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Remsik AB, van Kan PLE, Gloe S, Gjini K, Williams L, Nair V, Caldera K, Williams JC, Prabhakaran V. BCI-FES With Multimodal Feedback for Motor Recovery Poststroke. Front Hum Neurosci 2022; 16:725715. [PMID: 35874158 PMCID: PMC9296822 DOI: 10.3389/fnhum.2022.725715] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Accepted: 05/26/2022] [Indexed: 01/31/2023] Open
Abstract
An increasing number of research teams are investigating the efficacy of brain-computer interface (BCI)-mediated interventions for promoting motor recovery following stroke. A growing body of evidence suggests that of the various BCI designs, most effective are those that deliver functional electrical stimulation (FES) of upper extremity (UE) muscles contingent on movement intent. More specifically, BCI-FES interventions utilize algorithms that isolate motor signals-user-generated intent-to-move neural activity recorded from cerebral cortical motor areas-to drive electrical stimulation of individual muscles or muscle synergies. BCI-FES interventions aim to recover sensorimotor function of an impaired extremity by facilitating and/or inducing long-term motor learning-related neuroplastic changes in appropriate control circuitry. We developed a non-invasive, electroencephalogram (EEG)-based BCI-FES system that delivers closed-loop neural activity-triggered electrical stimulation of targeted distal muscles while providing the user with multimodal sensory feedback. This BCI-FES system consists of three components: (1) EEG acquisition and signal processing to extract real-time volitional and task-dependent neural command signals from cerebral cortical motor areas, (2) FES of muscles of the impaired hand contingent on the motor cortical neural command signals, and (3) multimodal sensory feedback associated with performance of the behavioral task, including visual information, linked activation of somatosensory afferents through intact sensorimotor circuits, and electro-tactile stimulation of the tongue. In this report, we describe device parameters and intervention protocols of our BCI-FES system which, combined with standard physical rehabilitation approaches, has proven efficacious in treating UE motor impairment in stroke survivors, regardless of level of impairment and chronicity.
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Affiliation(s)
- Alexander B. Remsik
- Department of Radiology, University of Wisconsin–Madison, Madison, WI, United States
- School of Medicine and Public Health, Institute for Clinical and Translational Research, University of Wisconsin–Madison, Madison, WI, United States
- Department of Kinesiology, University of Wisconsin–Madison, Madison, WI, United States
| | - Peter L. E. van Kan
- Department of Kinesiology, University of Wisconsin–Madison, Madison, WI, United States
- Neuroscience Training Program, University of Wisconsin–Madison, Madison, WI, United States
| | - Shawna Gloe
- Department of Radiology, University of Wisconsin–Madison, Madison, WI, United States
| | - Klevest Gjini
- Department of Radiology, University of Wisconsin–Madison, Madison, WI, United States
- Department of Neurology, University of Wisconsin–Madison, Madison, WI, United States
| | - Leroy Williams
- Department of Radiology, University of Wisconsin–Madison, Madison, WI, United States
- Department of Educational Psychology, University of Wisconsin–Madison, Madison, WI, United States
| | - Veena Nair
- Department of Radiology, University of Wisconsin–Madison, Madison, WI, United States
| | - Kristin Caldera
- Department of Orthopedics and Rehabilitation, School of Medicine and Public Health, University of Wisconsin–Madison, Madison, WI, United States
| | - Justin C. Williams
- Department of Biomedical Engineering, University of Wisconsin–Madison, Madison, WI, United States
- Department of Neurological Surgery, School of Medicine and Public Health, University of Wisconsin–Madison, Madison, WI, United States
| | - Vivek Prabhakaran
- Department of Radiology, University of Wisconsin–Madison, Madison, WI, United States
- Neuroscience Training Program, University of Wisconsin–Madison, Madison, WI, United States
- Department of Neurology, University of Wisconsin–Madison, Madison, WI, United States
- Department of Psychiatry, School of Medicine and Public Health, University of Wisconsin–Madison, Madison, WI, United States
- Medical Scientist Training Program, School of Medicine and Public Health, University of Wisconsin–Madison, Madison, WI, United States
- Department of Psychology, University of Wisconsin–Madison, Madison, WI, United States
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