Applications of brain-computer interfaces to the control of robotic and prosthetic arms

Cortical activation and BCI performance during brief tactile imagery: A comparative study with motor imagery

Brain-computer interfaces (BCIs) rely heavily on motor imagery (MI) for operation, yet tactile imagery (TI) presents a novel approach that may be advantageous in situations where visual feedback is impractical. The current study aimed to compare the cortical activity and digit classification performance induced by TI and MI to assess the viability of TI for use in BCIs. Twelve right-handed participants engaged in trials of TI and MI, focusing on their left and right index digits. Event-related desynchronization (ERD) in the mu and beta bands was analyzed, and classification accuracy was determined through an artificial neural network (ANN). Comparable ERD patterns were observed in both TI and MI, with significant decreases in ERD during imagery tasks. The ANN demonstrated high classification accuracy, with TI achieving a mean±SD of 79.30 ± 3.91 % and MI achieving 81.10 ± 2.96 %, with no significant difference between the two (p = 0.11). The study found that TI induces substantial ERD comparable to MI and maintains high classification accuracy, supporting its potential as an effective mental strategy for BCIs. This suggests that TI could be a valuable alternative in BCI applications, particularly for individuals unable to rely on visual cues.

Efficient Multiple Channels EEG Signal Classification Based on Hierarchical Extreme Learning Machine

The human brain can be seen as one of the most powerful processors in the world, and it has a very complex structure with different kinds of signals for monitoring organics, communicating to neurons, and reacting to different information, which allows large developments in observing human sleeping, revealing diseases, reflecting certain motivations of limbs, and other applications. Relative theory, algorithms, and applications also help us to build brain-computer interface (BCI) systems for different powerful functions. Therefore, we present a fast-reaction framework based on an extreme learning machine (ELM) with multiple layers for the ElectroEncephaloGram (EEG) signals classification in motor imagery, showing the advantages in both accuracy of classification and training speed compared with conventional machine learning methods. The experiments are performed on software with the dataset of BCI Competition II with fast training time and high accuracy. The final average results show an accuracy of 93.90% as well as a reduction of 75% of the training time as compared to conventional deep learning and machine learning algorithms for EEG signal classification, also showing its prospects of the improvement of the performance of the BCI system.

Antioxidant Dimethyl Fumarate Temporarily but Not Chronically Improves Intracortical Microelectrode Performance

Intracortical microelectrode arrays (MEAs) can be used in a range of applications, from basic neuroscience research to providing an intimate interface with the brain as part of a brain-computer interface (BCI) system aimed at restoring function for people living with neurological disorders or injuries. Unfortunately, MEAs tend to fail prematurely, leading to a loss in functionality for many applications. An important contributing factor in MEA failure is oxidative stress resulting from chronically inflammatory-activated microglia and macrophages releasing reactive oxygen species (ROS) around the implant site. Antioxidants offer a means for mitigating oxidative stress and improving tissue health and MEA performance. Here, we investigate using the clinically available antioxidant dimethyl fumarate (DMF) to reduce the neuroinflammatory response and improve MEA performance in a rat MEA model. Daily treatment of DMF for 16 weeks resulted in a significant improvement in the recording capabilities of MEA devices during the sub-chronic (Weeks 5-11) phase (42% active electrode yield vs. 35% for control). However, these sub-chronic improvements were lost in the chronic implantation phase, as a more exacerbated neuroinflammatory response occurs in DMF-treated animals by 16 weeks post-implantation. Yet, neuroinflammation was indiscriminate between treatment and control groups during the sub-chronic phase. Although worse for chronic use, a temporary improvement (<12 weeks) in MEA performance is meaningful. Providing short-term improvement to MEA devices using DMF can allow for improved use for limited-duration studies. Further efforts should be taken to explore the mechanism behind a worsened neuroinflammatory response at the 16-week time point for DMF-treated animals and assess its usefulness for specific applications.

Representation and decoding of bilateral arm motor imagery using unilateral cerebral LFP signals

Introduction

In the field of upper limb brain computer interfaces (BCIs), the research focusing on bilateral decoding mostly based on the neural signals from two cerebral hemispheres. In addition, most studies used spikes for decoding. Here we examined the representation and decoding of different laterality and regions arm motor imagery in unilateral motor cortex based on local field potentials (LFPs).

