Control de un exoesqueleto de brazo para rehabilitación de pacientes de ictus basado en EEG

El principal objetivo de este Trabajo Fin de Master es proponer un decodificador basado en EEG que sea capaz de discriminar entre movimientos de brazo en distintas direcciones y evaluarlo en un escenario que imite las condiciones de un entorno en tiempo real. Para ello, propodremos e implementaremos un decodificador; posteriormente se evaluará su comportamiento utilizando un conjuto de datos de seis sujetos sanos, grabados en la Universidad de Tubinga (Alemania)

Cognitive based neural prosthetics

Intense activity in neural prosthetic research has recently demonstrated the possibility of robotic interfaces that respond directly to the nervous system. The question remains of how the flow of information between the patient and the prosthetic device should be designed to provide a safe, effective system that maximizes the patient’s access to the outside world. Much recent work by other investigators has focused on using decoded neural signals as low-level commands to directly control the trajectory of screen cursors or robotic end-effectors. Here we review results that show that high-level, or cognitive, signals can be decoded from planned arm movements. These results, coupled with fundamental limitations in signal recording technology, motivate an approach in which cognitive neural signals play a larger role in the neural interface. This proposed paradigm predicates that neural signals should be used to instruct external devices, rather than control their detailed movement. This approach will reduce the effort required of the patient and will take advantage of established and on-going robotics research in intelligent systems and human-robot interfaces

Brain-machine interfaces for rehabilitation in stroke: A review

BACKGROUND: Motor paralysis after stroke has devastating consequences for the patients, families and caregivers. Although therapies have improved in the recent years, traditional rehabilitation still fails in patients with severe paralysis. Brain-machine interfaces (BMI) have emerged as a promising tool to guide motor rehabilitation interventions as they can be applied to patients with no residual movement. OBJECTIVE: This paper reviews the efficiency of BMI technologies to facilitate neuroplasticity and motor recovery after stroke. METHODS: We provide an overview of the existing rehabilitation therapies for stroke, the rationale behind the use of BMIs for motor rehabilitation, the current state of the art and the results achieved so far with BMI-based interventions, as well as the future perspectives of neural-machine interfaces. RESULTS: Since the first pilot study by Buch and colleagues in 2008, several controlled clinical studies have been conducted, demonstrating the efficacy of BMIs to facilitate functional recovery in completely paralyzed stroke patients with noninvasive technologies such as the electroencephalogram (EEG). CONCLUSIONS: Despite encouraging results, motor rehabilitation based on BMIs is still in a preliminary stage, and further improvements are required to boost its efficacy. Invasive and hybrid approaches are promising and might set the stage for the next generation of stroke rehabilitation therapies.This study was funded by the Bundesministerium für Bildung und Forschung BMBF MOTORBIC (FKZ13GW0053)andAMORSA(FKZ16SV7754), the Deutsche Forschungsgemeinschaft (DFG), the fortüne-Program of the University of Tübingen (2422-0-0 and 2452-0-0), and the Basque GovernmentScienceProgram(EXOTEK:KK2016/00083). NIL was supported by the Basque Government’s scholarship for predoctoral students

The potential of error-related potentials. Analysis and decoding for control, neuro-rehabilitation and motor substitution

