Detecting and classifying three different hand movement types through electroencephalography recordings for neurorehabilitation

Brain–computer interfaces can be used for motor substitution and recovery; therefore, detection and classification of movement intention are crucial for optimal control. In this study, palmar, lateral and pinch grasps were differentiated from the idle state and classified from single-trial EEG using only information prior to the movement onset. Fourteen healthy subjects performed the three grasps 100 times, while EEG was recorded from 25 electrodes. Temporal and spectral features were extracted from each electrode, and feature reduction was performed using sequential forward selection (SFS) and principal component analysis (PCA). The detection problem was investigated as the ability to discriminate between movement preparation and the idle state. Furthermore, all task pairs and the three movements together were classified. The best detection performance across movements (79 ± 8 %) was obtained by combining temporal and spectral features. The best movement–movement discrimination was obtained using spectral features: 76 ± 9 % (2-class) and 63 ± 10 % (3-class). For movement detection and discrimination, the performance was similar across grasp types and task pairs; SFS outperformed PCA. The results show it is feasible to detect different grasps and classify the distinct movements using only information prior to the movement onset, which may enable brain–computer interface-based neurorehabilitation of upper limb function through Hebbian learning mechanisms

Increased voluntary activation of the elbow flexors following a single session of spinal manipulation in a subclinical neck pain population

© 2019 by the authors. Licensee MDPI, Basel, Switzerland. To investigate the effects of a single session of spinal manipulation (SM) on voluntary activation of the elbow flexors in participants with subclinical neck pain using an interpolated twitch technique with transcranial magnetic stimulation (TMS), eighteen volunteers with subclinical neck pain participated in this randomized crossover trial. TMS was delivered during elbow flexion contractions at 50%, 75% and 100% of maximum voluntary contraction (MVC) before and after SM or control intervention. The amplitude of the superimposed twitches evoked during voluntary contractions was recorded and voluntary activation was calculated using a regression analysis. Dependent variables were analyzed with two-way (intervention × time) repeated measures ANOVAs. Significant intervention effects for SM compared to passive movement control were observed for elbow flexion MVC (p = 0.04), the amplitude of superimposed twitch (p = 0.04), and voluntary activation of elbow flexors (p =0.03). Significant within-group post-intervention changes were observed for the superimposed twitch (mean group decrease of 20.9%, p < 0.01) and voluntary activation (mean group increase of 3.0%, p < 0.01) following SM. No other significant within-group changes were observed. Voluntary activation of the elbow flexors increased immediately after one session of spinal manipulation in participants with subclinical neck pain. A decrease in the amplitude of superimposed twitch during elbow flexion MVC following spinal manipulation suggests a facilitation of motor cortical output

Intra- and Inter-rater Reliability of Manual Feature Extraction Methods in Movement Related Cortical Potential Analysis

Event related potentials (ERPs) provide insight into the neural activity generated in response to motor, sensory and cognitive processes. Despite the increasing use of ERP data in clinical research little is known about the reliability of human manual ERP labelling methods. Intra-rater and inter-rater reliability were evaluated in five electroencephalography (EEG) experts who labelled the peak negativity of averaged movement related cortical potentials (MRCPs) derived from thirty datasets. Each dataset contained 50 MRCP epochs from healthy people performing cued voluntary or imagined movement, or people with stroke performing cued voluntary movement. Reliability was assessed using the intraclass correlation coefficient and standard error of measurement. Excellent intra-and inter-rater reliability was demonstrated in the voluntary movement conditions in healthy people and people with stroke. In comparison reliability in the imagined condition was low to moderate. Post-hoc secondary epoch analysis revealed that the morphology of the signal contributed to the consistency of epoch inclusion; potentially explaining the differences in reliability seen across conditions. Findings from this study may inform future research focused on developing automated labelling methods for ERP feature extraction and call to the wider community of researchers interested in utilizing ERPs as a measure of neurophysiological change or in the delivery of EEG-driven interventions

Self-paced Online Vs. Cue-based Offline Brain-computer Interfaces for Inducing Neural Plasticity

