A review on brain computer interfaces: contemporary achievements and future goals towards movement restoration

Restoration of motor functions of patients with loss of mobility constitutes a yet unsolved medical problem, but also one of the most prominent research areas of neurosciences. Among suggested solutions, Brain Computer Interfaces have received much attention. BCI systems use electric, magnetic or metabolic brain signals to allow for control of external devices, such as wheelchairs, computers or neuroprosthetics, by disabled patients. Clinical applications includespinal cord injury, cerebrovascular accident rehabilitation, Amyotrophic Lateral Sclerosis patients. Various BCI systems are under re­search, facilitated by numerous measurement techniques including EEG, fMRI, MEG, nIRS and ECoG, each with its own advantages and disadvantages.Current research effort focuses on brain signal identification and extraction. Virtual Reality environments are also deployed for patient training. Wheelchair or robotic arm control has showed up as the first step towards actual mobility restoration. The next era of BCI research is envisaged to lie along the transmission of brain signals to systems that will control and restore movement of disabled patients via mechanical appendixes or directly to the muscle system by neurosurgical means

Mental practice with interactive 3D visual aids enhances surgical performance

Background: Evidence suggests that Mental Practice (MP) could be used to finesse surgical skills. However, MP is cognitively demanding and may be dependent on the ability of individuals to produce mental images. In this study, we hypothesised that the provision of interactive 3D visual aids during MP could facilitate surgical skill performance. Methods: 20 surgical trainees were case-matched to one of three different preparation methods prior to performing a simulated Laparoscopic Cholecystectomy (LC). Two intervention groups underwent a 25-minute MP session; one with interactive 3D visual aids depicting the relevant surgical anatomy (3D-MP group, n = 5) and one without (MP-Only, n = 5). A control group (n = 10) watched a didactic video of a real LC. Scores relating to technical performance and safety were recorded by a surgical simulator. Results: The Control group took longer to complete the procedure relative to the 3D&MP condition (p = .002). The number of movements was also statistically different across groups (p = .001), with the 3D&MP group making fewer movements relative to controls (p = .001). Likewise, the control group moved further in comparison to the 3D&MP condition and the MP-Only condition (p = .004). No reliable differences were observed for safety metrics. Conclusion: These data provide evidence for the potential value of MP in improving performance. Furthermore, they suggest that 3D interactive visual aids during MP could potentially enhance performance, beyond the benefits of MP alone. These findings pave the way for future RCTs on surgical preparation and performance

A Systematic Review of Investigations into Functional Brain Connectivity Following Spinal Cord Injury

Background: Complete or incomplete spinal cord injury (SCI) results in varying degree of motor, sensory and autonomic impairment. Long-lasting, often irreversible disability results from disconnection of efferent and afferent pathways. How does this disconnection affect brain function is not so clear. Changes in brain organization and structure have been associated with SCI and have been extensively studied and reviewed. Yet, our knowledge regarding brain connectivity changes following SCI is overall lacking. Methods: In this study we conduct a systematic review of articles regarding investigations of functional brain networks following SCI, searching on PubMed, Scopus and ScienceDirect according to PRISMA-P 2015 statement standards. Results: Changes in brain connectivity have been shown even during the early stages of the chronic condition and correlate with the degree of neurological impairment. Connectivity changes appear as dynamic post-injury procedures. Sensorimotor networks of patients and healthy individuals share similar patterns but new functional interactions have been identified as unique to SCI networks. Conclusions: Large-scale, multi-modal, longitudinal studies on SCI patients are needed to understand how brain network reorganization is established and progresses through the course of the condition. The expected insight holds clinical relevance in preventing maladaptive plasticity after SCI through individualized neurorehabilitation, as well as the design of connectivity-based brain-computer interfaces and assistive technologies for SCI patients

The role of the ER stress response protein PERK in rhodopsin retinitis pigmentosa

Mutations in rhodopsin, the light sensitive protein of rod cells, are the most common cause of dominant retinitis pigmentosa (RP), a type of inherited blindness caused by the dysfunction and death of photoreceptor cells. The P23H mutation, the most frequent single cause of RP in the USA, causes rhodopsin misfolding and induction of the unfolded protein response (UPR), an adaptive ER stress response and signalling network that aims to enhance the folding and degradation of misfolded proteins to restore proteostasis. Prolonged UPR activation, and in particular the PERK branch, can reduce protein synthesis and initiate cell death through induction of pro-apoptotic pathways. Here, we investigated the effect of pharmacological PERK inhibition on retinal disease process in the P23H-1 transgenic rat model of retinal degeneration. PERK inhibition with GSK2606414A led to an inhibition of eIF2α phosphorylation, which correlated with reduced ERG function and decreased photoreceptor survival at both high and low doses of PERK inhibitor. Additionally, PERK inhibition increased the incidence of inclusion formation in cultured cells overexpressing P23H rod opsin, and increased rhodopsin aggregation in the P23H-1 rat retina, suggesting enhanced P23H misfolding and aggregation. In contrast, treatment of P23H-1 rats with an inhibitor of eIF2α phosphatase, salubrinal, led to improved photoreceptor survival. Collectively, these data suggest the activation of PERK is part of a protective response to mutant rhodopsin that ultimately limits photoreceptor cell death

Evaluation of computational methodologies for accurate prediction of wall shear stress and turbulence parameters in a patient-specific aorta