Las interfaces cerebro-máquina (BMIs, por sus siglas en inglés) permiten la decodificación de patrones de activación neuronal del cerebro de los usuarios para proporcionar a personas con movilidad severamente limitada, ya sea debido a un accidente o a una enfermedad neurodegenerativa, una forma de establecer una conexión directa entre su cerebro y un dispositivo. En este sentido, las BMIs basadas en técnicas no invasivas, como el electroencefalograma (EEG) han ofrecido a estos usuarios nuevas oportunidades para recuperar el control sobre las actividades de su vida diaria que de otro modo no podrían realizar, especialmente en las áreas de comunicación y control de su entorno.En los últimos años, la tecnología está avanzando a grandes pasos y con ella la complejidad de dispositivos ha incrementado significativamente, ampliando el número de posibilidades para controlar sofisticados dispositivos robóticos, prótesis con numerosos grados de libertad o incluso para la aplicación de complejos patrones de estimulación eléctrica en las propias extremidades paralizadas de un usuario, que le permitan ejecutar movimientos precisos. Sin embargo, la cantidad de información que se puede transmitir entre el cerebro y estos dispositivos sigue siendo muy limitada, tanto por el número como por la velocidad a la que se pueden decodificar los comandos neuronales. Por lo tanto, depender únicamente de las señales neuronales no garantiza un control óptimo y preciso.Para poder sacar el máximo partido de estas tecnologías, el campo de las BMIs adoptó el conocido enfoque de “control-compartido". Esta estrategia de control pretende crear un sistema de cooperación entre el usuario y un dispositivo inteligente, liberando al usuario de las tareas más pesadas requeridas para ejecutar la tarea sin llegar a perder la sensación de estar en control. De esta manera, los usuarios solo necesitan centrar su atención en los comandos de alto nivel (por ejemplo, elegir un elemento específico que agarrar, o elegir el destino final donde moverse) mientras el agente inteligente resuelve problemas de bajo nivel (como planificación de trayectorias, esquivar obstáculos, etc.) que permitan realizar la tarea designada de la manera óptima.En particular, esta tesis gira en torno a una señal neuronal cognitiva de alto nivel originada como la falta de coincidencia entre las expectativas del usuario y las acciones reales ejecutadas por los dispositivos inteligentes. Estas señales, denominadas potenciales de error (ErrPs), se consideran una forma natural de intercomunicar nuestro cerebro con máquinas y, por lo tanto, los usuarios solo requieren monitorizar las acciones de un dispositivo y evaluar mentalmente si este último se comporta correctamente o no. Esto puede verse como una forma de supervisar el comportamiento del dispositivo, en el que la decodificación de estas evaluaciones mentales se utiliza para proporcionar a estos dispositivos retroalimentación directamente relacionada con la ejecución de una tarea determinada para que puedan aprender y adaptarse a las preferencias del usuario.Dado que la respuesta neuronal de ErrP está asociada a un evento exógeno (dispositivo que comete una acción errónea), la mayoría de los trabajos desarrollados han intentado distinguir si una acción es correcta o errónea mediante la explotación de eventos discretos en escenarios bien controlados. Esta tesis presenta el primer intento de cambiar hacia configuraciones asíncronas que se centran en tareas relacionadas con el aumento de las capacidades motoras, con el objetivo de desarrollar interfaces para usuarios con movilidad limitada. En este tipo de configuraciones, dos desafíos importantes son que los eventos correctos o erróneos no están claramente definidos y los usuarios tienen que evaluar continuamente la tarea ejecutada, mientras que la clasificación de las señales EEG debe realizarse de forma asíncrona. Como resultado, los decodificadores tienen que lidiar constantemente con la actividad EEG de fondo, que típicamente conduce a una gran cantidad de errores de detección de firmas de error. Para superar estos desafíos, esta tesis aborda dos líneas principales de trabajo.Primero, explora la neurofisiología de las señales neuronales evocadas asociadas con la percepción de errores durante el uso interactivo de un BMI en escenarios continuos y más realistas.Se realizaron dos estudios para encontrar características alternativas basadas en el dominio de la frecuencia como una forma de lidiar con la alta variabilidad de las señales del EEG. Resultados, revelaron que existe un patrón estable representado como oscilaciones "theta" que mejoran la generalización durante la clasificación. Además, se utilizaron técnicas de aprendizaje automático de última generación para aplicar el aprendizaje de transferencia para discriminar asincrónicamente los errores cuando se introdujeron de forma gradual y no se conoce presumiblemente el inicio que desencadena los ErrPs. Además, los análisis de neurofisiología arrojan algo de luz sobre los mecanismos cognitivos subyacentes que provocan ErrP durante las tareas continuas, lo que sugiere la existencia de modelos