Tactile Perception for Stroke Induce Changes in Electroencephalography

A scoping review on examination approaches for identifying tactile deficits at the upper extremity in individuals with stroke

PURPOSE

Accurate perception of tactile stimuli is essential for performing and learning activities of daily living. Through this scoping review, we sought to summarize existing examination approaches for identifying tactile deficits at the upper extremity in individuals with stroke. The goal was to identify current limitations and future research needs for designing more comprehensive examination tools.

METHODS

A scoping review was conducted in accordance with the Joanna Briggs Institute methodological framework and the PRISMA for Scoping Reviews (PRISMA-ScR) guidelines. A database search for tactile examination approaches at the upper extremity of individuals with stroke was conducted using Medline (Ovid), The Cochrane Library (Wiley), CINAHL Plus with Full Text (Ebsco), Scopus (Elsevier), PsycInfo (Ebsco), and Proquest Dissertations and Theses Global. Original research and review articles that involved adults (18 years or older) with stroke, and performed tactile examinations at the upper extremity were eligible for inclusion. Data items extracted from the selected articles included: if the examination was behavioral in nature and involved neuroimaging, the extent to which the arm participated during the examination, the number of possible outcomes of the examination, the type(s) of tactile stimulation equipment used, the location(s) along the arm examined, the peripheral nerves targeted for examination, and if any comparison was made with the non-paretic arm or with the arms of individuals who are neurotypical.

RESULTS

Twenty-two articles met the inclusion criteria and were accepted in this review. Most examination approaches were behavioral in nature and involved self-reporting of whether a tactile stimulus was felt while the arm remained passive (i.e., no volitional muscle activity). Typically, the number of possible outcomes with these behavioral approaches were limited (2-3), whereas the neuroimaging approaches had many more possible outcomes ( > 15 ). Tactile examinations were conducted mostly at the distal locations along the arm (finger or hand) without targeting any specific peripheral nerve. Although a majority of articles compared paretic and non-paretic arms, most did not compare outcomes to a control group of individuals who are neurotypical.

DISCUSSION

Our findings noted that most upper extremity tactile examinations are behavioral approaches, which are subjective in nature, lack adequate resolution, and are insufficient to identify the underlying neural mechanisms of tactile deficits. Also, most examinations are administered at distal locations of the upper extremity when the examinee's arm is relaxed (passive). Further research is needed to develop better tactile examination tools that combine behavioral responses and neurophysiological outcomes, and allow volitional tactile exploration. Approaches that include testing of multiple body locations/nerves along the upper extremity, provide higher resolution of outcomes, and consider normative comparisons with individuals who are neurotypical may provide a more comprehensive understanding of the tactile deficits occurring following a stroke.

Electroencephalographic Measurement on Post-stroke Sensory Deficiency in Response to Non-painful Cold Stimulation

Background

Reduced elementary somatosensation is common after stroke. However, the measurement of elementary sensation is frequently overlooked in traditional clinical assessments, and has not been evaluated objectively at the cortical level. This study designed a new configuration for the measurement of post-stroke elementary thermal sensation by non-painful cold stimulation (NPCS). The post-stroke cortical responses were then investigated during elementary NPCS on sensory deficiency via electroencephalography (EEG) when compared with unimpaired persons.

Method

Twelve individuals with chronic stroke and fifteen unimpaired controls were recruited. A 64-channel EEG system was used to investigate the post-stroke cortical responses objectively during the NPCS. A subjective questionnaire of cold sensory intensity was also administered via a numeric visual analog scale (VAS). Three water samples with different temperatures (i.e., 25, 10, and 0°C) were applied to the skin surface of the ventral forearm for 3 s via glass beaker, with a randomized sequence on either the left or right forearm of a participant. EEG relative spectral power (RSP) and topography were used to evaluate the neural responses toward NPCS with respect to the independent factors of stimulation side and temperature.