Methods

The LFP signals were recorded from a 96-channel Utah microelectrode array implanted in the left primary motor cortex of a paralyzed participant. There were 7 kinds of tasks: rest, left, right and bilateral elbow and wrist flexion. We performed time-frequency analysis on the LFP signals and analyzed the representation and decoding of different tasks using the power and energy of different frequency bands.

Results

The frequency range of <8 Hz and >38 Hz showed power enhancement, whereas 8-38 Hz showed power suppression in spectrograms while performing motor imagery. There were significant differences in average energy between tasks. What's more, the movement region and laterality were represented in two dimensions by demixed principal component analysis. The 135-300 Hz band signal had the highest decoding accuracy among all frequency bands and the contralateral and bilateral signals had more similar single-channel power activation patterns and larger signal correlation than contralateral and ipsilateral signals, bilateral and ipsilateral signals.

Discussion

The results showed that unilateral LFP signals had different representations for bilateral motor imagery on the average energy of the full array and single-channel power levels, and different tasks could be decoded. These proved the feasibility of multilateral BCI based on the unilateral LFP signal to broaden the application of BCI technology.

Clinical trial registration

https://www.chictr.org.cn/showproj.aspx?proj=130829, identifier ChiCTR2100050705.

Evaluation of EEG Oscillatory Patterns and Classification of Compound Limb Tactile Imagery

Objective: The purpose of this study was to investigate the cortical activity and digit classification performance during tactile imagery (TI) of a vibratory stimulus at the index, middle, and thumb digits within the left hand in healthy individuals. Furthermore, the cortical activities and classification performance of the compound TI were compared with similar compound motor imagery (MI) with the same digits as TI in the same subjects. Methods: Twelve healthy right-handed adults with no history of upper limb injury, musculoskeletal condition, or neurological disorder participated in the study. The study evaluated the event-related desynchronization (ERD) response and brain-computer interface (BCI) classification performance on discriminating between the digits in the left-hand during the imagery of vibrotactile stimuli to either the index, middle, or thumb finger pads for TI and while performing a motor activity with the same digits for MI. A supervised machine learning technique was applied to discriminate between the digits within the same given limb for both imagery conditions. Results: Both TI and MI exhibited similar patterns of ERD in the alpha and beta bands at the index, middle, and thumb digits within the left hand. While TI had significantly lower ERD for all three digits in both bands, the classification performance of TI-based BCI (77.74 ± 6.98%) was found to be similar to the MI-based BCI (78.36 ± 5.38%). Conclusions: The results of this study suggest that compound tactile imagery can be a viable alternative to MI for BCI classification. The study contributes to the growing body of evidence supporting the use of TI in BCI applications, and future research can build on this work to explore the potential of TI-based BCI for motor rehabilitation and the control of external devices.

Assessment of Safety of a Fully Implanted Endovascular Brain-Computer Interface for Severe Paralysis in 4 Patients: The Stentrode With Thought-Controlled Digital Switch (SWITCH) Study

Importance

Brain-computer interface (BCI) implants have previously required craniotomy to deliver penetrating or surface electrodes to the brain. Whether a minimally invasive endovascular technique to deliver recording electrodes through the jugular vein to superior sagittal sinus is safe and feasible is unknown.

Objective

To assess the safety of an endovascular BCI and feasibility of using the system to control a computer by thought.

Design, Setting, and Participants

The Stentrode With Thought-Controlled Digital Switch (SWITCH) study, a single-center, prospective, first in-human study, evaluated 5 patients with severe bilateral upper-limb paralysis, with a follow-up of 12 months. From a referred sample, 4 patients with amyotrophic lateral sclerosis and 1 with primary lateral sclerosis met inclusion criteria and were enrolled in the study. Surgical procedures and follow-up visits were performed at the Royal Melbourne Hospital, Parkville, Australia. Training sessions were performed at patients' homes and at a university clinic. The study start date was May 27, 2019, and final follow-up was completed January 9, 2022.

Interventions

Recording devices were delivered via catheter and connected to subcutaneous electronic units. Devices communicated wirelessly to an external device for personal computer control.