neuronales en nuestro cerebro que acumulan evidencia y solo toman una decisión al alcanzar un cierto umbral. En segundo lugar, esta tesis evalúa la implementación de estos potenciales relacionados con errores en tres aplicaciones orientadas al usuario. Estos estudios no solo exploran cómo maximizar el rendimiento de decodificación de las firmas ErrP, sino que también investigan los mecanismos neuronales subyacentes y cómo los diferentes factores afectan las señales provocadas.La primera aplicación de esta tesis presenta una nueva forma de guiar a un robot móvil que se mueve en un entorno continuo utilizando solo potenciales de error como retroalimentación que podrían usarse para el control directo de dispositivos de asistencia. Con este propósito, proponemos un algoritmo basado en el emparejamiento de políticas para el aprendizaje de refuerzo inverso para inferir el objetivo del usuario a partir de señales cerebrales.La segunda aplicación presentada en esta tesis contempla los primeros pasos hacia un BCI híbrido para ejecutar distintos tipos de agarre de objetos, con el objetivo de ayudar a las personas que han perdido la funcionalidad motora de su extremidad superior. Este BMI combina la decodificación del tipo de agarre a partir de señales de EEG obtenidas del espectro de baja frecuencia con los potenciales de error provocados como resultado de la monitorización de movimientos de agarre erróneos. Los resultados muestran que, en efecto los ErrP aparecen en combinaciones de señales motoras originadas a partir de movimientos de agarre consistentes en una única repetición. Además, la evaluación de los diferentes factores involucrados en el diseño de la interfaz híbrida (como la velocidad de los estímulos, el tipo de agarre o la tarea mental) muestra cómo dichos factores afectan la morfología del subsiguiente potencial de error evocado.La tercera aplicación investiga los correlatos neuronales y los procesos cognitivos subyacentes asociados con desajustes somatosensoriales producidos por perturbaciones inesperadas durante la estimulación eléctrica neuromuscular en el brazo de un usuario. Este estudio simula los posibles errores que ocurren durante la terapia de neuro-rehabilitación, en la que la activación simultánea de la estimulación aferente mientras los sujetos se concentran en la realización de una tarea motora es crucial para una recuperación óptima. Los resultados muestran que los errores pueden aumentar la atención del sujeto en la tarea y desencadenar mecanismos de aprendizaje que al mismo tiempo podrían promover la neuroplasticidad motora.En resumen, a lo largo de esta tesis, se han diseñado varios paradigmas experimentales para mejorar la comprensión de cómo se generan los potenciales relacionados con errores durante el uso interactivo de BMI en aplicaciones orientadas al usuario. Se han propuesto diferentes métodos para pasar de la configuración bloqueada en el tiempo a la asíncrona, tanto en términos de decodificación como de percepción de los eventos erróneos; y ha explorado tres aplicaciones relacionadas con el aumento de las capacidades motoras, en las cuales los ErrPs se pueden usar para el control de dispositivos, la sustitución de motores y la neuro-rehabilitación.Brain-machine interfaces (BMIs) allow the decoding of cortical activation patterns from the users brain to provide people with severely limited mobility, due to an accident or disease, a way to establish a direct connection between their brain and a device. In this sense, BMIs based in noninvasive recordings, such as the electroencephalogram (EEG) have o↵ered these users new opportunities to regain control over activities of their daily life that they could not perform otherwise, especially in the areas of communication and control of their environment. Over the past years and with the latest technological advancements, devices have significantly grown on complexity expanding the number of possibilities to control complex robotic devices, prosthesis with numerous degrees of freedom or even to apply compound patterns of electrical stimulation on the subjects own paralyzed extremities to execute precise movements. However, the band-with of communication between brain and devices is still very limited, both in terms of the number and the speed at which neural commands can be decoded, and thus solely relying on neural signals do not guarantee accurate control them. In order to benefit of these technologies, the field of BMIs adopted the well-known approach of shared-control. This strategy intends to create a cooperation system between the user and an intelligent device, liberating the user from the burdensome parts of the task without losing the feeling of being in control. Here, users only need to focus their attention on high-level commands (e.g. choose the final destination to reach, or a specific item to grab) while the intelligent agent resolve low-level problems (e.g. trajectory planning, obstacle avoidance, etc) to perform the designated task in the optimal way. In particular, this thesis revolves around a high-level cognitive neural signal originated as the mismatch between the expectations