Background: Recent studies suggest that blood flow in main arteries is intrinsically disturbed, even under healthy conditions. Despite this, many computational fluid dynamics (CFD) analyses of aortic haemodynamics make the assumption of laminar flow, and best practices surrounding appropriate modelling choices are lacking. This study aims to address this gap by evaluating different modelling and post-processing approaches in simulations of a patient-specific aorta. Methods: Magnetic resonance imaging (MRI) and 4D flow MRI from a patient with aortic valve stenosis were used to reconstruct the aortic geometry and derive patient-specific inlet and outlet boundary conditions. Three different computational approaches were considered based on assumed laminar or assumed disturbed flow states including low-resolution laminar (LR-laminar), high-resolution laminar (HR-Laminar) and large-eddy simulation (LES). Each simulation was ran for 30 cardiac cycles and post-processing was conducted on either the final cardiac cycle, or using a phase-averaged approach which utilised all 30 simulated cycles. Model capabilities were evaluated in terms of mean and turbulence-based parameters. Results: All simulation types, regardless of post-processing approach could correctly predict velocity values and flow patterns throughout the aorta. Lower resolution simulations could not accurately predict gradient-derived parameters including wall shear stress and viscous energy loss (largest differences up to 44.6% and 130.3%, respectively), although phase-averaging these parameters improved predictions. The HR-Laminar simulation produced more comparable results to LES with largest differences in wall shear stress and viscous energy loss parameters up to 5.1% and 11.6%, respectively. Laminar-based parameters were better estimated than turbulence-based parameters. Conclusions: Our findings suggest that well-resolved laminar simulations can accurately predict many laminar-based parameters in disturbed flows, but there is no clear benefit to running a HR-Laminar simulation over an LES simulation based on their comparable computational cost. Additionally, post-processing ‘typical’ laminar simulation results with a phase-averaged approach is a simple and cost-effective way to improve accuracy of lower-resolution simulation results

Analysis of turbulence effects in a patient-specific aorta with aortic valve stenosis

Blood flow in the aorta is often assumed laminar, however aortic valve pathologies may induce transition to turbulence and our understanding of turbulence effects is incomplete. The aim of the study was to provide a detailed analysis of turbulence effects in aortic valve stenosis (AVS). Methods: Large-eddy simulation (LES) of flow through a patient-specific aorta with AVS was conducted. Magnetic resonance imaging (MRI) was performed and used for geometric reconstruction and patient-specific boundary conditions. Computed velocity field was compared with 4D flow MRI to check qualitative and quantitative consistency. The effect of turbulence was evaluated in terms of fluctuating kinetic energy, turbulence-related wall shear stress (WSS) and energy loss. Results: Our analysis suggested that turbulence was induced by a combination of a high velocity jet impinging on the arterial wall and a dilated ascending aorta which provided sufficient space for turbulence to develop. Turbulent WSS contributed to 40% of the total WSS in the ascending aorta and 38% in the entire aorta. Viscous and turbulent irreversible energy losses accounted for 3.9 and 2.7% of the total stroke work, respectively. Conclusions: This study demonstrates the importance of turbulence in assessing aortic haemodynamics in a patient with AVS. Neglecting the turbulent contribution to WSS could potentially result in a significant underestimation of the total WSS. Further work is warranted to extend the analysis to more AVS cases and patients with other aortic valve diseases

Source Detection and Functional Connectivity of the Sensorimotor Cortex during Actual and Imaginary Limb Movement:A Preliminary Study on the Implementation of eConnectome in Motor Imagery Protocols

Introduction . Sensorimotor cortex is activated similarly during motor execution and motor imagery. The study of functional connectivity networks (FCNs) aims at successfully modeling the dynamics of information flow between cortical areas. Materials and Methods . Seven healthy subjects performed 4 motor tasks (real foot, imaginary foot, real hand, and imaginary hand movements), while electroencephalography was recorded over the sensorimotor cortex. Event-Related Desynchronization/Synchronization (ERD/ERS) of the mu-rhythm was used to evaluate MI performance. Source detection and FCNs were studied with eConnectome. Results and Discussion . Four subjects produced similar ERD/ERS patterns between motor execution and imagery during both hand and foot tasks, 2 subjects only during hand tasks, and 1 subject only during foot tasks. All subjects showed the expected brain activation in well-performed MI tasks, facilitating cortical source estimation. Preliminary functional connectivity analysis shows formation of networks on the sensorimotor cortex during motor imagery and execution. Conclusions . Cortex activation maps depict sensorimotor cortex activation, while similar functional connectivity networks are formed in the sensorimotor cortex both during actual and imaginary movements. eConnectome is demonstrated as an effective tool for the study of cortex activation and FCN. The implementation of FCN in motor imagery could induce promising advancements in Brain Computer Interfaces

Philanthropy or solidarity? Ethical dilemmas about humanitarianism in crisis afflicted Greece

That philanthropy perpetuates the conditions that cause inequality is an old argument shared by thinkers such as Karl Marx, Oscar Wilde and Slavoj Zizek. I recorded the same argument in conversations regarding a growing humanitarian concern in austerity-ridden Greece. At the local level a number of solidarity initiatives provide the most impoverished families with humanitarian help. Some citizens participate in such initiatives wholeheartedly, while some other citizens criticize solidarity movements drawing primarily from Marxist-inspired arguments, such as, for example, that humanitarianism rationalises state inaction. The local narratives presented in this article bring forward two parallel possibilities engendered by the humanitarian face of social solidarity: first, its empowering potential (where solidarity initiatives enhance local social awareness), and second, the de-politicisation of the crisis and the experience of suffering (a liability that stems from the effectiveness of humanitarianism in ameliorating only temporarily the superficial consequences of the crisis). These two overlapping possibilities can help us problematise the contextual specificity and strategic employment of humanitarian solidarity in times of austerity