Main Outcomes and Measures

The primary safety end point was device-related serious adverse events resulting in death or permanent increased disability. Secondary end points were blood vessel occlusion and device migration. Exploratory end points were signal fidelity and stability over 12 months, number of distinct commands created by neuronal activity, and use of system for digital device control.

Results

Of 4 patients included in analyses, all were male, and the mean (SD) age was 61 (17) years. Patients with preserved motor cortex activity and suitable venous anatomy were implanted. Each completed 12-month follow-up with no serious adverse events and no vessel occlusion or device migration. Mean (SD) signal bandwidth was 233 (16) Hz and was stable throughout study in all 4 patients (SD range across all sessions, 7-32 Hz). At least 5 attempted movement types were decoded offline, and each patient successfully controlled a computer with the BCI.

Conclusions and Relevance

Endovascular access to the sensorimotor cortex is an alternative to placing BCI electrodes in or on the dura by open-brain surgery. These final safety and feasibility data from the first in-human SWITCH study indicate that it is possible to record neural signals from a blood vessel. The favorable safety profile could promote wider and more rapid translation of BCI to people with paralysis.

Trial Registration

ClinicalTrials.gov Identifier: NCT03834857.

Use of Invasive Brain-Computer Interfaces in Pediatric Neurosurgery: Technical and Ethical Considerations

Invasive brain-computer interfaces hold promise to alleviate disabilities in individuals with neurologic injury, with fully implantable brain-computer interface systems expected to reach the clinic in the upcoming decade. Children with severe neurologic disabilities, like quadriplegic cerebral palsy or cervical spine trauma, could benefit from this technology. However, they have been excluded from clinical trials of intracortical brain-computer interface to date. In this manuscript, we discuss the ethical considerations related to the use of invasive brain-computer interface in children with severe neurologic disabilities. We first review the technical hardware and software considerations for the application of intracortical brain-computer interface in children. We then discuss ethical issues related to motor brain-computer interface use in pediatric neurosurgery. Finally, based on the input of a multidisciplinary panel of experts in fields related to brain-computer interface (functional and restorative neurosurgery, pediatric neurosurgery, mathematics and artificial intelligence research, neuroengineering, pediatric ethics, and pragmatic ethics), we then formulate initial recommendations regarding the clinical use of invasive brain-computer interfaces in children.

The present and future of neural interfaces

The 2020's decade will likely witness an unprecedented development and deployment of neurotechnologies for human rehabilitation, personalized use, and cognitive or other enhancement. New materials and algorithms are already enabling active brain monitoring and are allowing the development of biohybrid and neuromorphic systems that can adapt to the brain. Novel brain-computer interfaces (BCIs) have been proposed to tackle a variety of enhancement and therapeutic challenges, from improving decision-making to modulating mood disorders. While these BCIs have generally been developed in an open-loop modality to optimize their internal neural decoders, this decade will increasingly witness their validation in closed-loop systems that are able to continuously adapt to the user's mental states. Therefore, a proactive ethical approach is needed to ensure that these new technological developments go hand in hand with the development of a sound ethical framework. In this perspective article, we summarize recent developments in neural interfaces, ranging from neurohybrid synapses to closed-loop BCIs, and thereby identify the most promising macro-trends in BCI research, such as simulating vs. interfacing the brain, brain recording vs. brain stimulation, and hardware vs. software technology. Particular attention is devoted to central nervous system interfaces, especially those with application in healthcare and human enhancement. Finally, we critically assess the possible futures of neural interfacing and analyze the short- and long-term implications of such neurotechnologies.

Brain-machine interface-based training for improving upper extremity function after stroke: A meta-analysis of randomized controlled trials

Background

Upper extremity dysfunction after stroke is an urgent clinical problem that greatly affects patients' daily life and reduces their quality of life. As an emerging rehabilitation method, brain-machine interface (BMI)-based training can extract brain signals and provide feedback to form a closed-loop rehabilitation, which is currently being studied for functional restoration after stroke. However, there is no reliable medical evidence to support the effect of BMI-based training on upper extremity function after stroke. This review aimed to evaluate the efficacy and safety of BMI-based training for improving upper extremity function after stroke, as well as potential differences in efficacy of different external devices.

