Movement-related event-related desynchronization in neuropsychiatric disorders

Effects of home-based EEG neurofeedback training as a non-pharmacological intervention for Parkinson's disease

OBJECTIVES

Aberrant movement-related cortical activity has been linked to impaired motor function in Parkinson's disease (PD). Dopaminergic drug treatment can restore these, but dosages and long-term treatment are limited by adverse side-effects. Effective non-pharmacological treatments could help reduce reliance on drugs. This experiment reports the first study of home-based electroencephalographic (EEG) neurofeedback training as a non-pharmacological candidate treatment for PD. Our primary aim was to test the feasibility of our EEG neurofeedback intervention in a home setting.

METHODS

Sixteen people with PD received six home visits comprising symptomology self-reports, a standardised motor assessment, and a precision handgrip force production task while EEG was recorded (visits 1, 2 and 6); and 3 × 1-hr EEG neurofeedback training sessions to supress the EEG mu rhythm before initiating handgrip movements (visits 3 to 5).

RESULTS

Participants successfully learned to self-regulate mu activity, and this appeared to expedite the initiation of precision movements (i.e., time to reach target handgrip force off-medication pre-intervention = 628 ms, off-medication post-intervention = 564 ms). There was no evidence of wider symptomology reduction (e.g., Movement Disorder Society Unified Parkinson's Disease Rating Scale Part III Motor Examination, off-medication pre-intervention = 29.00, off-medication post intervention = 30.07). Interviews indicated that the intervention was well-received.

CONCLUSION

Based on the significant effect of neurofeedback on movement-related cortical activity, positive qualitative reports from participants, and a suggestive benefit to movement initiation, we conclude that home-based neurofeedback for people with PD is a feasible and promising non-pharmacological treatment that warrants further research.

Bilaterally Reduced Rolandic Beta Band Activity in Minor Stroke Patients

Stroke patients with hemiparesis display decreased beta band (13–25 Hz) rolandic activity, correlating to impaired motor function. However, clinically, patients without significant weakness, with small lesions far from sensorimotor cortex, exhibit bilateral decreased motor dexterity and slowed reaction times. We investigate whether these minor stroke patients also display abnormal beta band activity. Magnetoencephalographic (MEG) data were collected from nine minor stroke patients (NIHSS < 4) without significant hemiparesis, at ~1 and ~6 months postinfarct, and eight age-similar controls. Rolandic relative beta power during matching tasks and resting state, and Beta Event Related (De)Synchronization (ERD/ERS) during button press responses were analyzed. Regardless of lesion location, patients had significantly reduced relative beta power and ERS compared to controls. Abnormalities persisted over visits, and were present in both ipsi- and contra-lesional hemispheres, consistent with bilateral impairments in motor dexterity and speed. Minor stroke patients without severe weakness display reduced rolandic beta band activity in both hemispheres, which may be linked to bilaterally impaired dexterity and processing speed, implicating global connectivity dysfunction affecting sensorimotor cortex independent of lesion location. Findings not only illustrate global network disruption after minor stroke, but suggest rolandic beta band activity may be a potential biomarker and treatment target, even for minor stroke patients with small lesions far from sensorimotor areas.

Exploring Self-Paced Embodiable Neurofeedback for Post-stroke Motor Rehabilitation