Results

For unimpaired controls, NPCS initiated significant RSP variations, mainly located in the theta band with the highest discriminative resolution on the different temperatures (P < 0.001). For stroke participants, the distribution of significant RSP spread across all EEG frequency bands and the temperature discrimination was lower than that observed in unimpaired participants (P < 0.05). EEG topography showed that the NPCS could activate extensive and bilateral sensory cortical areas after stroke. Significant group differences on RSP intensities were obtained in each EEG band (P < 0.05). Meanwhile, significant asymmetry cortical responses in RSP toward different upper limbs were observed during the NPCS in both unimpaired controls and participants with stroke (P < 0.05). No difference was found between the groups in the VAS ratings of the different temperatures (P > 0.05).

Conclusion

The post-stroke cortical responses during NPCS on sensory deficiency were characterized by the wide distribution of representative RSP bands, lowered resolution toward different temperatures, and extensive activated sensory cortical areas.

Evaluation of Post-Stroke Impairment in Fine Tactile Sensation by Electroencephalography (EEG)-Based Machine Learning

Electroencephalography (EEG)-based measurements of fine tactile sensation produce large amounts of data, with high costs for manual evaluation. In this study, an EEG-based machine-learning (ML) model with support vector machine (SVM) was established to automatically evaluate post-stroke impairments in fine tactile sensation. Stroke survivors (n = 12, stroke group) and unimpaired participants (n = 15, control group) received stimulations with cotton, nylon, and wool fabrics to the different upper limbs of a stroke participant and the dominant side of the control. The average and maximal values of relative spectral power (RSP) of EEG in the stimulations were used as the inputs to the SVM-ML model, which was first optimized for classification accuracies for different limb sides through hyperparameter selection (γ, C) in radial basis function (RBF) kernel and cross-validation during cotton stimulation. Model generalization was investigated by comparing accuracies during stimulations with different fabrics to different limbs. The highest accuracies were achieved with (γ = 21, C = 23) for the RBF kernel (76.8%) and six-fold cross-validation (75.4%), respectively, in the gamma band for cotton stimulation; these were selected as optimal parameters for the SVM-ML model. In model generalization, significant differences in the post-stroke fabric stimulation accuracies were shifted to higher (beta/gamma) bands. The EEG-based SVM-ML model generated results similar to manual evaluation of cortical responses to fabric stimulations; this may aid automatic assessments of post-stroke fine tactile sensations.

Dynamic causal modeling of sensorimotor networks elicited by saltatory pneumotactile velocity in the glabrous hand

BACKGROUND AND PURPOSE

The effective connectivity of neuronal networks during passive saltatory pneumotactile velocity stimulation to the glabrous hand with different velocities is still unknown. The present study investigated the effectivity connectivity elicited by saltatory pneumotactile velocity arrays placed on the glabrous hand at three velocities (5, 25, and 65 cm/second).

METHODS

Dynamic causal modeling (DCM) was used on functional MRI data sampled from 20 neurotypical adults. Five brain regions, including the left primary somatosensory (SI) and motor (M1) cortices, bilateral secondary somatosensory (SII) cortices, and right cerebellar lobule VI, were used to build model space.

RESULTS

Three velocities (5, 25, and 65 cm/second) of saltatory pneumotactile stimuli were processed in both serial and parallel modes within the sensorimotor networks. The medium velocity of 25 cm/second modulated forward interhemispheric connection from the contralateral SII to the ipsilateral SII. Pneumotactile stimulation at the medium velocity of 25 cm/second also influenced contralateral M1 through contralateral SI. Finally, the right cerebellar lobule VI was involved in the sensorimotor networks.

CONCLUSIONS

Our DCM results suggest the coexistence of both serial and parallel processing for saltatory pneumotactile velocity stimulation. Significant contralateral M1 modulation promotes the prospect that the passive saltatory pneumotactile velocity arrays can be used to design sensorimotor rehabilitation protocols to activate M1. The effective connectivity from the right cerebellar lobule VI to other cortical regions demonstrates the cerebellum's role in the sensorimotor networks through feedforward and feedback neuronal pathways.

