physical exercises and sporting activities and thus were here identified as a miscellaneous grouping. Most of the physical activities were isometric exertions, moving parts of upper and lower limbs, or walking and cycling. These primary categories were sub-categorized based on movement patterns, the use of the event-related potentials (ERP) technique, the use of recording methods along with EEG and considering mental effects. Further information on subjects' gender, EEG recording devices, data processing, and artifact correction methods and citations was extracted. Due to the heterogeneous nature of the findings from various studies, statistical analyses were not performed. These were thus included in a descriptive fashion. Finally, contemporary research gaps were pointed out, and future research prospects to address those gaps were discussed

MUNDUS project : MUltimodal neuroprosthesis for daily upper limb support

Background: MUNDUS is an assistive framework for recovering direct interaction capability of severely motor impaired people based on arm reaching and hand functions. It aims at achieving personalization, modularity and maximization of the user’s direct involvement in assistive systems. To this, MUNDUS exploits any residual control of the end-user and can be adapted to the level of severity or to the progression of the disease allowing the user to voluntarily interact with the environment. MUNDUS target pathologies are high-level spinal cord injury (SCI) and neurodegenerative and genetic neuromuscular diseases, such as amyotrophic lateral sclerosis, Friedreich ataxia, and multiple sclerosis (MS). The system can be alternatively driven by residual voluntary muscular activation, head/eye motion, and brain signals. MUNDUS modularly combines an antigravity lightweight and non-cumbersome exoskeleton, closed-loop controlled Neuromuscular Electrical Stimulation for arm and hand motion, and potentially a motorized hand orthosis, for grasping interactive objects. Methods: The definition of the requirements and of the interaction tasks were designed by a focus group with experts and a questionnaire with 36 potential end-users. Five end-users (3 SCI and 2 MS) tested the system in the configuration suitable to their specific level of impairment. They performed two exemplary tasks: reaching different points in the working volume and drinking. Three experts evaluated over a 3-level score (from 0, unsuccessful, to 2, completely functional) the execution of each assisted sub-action. Results: The functionality of all modules has been successfully demonstrated. User’s intention was detected with a 100% success. Averaging all subjects and tasks, the minimum evaluation score obtained was 1.13 ± 0.99 for the release of the handle during the drinking task, whilst all the other sub-actions achieved a mean value above 1.6. All users, but one, subjectively perceived the usefulness of the assistance and could easily control the system. Donning time ranged from 6 to 65 minutes, scaled on the configuration complexity. Conclusions: The MUNDUS platform provides functional assistance to daily life activities; the modules integration depends on the user’s need, the functionality of the system have been demonstrated for all the possible configurations, and preliminary assessment of usability and acceptance is promising

Cognitive control, conflict monitoring, and aerobic exercise.

Cognitive control includes a subset of top-down cognitive functions that allow flexible goal-directed behaviour that are often impaired in people with mental illness and in older adults. Even in healthy individuals, cognitive control ability is an important determinant of work and school success, physical health, and overall quality of life. Fortunately, modifiable lifestyle factors, including physical activity, may improve cognitive control in both healthy and impaired individuals. In particular, aerobic exercise benefits many types of cognitive function and may have its greatest impact on cognitive control – both after long-term training and even after a single session. The overall objective of this dissertation was to examine whether a single session of aerobic exercise impacts the ability of cognitive control to resolve conflict during choice reaction tasks. The dissertation examined the influence of a single session of aerobic exercise on behavioural performance and electroencephalography (EEG) markers of conflict measured during the flanker task – a choice reaction task that introduces conflict into information processing by including irrelevant distractor stimuli that may be congruent or incongruent with the target stimulus. A subset of this data was used to examine the relationship between behavioural and EEG markers of conflict during the flanker task. Behaviourally, aerobic exercise did not influence response accuracy or reaction time, but it reduced movement time. Aerobic exercise also did not influence the amplitude of the error-related negativity (ERN) or correct-related negativity (CRN) – EEG measures of brain activity related to monitoring conflict caused by error commission or flanker congruence. Across all exercise studies, aerobic exercise did not influence behavioural or EEG markers of conflict suggesting that previously observed exercise-induced performance improvements may be due to faster movement rather than enhanced cognitive control. Closer examination of the CRN as a measure of conflict-related brain activity, however, indicated that it was not influenced by flanker congruence, nor was it associated with conflict-related changes in behaviour, demonstrating the need to further examine the role of the CRN in information processing. The accumulation of findings within this dissertation do not support a beneficial impact of aerobic exercise on the ability of cognitive control to resolve conflict during choice reaction tasks; however, this work also highlights the need to examine methodological shortcomings and differences between studies when assessing the influence of aerobic exercise on cognitive function

EEG-Based BCI Control Schemes for Lower-Limb Assistive-Robots

Over recent years, brain-computer interface (BCI) has emerged as an alternative communication system between the human brain and an output device. Deciphered intents, after detecting electrical signals from the human scalp, are translated into control commands used to operate external devices, computer displays and virtual objects in the real-time. BCI provides an augmentative communication by creating a muscle-free channel between the brain and the output devices, primarily for subjects having neuromotor disorders, or trauma to nervous system, notably spinal cord injuries (SCI), and subjects with unaffected sensorimotor functions but disarticulated or amputated residual limbs. This review identifies the potentials of electroencephalography (EEG) based BCI applications for locomotion and mobility rehabilitation. Patients could benefit from its advancements such as, wearable lower-limb (LL) exoskeletons, orthosis, prosthesis, wheelchairs, and assistive-robot devices. The EEG communication signals employed by the aforementioned applications that also provide feasibility for future development in the field are sensorimotor rhythms (SMR), event-related potentials (ERP) and visual evoked potentials (VEP). The review is an effort to progress the development of user's mental task related to LL for BCI reliability and confidence measures. As a novel contribution, the reviewed BCI control paradigms for wearable LL and assistive-robots are presented by a general control framework fitting in hierarchical layers. It reflects informatic interactions, between the user, the BCI operator, the shared controller, the robotic device and the environment. Each sub layer of the BCI operator is discussed in detail, highlighting the feature extraction, classification and execution methods employed by the various systems. All applications' key features and their interaction with the environment are reviewed for the EEG-based activity mode recognition, and presented in form of a table. It i