Neurofeedback-guided motor-imagery training (NF-MIT) has been proposed as a promising intervention following upper limb motor impairment. In this intervention, paretic stroke patients receive online feedback about their brain activity while conducting a motor-imagery (MI) task with the paretic limb. Typically, the feedback provided in NF-MIT protocols is an abstract visual signal based on a fixed trial. Here we developed a self-paced NF-MIT paradigm with an embodiable feedback signal (EFS), which was designed to resemble the content of the mental act as closely as possible. To this end, the feedback was delivered via an embodiable, anthropomorphic robotic hand (RH), which was integrated into a closed-looped EEG-based brain-computer interface (BCI). Whenever the BCI identified a new instance of a hand-flexion or hand-extension imagination by the participant, the RH carried out the corresponding movement with minimum delay. Nine stroke patients and nine healthy participants were instructed to control RH movements as accurately as possible, using mental activity alone. We evaluated the general feasibility of our paradigm on electrophysiological, subjective and performance levels. Regarding electrophysiological measures, individuals showed the predicted event-related desynchronization (ERD) patterns over sensorimotor brain areas. On the subjective level, we found that most individuals integrated the RH into their body scheme. With respect to RH control, none of our participants achieved a high level of control, but most managed to control the RH actions to some degree. Importantly, patients and controls achieved similar performance levels. The results support the view that self-paced embodiable NF-MIT is feasible for stroke patients and can complement classical NF-MIT.

An exploration of neural dynamics of motor imagery for people with amyotrophic lateral sclerosis

OBJECTIVE

Studies of the neuropathological effects of amyotrophic lateral sclerosis (ALS) on the underlying motor system have investigated abnormalities in the magnitude and timing of the event-related desynchronization (ERD) and synchronization (ERS) during motor execution (ME). However, the spatio-spectral-temporal dynamics of these sensorimotor oscillations during motor imagery (MI) have not been fully explored for these patients. This study explores the neural dynamics of sensorimotor oscillations for ALS patients during MI by quantifying ERD/ERS features in frequency, time, and space.

APPROACH

Electroencephalogram (EEG) data were recorded from six patients with ALS and 11 age-matched healthy controls (HC) while performing a MI task. ERD/ERS features were extracted using wavelet-based time-frequency analysis and compared between the two groups to quantify the abnormal neural dynamics of ALS in terms of both time and frequency. Topographic correlation analysis was conducted to compare the localization of MI activity between groups and to identify subject-specific frequencies in the µ and β frequency bands.

MAIN RESULTS

Overall, reduced and delayed ERD was observed for ALS patients, particularly during right-hand MI. ERD features were also correlated with ALS clinical scores, specifically disease duration, bulbar, and cognitive functions.

SIGNIFICANCE

The analyses in this study quantify abnormalities in the magnitude and timing of sensorimotor oscillations for ALS patients during MI tasks. Our findings reveal notable differences between MI and existing results on ME in ALS. The observed alterations are speculated to reflect disruptions in the underlying cortical networks involved in MI functions. Quantifying the neural dynamics of MI plays an important role in the study of EEG-based cortical markers for ALS.

The Impact of Different Visual Feedbacks in User Training on Motor Imagery Control in BCI

The challenges of research into brain–computer interfaces (BCI) include significant individual differences in learning pace and in the effective operation of BCI devices. The use of neurofeedback training is a popular method of improving the effectiveness BCI operation. The purpose of the present study was to determine to what extent it is possible to improve the effectiveness of operation of sensorimotor rhythm-based brain–computer interfaces (SMR-BCI) by supplementing user training with elements modifying the characteristics of visual feedback. Four experimental groups had training designed to reinforce BCI control by: visual feedback in the form of dummy faces expressing emotions (Group 1); flashing the principal elements of visual feedback (Group 2) and giving both visual feedbacks in one condition (Group 3). The fourth group participated in training with no modifications (Group 4). Training consisted of a series of trials where the subjects directed a ball into a basket located to the right or left side of the screen. In Group 1 a schematic image a face, placed on the controlled object, showed various emotions, depending on the accuracy of control. In Group 2, the cue and targets were flashed with different frequency (4 Hz) than the remaining elements visible on the monitor. Both modifications were also used simultaneously in Group 3. SMR activity during the task was recorded before and after the training. In Group 3 there was a significant improvement in SMR control, compared to subjects in Group 2 and 4 (control). Differences between subjects in Groups 1, 2 and 4 (control) were insignificant. This means that relatively small changes in the training procedure may significantly impact the effectiveness of BCI control. Analysis of behavioural data acquired from all participants at training showed greater effectiveness in directing the object towards the right side of the screen. Subjects with the greatest improvement in SMR control showed a significantly lower difference in the accuracy of rightward and leftward movement than others.