of the user and the actual actions executed by the intelligent devices. These signals, denoted as error-related potentials (ErrPs), are thought as a natural way to intercommunicate our brain with machines and thus users only require to monitor the actions of a device and mentally assess whether the latter is behaving correctly or not. This can be seen as a way to supervise the device’s behavior, in which the decoding of these mental assessments is used to provide these devices with feedback directly related with the performance of a given task so they can learn and adapt to the user’s preferences. Since the ErrP’s neural response is associated to an exogenous event (device committing an erroneous action), most of the developed works have attempted to distinguish whether an action is correct or erroneous by exploiting discrete events under well-controlled scenarios. This thesis presents the first attempt to shift towards asynchronous settings that focus on tasks related with the augmentation of motor capabilities, with the objective of developing interfaces for users with limited mobility. In this type of setups, two important challenges are that correct or erroneous events are not clearly defined and users have to continuously evaluate the executed task, while classification of EEG signals has to be performed asynchronously. As a result, the decoders have to constantly deal with background EEG activity, which typically leads to a large number of missdetection of error signatures. To overcome these challenges, this thesis addresses two main lines of work. First, it explores the neurophysiology of the evoked neural signatures associated with the perception of errors during the interactive use of a BMI in continuous and more realistic scenarios. Two studies were performed to find alternative features based on the frequency domain as a way of dealing with the high variability of EEG signals. Results, revealed that there exists a stable pattern represented as theta oscillations that enhance generalization during classification. Also, state-of-the-art machine learning techniques were used to apply transfer learning to asynchronously discriminate errors when they were introduced in a gradual fashion and the onset that triggers the ErrPs is not presumably known. Furthermore, neurophsysiology analyses shed some light about the underlying cognitive mechanisms that elicit ErrP during continuous tasks, suggesting the existence of neural models in our brain that accumulate evidence and only take a decision upon reaching a certain threshold. Secondly, this thesis evaluates the implementation of these error-related potentials in three user-oriented applications. These studies not only explore how to maximize the decoding performance of ErrP signatures but also investigate the underlying neural mechanisms and how di↵erent factors a↵ect the elicited signals. The first application of this thesis presents a new way to guide a mobile robot moving in a continuous environment using only error potentials as feedback which could be used for the direct control of assistive devices. With this purpose, we propose an algorithm based on policy matching for inverse reinforcement learning to infer the user goal from brain signals. The second application presented in this thesis contemplates the first steps towards a hybrid BMI for grasping oriented to assist people who have lost motor functionality of their upper-limb. This BMI combines the decoding of the type of grasp from low-frequency EEG signals with error-related potentials elicited as the result of monitoring an erroneous grasping. The results show that ErrPs are elicited in combination of motor signatures from the low-frequency spectrum originated from single repetition grasping tasks and evaluates how di↵erent design factors (such as the speed of the stimuli, type of grasp or mental task) impact the morphology of the subsequent evoked ErrP. The third application investigates the neural correlates and the underlying cognitive processes associated with somatosensory mismatches produced by unexpected disturbances during neuromsucular electrical stimulation on a user’s arm. This study simulates possible errors that occur during neurorehabilitation therapy, in which the simultaneous activation of a↵erent stimulation while the subjects are concentrated in performing a motor task is crucial for optimal recovery. The results showed that errors may increase subject’s attention on the task and trigger learning mechanisms that at the same time could promote motor neuroplasticity. In summary, throughout this thesis, several experimental paradigms have been designed to improve the understanding of how error-related potentials are generated during the interactive use of BMIs in user-oriented applications. Di↵erent methods have been proposed to shift from time-locked to asynchronous settings, both in terms of decoding and perception of the erroneous events; and it has explored three applications related with the augmentation of motor capabilities, in which ErrPs can be used for control of devices, motor substitution and neurorehabilitation.<br /