Methods

English-language literature published before April 1, 2022, was searched in five electronic databases using search terms including “brain-computer/machine interface”, “stroke” and “upper extremity.” The identified articles were screened, data were extracted, and the methodological quality of the included trials was assessed. Meta-analysis was performed using RevMan 5.4.1 software. The GRADE method was used to assess the quality of the evidence.

Results

A total of 17 studies with 410 post-stroke patients were included. Meta-analysis showed that BMI-based training significantly improved upper extremity motor function [standardized mean difference (SMD) = 0.62; 95% confidence interval (CI) (0.34, 0.90); I² = 38%; p < 0.0001; n = 385; random-effects model; moderate-quality evidence]. Subgroup meta-analysis indicated that BMI-based training significantly improves upper extremity motor function in both chronic [SMD = 0.68; 95% CI (0.32, 1.03), I² = 46%; p = 0.0002, random-effects model] and subacute [SMD = 1.11; 95%CI (0.22, 1.99); I² = 76%; p = 0.01; random-effects model] stroke patients compared with control interventions, and using functional electrical stimulation (FES) [SMD = 1.11; 95% CI (0.67, 1.54); I² = 11%; p < 0.00001; random-effects model]or visual feedback [SMD = 0.66; 95% CI (0.2, 1.12); I² = 4%; p = 0.005; random-effects model;] as the feedback devices in BMI training was more effective than using robot. In addition, BMI-based training was more effective in improving patients' activities of daily living (ADL) than control interventions [SMD = 1.12; 95% CI (0.65, 1.60); I² = 0%; p < 0.00001; n = 80; random-effects model]. There was no statistical difference in the dropout rate and adverse effects between the BMI-based training group and the control group.

Conclusion

BMI-based training improved upper limb motor function and ADL in post-stroke patients. BMI combined with FES or visual feedback may be a better combination for functional recovery than robot. BMI-based trainings are well-tolerated and associated with mild adverse effects.

Smart Device-Driven Corticolimbic Plasticity in Cognitive–Emotional Restructuring of Space-Related Neuropsychiatric Disease and Injury

Escalating government and commercial efforts to plan and deploy viable manned near-to-deep solar system exploration and habitation over the coming decades now drives next-generation space medicine innovations. The application of cutting-edge precision medicine, such as brain stimulation techniques, provides powerful clinical and field/flight situation methods to selectively control vagal tone and neuroendocrine-modulated corticolimbic plasticity, which is affected by prolonged cosmic radiation exposure, social isolation or crowding, and weightlessness in constricted operational non-terran locales. Earth-based clinical research demonstrates that brain stimulation approaches may be combined with novel psychotherapeutic integrated memory structure rationales for the corrective reconsolidation of arousing or emotional experiences, autobiographical memories, semantic schema, and other cognitive structures to enhance neuropsychiatric patient outcomes. Such smart cotherapies or countermeasures, which exploit natural, pharmaceutical, and minimally invasive neuroprosthesis-driven nervous system activity, may optimize the cognitive-emotional restructuring of astronauts suffering from space-related neuropsychiatric disease and injury, including mood, affect, and anxiety symptoms of any potential severity and pathophysiology. An appreciation of improved neuropsychiatric healthcare through the merging of new or rediscovered smart theragnostic medical technologies, capable of rendering personalized neuroplasticity training and managed psychotherapeutic treatment protocols, will reveal deeper insights into the illness states experienced by astronauts. Future work in this area should emphasize the ethical role of telemedicine and/or digital clinicians to advance the (semi)autonomous, technology-assisted medical prophylaxis, diagnosis, treatment, monitoring, and compliance of astronauts for elevated health, safety, and performance in remote extreme space and extraterrestrial environments.