Early diagnosis of mild cognitive impairment and Alzheimer's with event-related potentials and event-related desynchronization in N-back working memory tasks

BACKGROUND AND OBJECTIVE

In this study we investigate whether or not event-related potentials (ERP) and/or event-related (de)synchronization (ERD/ERS) can be used to differentiate between 27 healthy elderly (HE), 21 subjects diagnosed with mild cognitive impairment (MCI) and 15 mild Alzheimer's disease (AD) patients.

METHODS

Using 32-channel EEG recordings, we measured ERP responses to a three-level (N-back, N = 0,1,2) visual working memory task. We also performed ERD analysis over the same EEG data, dividing the full-band signal into the well-known delta, theta, alpha, beta and gamma bands. Both ERP and ERD analyses were followed by cluster analysis with correction for multicomparisons whenever significant differences were found between groups.

RESULTS

Regarding ERP (full-band analysis), our findings have shown both patient groups (MCI and AD) with reduced P450 amplitude (compared to HE controls) in the execution of the non-match 1-back task at many scalp electrodes, chiefly at parietal and centro-parietal areas. However, no significant differences were found between MCI and AD in ERP analysis whatever was the task. As for sub-band analyses, ERD/ERS measures revealed that HE subjects elicited consistently greater alpha ERD responses than MCI and AD patients during the 1-back task in the match condition, with all differences located at frontal, central and occipital regions. Moreover, in the non-match condition, it was possible to distinguish between MCI and AD patients when they were performing the 0-back task, with MCI presenting more desynchronization than AD on the theta band at temporal and fronto-temporal areas. In summary, ERD analyses have revealed themselves more valuable than ERP, since they showed significant differences in all three group comparisons: HE vs. MCI, HE vs. AD, and MCI vs. AD.

CONCLUSIONS

Based on these findings, we conclude that ERD responses to working memory (N-back) tasks could be useful not only for early MCI diagnosis or for improved AD diagnosis, but probably also for assessing the likelihood of MCI progression to AD, after further validated by a longitudinal study.

The network sustaining action myoclonus: a MEG-EMG study in patients with EPM1

Background

To explore the cortical network sustaining action myoclonus and to found markers of the resulting functional impairment, we evaluated the distribution of the cortico-muscular coherence (CMC) and the frequency of coherent cortical oscillations with magnetoencephalography (MEG). All patients had EPM1 (Unverricht-Lundborg) disease known to present with prominent and disabling movement-activated myoclonus.

Methods

Using autoregressive models, we evaluated CMC on MEG sensors grouped in regions of interests (ROIs) above the main cortical areas. The movement was a repeated sustained isometric extension of the right hand and right foot. We compared the data obtained in 10 EPM1 patients with those obtained in 10 age-matched controls.

Results

As expected, CMC in beta band was significantly higher in EPM1 patients compared to controls in the ROIs exploring the sensorimotor cortex, but, it was also significantly higher in adjacent ROIs ipsilateral and contralateral to the activated limb. Moreover, the beta-CMC peak occurred at frequencies significantly slower and more stable frequencies in EPM1 patients with respect to controls. The frequency of the beta-CMC peak inversely correlated with the severity of myoclonus.

Conclusions

the high and spatially extended beta-CMC peaking in a restricted range of low-beta frequencies in EPM1 patients, suggest that action myoclonus may result not only from an enhanced local synchronization but also from a specific oscillatory activity involving an expanded neuronal pool. The significant relationship between beta-CMC peak frequency and the severity of the motor impairment can represent a useful neurophysiological marker for the patients’ evaluation and follow-up.