Measurement of sensory deficiency in fine touch after stroke during textile fabric stimulation by electroencephalography (EEG)

Objective

Sensory deficiency of fine touch limits the restoration of motor functions after stroke, and its evaluation was seldom investigated from a neurological perspective. In this study, we investigated the cortical response measured by electroencephalography (EEG) on the fine touch sensory impairment during textile fabric stimulation after stroke.

Approach

Both participants with chronic stroke (n = 12, stroke group) and those unimpaired (n = 15, control group) were recruited. To investigate fine touch during textile fabric stimulations, full brain EEG recordings (64-channel) were used, as well as the touch sensation questionnaires based on the American Association of Textile Chemists and Colorists (AATCC) Evaluation Procedure 5. During the EEG measurement, relative spectral power (RSP) and EEG topography were used to evaluate the neural responses toward the fabric stimuli. In the subjective questionnaire, the fine touch for fabric stimuli was rated and represented by 13 different sensation parameters. The correlation between the fine touch evaluated by the EEG and the questionnaire was also investigated.

Main results

The neural responses of individuals with fine touch impairments after stroke were characterized by a shifted power spectrum to a higher frequency band, enlarged sensory cortical areas and higher RSP intensity (P < 0.05). Asymmetric neural responses were obtained when stimulating different upper limbs for both unimpaired participants and stroke participants (P < 0.05). The fine touch sensation of the stroke participants was impaired even in the unaffected limb. However, as a result of different neural processes, the correlation between the EEG and the questionnaire was weak (r < 0.2).

Significance

EEG RSP was able to capture the varied cortical responses induced by textile fabric fine touch stimulations related to the fine touch sensory impairment after stroke.

Visualizing Individual Perceptual Differences Using Intuitive Word-Based Input

Numerous studies have investigated the fundamental dimensions of human tactile perceptual space using a wide range of materials. Participants generally touch materials and quantitatively evaluate variations in tactile sensations for pairs of adjectives pertaining to the material properties, such as smooth—rough and soft—hard. Thus, observers evaluate their perceptual experiences one by one in terms of adjective pairs. We previously proposed an alternative method of qualitative evaluation of tactile sensations. Our system can automatically estimate ratings of fundamental tactile properties from single sound-symbolic words. We were able to construct a word-based perceptual space by collecting words that express tactile sensations and applying them to the system. However, to explore individual differences in perceptual spaces, different databases for converting words into ratings of adjective pairs are required for each individual. To address this, in the present study we created an application that can automatically generate an individualized perceptual space by moving only a few words in the initial word-based perceptual space. In addition, we evaluated the efficacy of the application by comparing the tactile perceptual space before and after use.

The Step Response in Isometric Grip Force Tracking: A Model to Characterize Aging- and Stroke-Induced Changes

This paper aimed to construct a model to represent dynamic motor behavior to quantitatively investigate aging- and stroke-induced changes and, thus, to explore the underlying mechanisms of grip control. Grip force tracking tasks were conducted by stroke patients, age-matched healthy controls, and healthy young adults at 25%, 50%, and 75% maximum voluntary contractions (MVC), respectively. Sensorimotor control of the tracking task was modeled as the step response of a second-order system. The results revealed that aging had no significant effect on the parameters of the model, whereas significant differences were found between the age-matched control and stroke groups. Target force level significantly affected the damping ratio and natural frequency in the young group, and significantly affected the damping ratio in the stroke group. Significant correlations were found between the wolf motor function test score and damping ratio, natural frequency, and settling time at 25% MVC. The model could describe the stroke-induced oscillation and slow response in dynamic grip force control and has the potential to be a quantitative evaluation of motor disabilities in clinic.