Raising the stakes for cortical visual prostheses

In this issue of the JCI, the dream of restoring useful vision to blind individuals with neurotechnology moves one step closer to realization. Fernández et al. implanted an electrode array with 96 penetrating electrodes in the visual cortex of a blind patient who had been without light perception for 16 years due to optic neuropathy. Remarkably, the patient was able to perceive visual patterns created by passing current through array electrodes. The use of a penetrating electrode array meant that action potentials from single neurons could be recorded to study the neural response to stimulation. Compared with electrodes resting on the cortical surface, penetrating electrodes require one-tenth the current to create a visual percept. However, patterned electrical stimulation often fails to produce the expected percept for penetrating and surface electrode arrays, highlighting the need for further research to untangle the relationship between stimulus and perception.

Sub-100 μW Multispectral Riemannian Classification for EEG-Based Brain-Machine Interfaces

Motor imagery (MI) brain-machine interfaces (BMIs) enable us to control machines by merely thinking of performing a motor action. Practical use cases require a wearable solution where the classification of the brain signals is done locally near the sensor using machine learning models embedded on energy-efficient microcontroller units (MCUs), for assured privacy, user comfort, and long-term usage. In this work, we provide practical insights on the accuracy-cost trade-off for embedded BMI solutions. Our multispectral Riemannian classifier reaches 75.1% accuracy on a 4-class MI task. The accuracy is further improved by tuning different types of classifiers to each subject, achieving 76.4%. We further scale down the model by quantizing it to mixed-precision representations with a minimal accuracy loss of 1% and 1.4%, respectively, which is still up to 4.1% more accurate than the state-of-the-art embedded convolutional neural network. We implement the model on a low-power MCU within an energy budget of merely 198 μJ and taking only 16.9 ms per classification. Classifying samples continuously, overlapping the 3.5 s samples by 50% to avoid missing user inputs allows for operation at just 85 μW. Compared to related works in embedded MI-BMIs, our solution sets the new state-of-the-art in terms of accuracy-energy trade-off for near-sensor classification.

Neurorobotic fusion of prosthetic touch, kinesthesia, and movement in bionic upper limbs promotes intrinsic brain behaviors

[Figure: see text].

Brain-Computer Interfaces for Children With Complex Communication Needs and Limited Mobility: A Systematic Review

Brain-computer interfaces (BCIs) represent a new frontier in the effort to maximize the ability of individuals with profound motor impairments to interact and communicate. While much literature points to BCIs' promise as an alternative access pathway, there have historically been few applications involving children and young adults with severe physical disabilities. As research is emerging in this sphere, this article aims to evaluate the current state of translating BCIs to the pediatric population. A systematic review was conducted using the Scopus, PubMed, and Ovid Medline databases. Studies of children and adolescents that reported BCI performance published in English in peer-reviewed journals between 2008 and May 2020 were included. Twelve publications were identified, providing strong evidence for continued research in pediatric BCIs. Research evidence was generally at multiple case study or exploratory study level, with modest sample sizes. Seven studies focused on BCIs for communication and five on mobility. Articles were categorized and grouped based on type of measurement (i.e., non-invasive and invasive), and the type of brain signal (i.e., sensory evoked potentials or movement-related potentials). Strengths and limitations of studies were identified and used to provide requirements for clinical translation of pediatric BCIs. This systematic review presents the state-of-the-art of pediatric BCIs focused on developing advanced technology to support children and youth with communication disabilities or limited manual ability. Despite a few research studies addressing the application of BCIs for communication and mobility in children, results are encouraging and future works should focus on customizable pediatric access technologies based on brain activity.

Posterior parietal cortex contributions to cross-modal brain plasticity upon sensory loss

Sensory loss causes compensatory behavior, like echolocation upon vision loss or improved visual motion detection upon deafness. This is enabled by recruitment of the deprived cortical area by the intact senses. Such cross-modal plasticity can however hamper rehabilitation via sensory substitution devices. To steer rehabilitation towards the desired outcome for the patient, having control over the cross-modal take-over is essential. Evidence accumulates to support a role for the posterior parietal cortex (PPC) in multimodal plasticity. This area shows increased activity after sensory loss, keeping similar functions but driven by other senses. Patient-specific factors like stress, social situation, age and attention, have a significant influence on the PPC and on cross-modal plasticity. We propose that understanding the response of the PPC to sensory loss and context is extremely important for determining the best possible implant-based therapies, and that mouse research holds potential to help unraveling the underlying anatomical, cellular and neuromodulatory mechanisms.