Decoding Upper Limb Movement Attempt From EEG Measurements of the Contralesional Motor Cortex in Chronic Stroke Patients

GOAL

Stroke survivors usually require motor rehabilitation therapy as, due to the lesion, they completely or partially loss mobility in the limbs. Brain-computer interface technology offers the possibility of decoding the attempt to move paretic limbs in real time to improve existing motor rehabilitation. However, a major difficulty for the practical application of the BCI to stroke survivors is that the brain rhythms that encode the motor states might be diminished due to the lesion. This study investigates the continuous decoding of natural attempt to move the paralyzed upper limb in stroke survivors from electroencephalographic signals of the unaffected contralesional motor cortex.

RESULTS

Experiments were carried out with the aid of six severely affected chronic stroke patients performing/attempting self-selected reaching movements of the unaffected/affected upper limb. The electroencephalographic (EEG) analysis showed significant cortical activation on the uninjured motor cortex when moving the contralateral unaffected arm and in the attempt to move the ipsilateral affected arm. Using this activity, significant continuous decoding of movement was obtained in six out of six participants in movements of the unaffected limb, and in four out of six participants in the attempt to move the affected limb.

CONCLUSION

This study showed that it is possible to construct a decoder of the attempt to move the paretic arm for chronic stroke patients using the EEG activity of the healthy contralesional motor cortex.

SIGNIFICANCE

This decoding model could provide to stroke survivors with a natural, easy, and intuitive way to achieve control of BCIs or robot-assisted rehabilitation devices.

Treatment effectiveness of brain-computer interface training for patients with focal hand dystonia: A double-case study

Neuronal mechanism underlying dystonia is poorly understood. Dystonia can be treated with botulinum toxin injections or deep brain stimulation but these methods are not available for every patient therefore we need to consider other methods Our study aimed to develop a novel rehabilitation training using brain-computer interface system that decreases neural overexcitation in the sensorimotor cortex by bypassing brain and external world without the normal neuromuscular pathway. To achieve this purpose, we recorded electroencephalograms (10 channels) and forearm electromyograms (3 channels) from 2 patients with the diagnosis of writer's cramp and healthy control participants as a preliminary experiment. The patients were trained to control amplitude of their electroencephalographic signal using feedback from the brain-computer interface for 1 hour a day and then continued the training twice a month. After the 5-month training, a patient clearly showed reduction of dystonic movement during writing.

Alpha and beta band event-related desynchronization reflects kinematic regularities

The short-lasting attenuation of brain oscillations is termed event-related desynchronization (ERD). It is frequently found in the alpha and beta bands in humans during generation, observation, and imagery of movement and is considered to reflect cortical motor activity and action-perception coupling. The shared information driving ERD in all these motor-related behaviors is unknown. We investigated whether particular laws governing production and perception of curved movement may account for the attenuation of alpha and beta rhythms. Human movement appears to be governed by relatively few kinematic laws of motion. One dominant law in biological motion kinematics is the 2/3 power law (PL), which imposes a strong dependency of movement speed on curvature and is prominent in action-perception coupling. Here we directly examined whether the 2/3 PL elicits ERD during motion observation by characterizing the spatiotemporal signature of ERD. ERDs were measured while human subjects observed a cloud of dots moving along elliptical trajectories either complying with or violating the 2/3 PL. We found that ERD within both frequency bands was consistently stronger, arose faster, and was more widespread while observing motion obeying the 2/3 PL. An activity pattern showing clear 2/3 PL preference and lying within the alpha band was observed exclusively above central motor areas, whereas 2/3 PL preference in the beta band was observed in additional prefrontal-central cortical sites. Our findings reveal that compliance with the 2/3 PL is sufficient to elicit a selective ERD response in the human brain.