Neural correlates of grasping

Prehension, the capacity to reach and grasp objects, comprises two main components: reaching, i.e., moving the hand towards an object, and grasping, i.e., shaping the hand with respect to its properties. Knowledge of this topic has gained a huge advance in recent years, dramatically changing our view on how prehension is represented within the dorsal stream. While our understanding of the various nodes coding the grasp component is rapidly progressing, little is known of the integration between grasping and reaching. With this Mini Review we aim to provide an up-to-date overview of the recent developments on the coding of prehension. We will start with a description of the regions coding various aspects of grasping in humans and monkeys, delineating where it might be integrated with reaching. To gain insights into the causal role of these nodes in the coding of prehension, we will link this functional description to lesion studies. Finally, we will discuss future directions that might be promising to unveil new insights on the coding of prehension movements

Combining brain-computer interfaces and assistive technologies: state-of-the-art and challenges

In recent years, new research has brought the field of EEG-based Brain-Computer Interfacing (BCI) out of its infancy and into a phase of relative maturity through many demonstrated prototypes such as brain-controlled wheelchairs, keyboards, and computer games. With this proof-of-concept phase in the past, the time is now ripe to focus on the development of practical BCI technologies that can be brought out of the lab and into real-world applications. In particular, we focus on the prospect of improving the lives of countless disabled individuals through a combination of BCI technology with existing assistive technologies (AT). In pursuit of more practical BCIs for use outside of the lab, in this paper, we identify four application areas where disabled individuals could greatly benefit from advancements in BCI technology, namely,“Communication and Control”, “Motor Substitution”, “Entertainment”, and “Motor Recovery”. We review the current state of the art and possible future developments, while discussing the main research issues in these four areas. In particular, we expect the most progress in the development of technologies such as hybrid BCI architectures, user-machine adaptation algorithms, the exploitation of users’ mental states for BCI reliability and confidence measures, the incorporation of principles in human-computer interaction (HCI) to improve BCI usability, and the development of novel BCI technology including better EEG devices

Hybrid brain/neural interface and autonomous vision-guided whole-arm exoskeleton control to perform activities of daily living (ADLs)

[EN] Background The aging of the population and the progressive increase of life expectancy in developed countries is leading to a high incidence of age-related cerebrovascular diseases, which affect people's motor and cognitive capabilities and might result in the loss of arm and hand functions. Such conditions have a detrimental impact on people's quality of life. Assistive robots have been developed to help people with motor or cognitive disabilities to perform activities of daily living (ADLs) independently. Most of the robotic systems for assisting on ADLs proposed in the state of the art are mainly external manipulators and exoskeletal devices. The main objective of this study is to compare the performance of an hybrid EEG/EOG interface to perform ADLs when the user is controlling an exoskeleton rather than using an external manipulator. Methods Ten impaired participants (5 males and 5 females, mean age 52 +/- 16 years) were instructed to use both systems to perform a drinking task and a pouring task comprising multiple subtasks. For each device, two modes of operation were studied: synchronous mode (the user received a visual cue indicating the sub-tasks to be performed at each time) and asynchronous mode (the user started and finished each of the sub-tasks independently). Fluent control was assumed when the time for successful initializations ranged below 3 s and a reliable control in case it remained below 5 s. NASA-TLX questionnaire was used to evaluate the task workload. For the trials involving the use of the exoskeleton, a custom Likert-Scale questionnaire was used to evaluate the user's experience in terms of perceived comfort, safety, and reliability. Results All participants were able to control both systems fluently and reliably. However, results suggest better performances of the exoskeleton over the external manipulator (75% successful initializations remain below 3 s in case of the exoskeleton and bellow 5s in case of the external manipulator). Conclusions Although the results of our study in terms of fluency and reliability of EEG control suggest better performances of the exoskeleton over the external manipulator, such results cannot be considered conclusive, due to the heterogeneity of the population under test and the relatively limited number of participants.This study was funded by the European Commission under the project AIDE (G.A. no: 645322), Spanish Ministry of Science and Innovation, through the projects PID2019-108310RB-I00 and PLEC2022-009424 and by the Ministry of Universities and European Union, "fnanced by European Union-Next Generation EU" through Margarita Salas grant for the training of young doctors.Catalán, JM.; Trigili, E.; Nann, M.; Blanco-Ivorra, A.; Lauretti, C.; Cordella, F.; Ivorra, E.... (2023). Hybrid brain/neural interface and autonomous vision-guided whole-arm exoskeleton control to perform activities of daily living (ADLs). Journal of NeuroEngineering and Rehabilitation. 20(1):1-16. https://doi.org/10.1186/s12984-023-01185-w11620

The future of upper extremity rehabilitation robotics: research and practice

The loss of upper limb motor function can have a devastating effect on people’s lives. To restore upper limb control and functionality, researchers and clinicians have developed interfaces to interact directly with the human body’s motor system. In this invited review, we aim to provide details on the peripheral nerve interfaces and brain‐machine interfaces that have been developed in the past 30 years for upper extremity control, and we highlight the challenges that still remain to transition the technology into the clinical market. The findings show that peripheral nerve interfaces and brain‐machine interfaces have many similar characteristics that enable them to be concurrently developed. Decoding neural information from both interfaces may lead to novel physiological models that may one day fully restore upper limb motor function for a growing patient population.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/155489/1/mus26860_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/155489/2/mus26860.pd