Brain-computer interfaces (BCIs), operated in a cue-based (offline) or self-paced (online) mode, can be used for inducing cortical plasticity for stroke rehabilitation by the pairing of movement-related brain activity with peripheral electrical stimulation. The aim of this study was to compare the difference in cortical plasticity induced by the two BCI modes. Fifteen healthy participants participated in two experimental sessions: cue-based BCI and self-paced BCI. In both sessions, imagined dorsiflexions were extracted from continuous electroencephalogram (EEG) and paired 50 times with the electrical stimulation of the common peroneal nerve. Before, immediately after, and 30 minutes after each intervention, the cortical excitability was measured through the motor-evoked potentials (MEPs) of tibialis anterior elicited through transcranial magnetic stimulation. Linear mixed regression models showed that the MEP amplitudes increased significantly (p < 0.05) from pre- to post- and 30-minutes post-intervention in terms of both the absolute and relative units, regardless of the intervention type. Compared to pre-interventions, the absolute MEP size increased by 79% in post- and 68% in 30-minutes post-intervention in the self-paced mode (with a true positive rate of ~75%), and by 37% in post- and 55% in 30-minutes post-intervention in the cue-based mode. The two modes were significantly different (p = 0.03) at post-intervention (relative units) but were similar at both post timepoints (absolute units). These findings suggest that immediate changes in cortical excitability may have implications for stroke rehabilitation, where it could be used as a priming protocol in conjunction with another intervention; however, the findings need to be validated in studies involving stroke patients

Peripheral Electrical Stimulation Paired With Movement-related Cortical Potentials Improves Isometric Muscle Strength and Voluntary Activation Following Stroke

Background: Endogenous paired associative stimulation (ePAS) is a neuromodulatory intervention that has potential to aid stroke recovery. ePAS involves pairing endogenous electroencephalography (EEG) signals known as movement-related cortical potentials (MRCPs), with peripheral electrical stimulation. Previous studies have used transcranial magnetic stimulation (TMS) to demonstrate changes in corticomotor excitability following ePAS. However, the use of TMS as a measure in stroke research is limited by safety precautions, intolerance, and difficulty generating a measurable response in more severely affected individuals. We were interested in evaluating the effect of ePAS using more feasible measures in people with stroke. This study asks whether ePAS produces immediate improvements in the primary outcomes of maximal voluntary isometric contraction (MVIC) and total neuromuscular fatigue of the dorsiflexor muscles, and in the secondary outcomes of muscle power, voluntary activation (VA), central fatigue, peripheral fatigue, and electromyography activity. Method: In this repeated-measures cross-over study, 15 participants with chronic stroke completed two interventions, ePAS and sham, in a randomized order. During ePAS, 50 repetitions of visually cued dorsiflexion were completed, while single pulses of electrical stimulation were delivered to the deep branch of the common peroneal nerve. Each somatosensory volley was timed to arrive in the primary motor cortex at the peak negativity of the MRCP. Univariate and multivariate linear mixed models were used to analyze the primary and secondary data, respectively. Results: There was a statistically significant increase in dorsiflexor MVIC immediately following the ePAS intervention (mean increase 7 N), compared to the sham intervention (mean change 0 N) (univariate between-condition analysis p = 0.047). The multivariate analysis revealed a statistically significant effect of ePAS on VA of the tibialis anterior muscle, such that ePAS increased VA by 7 percentage units (95% confidence interval 1.3–12.7%). There was no statistically significant effect on total neuromuscular fatigue, muscle power, or other secondary measures. Conclusion: A single session of ePAS can significantly increase isometric muscle strength and VA in people with chronic stroke. The findings confirm that ePAS has a central neuromodulatory mechanism and support further exploration of its potential as an adjunct to stroke rehabilitation. In addition, the findings offer alternative, feasible outcome measures for future research. Clinical trial registration: Australia New Zealand Clinical Trials Registry ACTRN12617000838314 (www.anzctr.org.au), Universal Trial Number U111111953714