Continuous decoding of intention to move from contralesional hemisphere brain oscillations in severely affected chronic stroke patients

Decoding motor information directly from brain activity is essential in robot-assisted rehabilitation systems to promote motor relearning. However, patients who suffered a stroke in the motor cortex have lost brain activity in the injured area, and consequently, mobility in contralateral limbs. Such a loss eliminates the possibility of extracting motor information from brain activity while the patient is undergoing therapy for the affected limb. This work proposes to decode motor information from EEG activity of the contralesional hemisphere in patients who suffered a hemiparetic stroke. Four stroke patients participated in this study and the results proved the feasibility of decoding motor information while patients attempted to move the affected limb.

Modulations of EEG beta power during planning and execution of grasping movements

Although beta oscillations (≈ 13–35 Hz) are often considered as a sensorimotor rhythm, their functional role remains debated. In particular, the modulations of beta power during preparation and execution of complex movements in different contexts were barely investigated. Here, we analysed the beta oscillations recorded with electroencephalography (EEG) in a precued grasping task in which we manipulated two critical parameters: the grip type (precision vs. side grip) and the force (high vs. low force) required to pull an object along a horizontal axis. A cue was presented 3 s before a GO signal and provided full, partial or no information about the two movement parameters. We measured beta power over the centro-parietal areas during movement preparation and execution as well as during object hold. We explored the modulations of power in relation to the amount and type of prior information provided by the cue. We also investigated how beta power was affected by the grip and force parameters.

We observed an increase in beta power around the cue onset followed by a decrease during movement preparation and execution. These modulations were followed by a transient power increase during object hold. This pattern of modulations did not differ between the 4 movement types (2 grips ×2 forces). However, the amount and type of prior information provided by the cue had a significant effect on the beta power during the preparatory delay. We discuss how these results fit with current hypotheses on the functional role of beta oscillations.

The ups and downs of β oscillations in sensorimotor cortex

Since the first descriptions of sensorimotor rhythms by Berger (1929) and by Jasper and Penfield (1949), the potential role of beta oscillations (~13-30 Hz) in the brain has been intensely investigated. We start this review by showing that experimental studies in humans and monkeys have reached a consensus on the facts that sensorimotor beta power is low during movement, transiently increases after movement end (the "beta rebound") and tonically increases during object grasping. Recently, a new surge of studies exploiting more complex sensorimotor tasks including multiple events, such as instructed delay tasks, reveal novel characteristics of beta oscillatory activity. We therefore proceed by critically reviewing also this literature to understand whether modulations of beta oscillations in task epochs other than those during and after movement are consistent across studies, and whether they can be reconciled with a role for beta oscillations in sensorimotor transmission. We indeed find that there are additional processes that also strongly affect sensorimotor beta oscillations, such as visual cue anticipation and processing, fitting with the view that beta oscillations reflect heightened sensorimotor transmission beyond somatosensation. However, there are differences among studies, which may be interpreted more readily if we assume multiple processes, whose effects on the overall measured beta power overlap in time. We conclude that beta oscillations observed in sensorimotor cortex may serve large-scale communication between sensorimotor and other areas and the periphery.

Befunde aus EEG-Untersuchungen zum Mentalen Training

Mentales Training (MT) im Sinne der planmäßig wiederholten Vorstellung eines Bewegungsablaufes ist ein zentraler Gegenstand sportpsychologischer Forschung. Im Hochleistungssport und in der Rehabilitation wird es zur Optimierung von Bewegungen eingesetzt. Einen Erklärungsansatz der Trainingswirkung bietet die Simulationstheorie mit dem zentralen Postulat, dass Bewegungsausführung und -vorstellung gleiche neuronale Strukturen aktivieren (funktionale Äquivalenz). Diese Annahme wurde mittels verschiedener neurophysiologischer Methoden geprüft, die teils zu widersprüchlichen Befunden führten. Die Elektroenzephalographie (EEG) kann unserer Ansicht nach dabei helfen, Lücken im theoretischen Erkenntnisprozess zu schließen. In diesem Artikel geben wir einen Überblick über die aktuelle Befundlage zum Mentalen Training mittels EEG. Es sollen drei wesentliche Vorteile der Methode aufgezeigt werden: (a) das EEG liefert Maße der neurophysiologischen Aktivität mit hoher zeitlicher Auflösung, (b) technische Weiterentwicklungen (drahtlose Hardware, tragbare Ausrüstung) erlauben die notwendige Bewegungsfreiheit für eine Anwendung im Sportkontext und (c) in der Rehabilitation kann die Vorstellung von Bewegungen als mentale Strategie dienen, um eine Neuroprothese auf Basis von Hirnsignalen zu steuern.

Interactive rehabilitation and dynamical analysis of scalp EEG

Electroencephalography (EEG) has been used for decades to measure the brain's electrical activity. Planning and performing a complex movement (e.g., reaching and grasping) requires the coordination of muscles by electrical activity that can be recorded with scalp EEG from relevant regions of the cortex. Prior studies, utilizing motion capture and kinematic measures, have shown that an augmented reality feedback system for rehabilitation of stroke patients can help patients develop new motor plans and perform reaching tasks more accurately. Historically, traditional signal analysis techniques have been utilized to quantify changes in EEG when subjects perform common, simple movements. These techniques have included measures of event-related potentials in the time and frequency domains (e.g., energy and coherence measures). In this study, a more advanced, nonlinear, analysis technique, mutual information (MI), is applied to the EEG to capture the dynamics of functional connections between brain sites. In particular, the cortical activity that results from the planning and execution of novel reach trajectories by normal subjects in an augmented reality system was quantified by using statistically significant MI interactions between brain sites over time. The results show that, during the preparation for as well as the execution of a reach, the functional connectivity of the brain changes in a consistent manner over time, in terms of both the number and strength of cortical connections. A similar analysis of EEG from stroke patients may provide new insights into the functional deficiencies developed in the brain after stroke, and contribute to evaluation, and possibly the design, of novel therapeutic schemes within the framework of rehabilitation and BMI (brain machine interface).

Absence of stimulus-driven synchronization effects on sensory perception in autism: Evidence for local underconnectivity?

Background

A number of neurophysiological characteristics demonstrated in autism share the common theme of under-connectivity in the cerebral cortex. One of the prominent theories of the cause of the dysfunctional connectivity in autism is based on distinct anatomical structures that differ between the autistic and the neurotypical cortex. The functional minicolumn has been identified as occupying a much smaller space in the cortex of people with autism as compared to neurotypical controls, and this aberration in architecture has been proposed to lead to under-connectivity at the local or within-macrocolumn level, which in turn leads to dysfunctional connectivity globally across cortical areas in persons with autism. Numerous reports have indicated reduced synchronization of activity on a large scale in the brains of people with autism. We hypothesized that if the larger-scale aberrant dynamics in autism were due – at least in part – to a widespread propagation of the errors introduced at the level of local connectivity between minicolumns, then aberrations in local functional connectivity should also be detectable in autism.

Methods

Recently, we reported a method for measuring the perceptual changes that are impacted by the presence of synchronized conditioning stimuli on the skin. In this study, the temporal order judgment (TOJ) and temporal discriminative threshold (TDT) of 10 adult autism subjects were assessed both in the absence and presence of synchronized conditioning vibrotactile stimuli.

Results

Our previous report demonstrated that delivering simultaneous and synchronized vibrotactile stimuli to near-adjacent skin sites decreases a subject's ability to determine temporal order by 3 to 4-fold. However, results presented in this report show that subjects with autism do not demonstrate such decreased capacity in temporal order judgment (TOJ) in the presence of synchronized conditioning stimuli, although these same subjects do have TOJ thresholds well above that of controls.

Conclusion

It is speculated that the differences in sensory perceptual capacities in the presence of synchronized conditioning stimuli in autism are due to local under-connectivity in cortex at the minicolumnar organizational level, and that the above-average TOJ thresholds in autism could be attributed to structural differences that have been observed in the frontostrial system of this population.