The interaction between changes of muscle activation and cortical network dynamics during isometric elbow contraction: a sEMG and fNIRS study

Corticomuscular coupling alterations during elbow isometric contraction correlated with clinical scores: an fNIRS-sEMG study in stroke survivors

The study aimed to investigate changes in corticomuscular coupling during elbow flexion and extension in stroke survivors using functional near-infrared spectroscopy (fNIRS) and surface electromyography (sEMG), and to evaluate the relationship between coupling characteristics and clinical assessment scales. This study recruited 12 stroke survivors and 12 age-matched healthy subjects, and further divided the subjects into the affected side group, healthy-side group and age-matched healthy group. They performed elbow flexion and extension tasks at 30% and 70% of the maximum voluntary contraction (MVC). The cerebral blood flow dynamics of the bilateral prefrontal cortex, motor cortex, and occipital lobe, along with sEMG signals from the biceps brachii and triceps brachii, were simultaneously recorded. At matched force levels, the fuzzy approximate entropy values of both agonist and antagonistic muscles were notably lower in the affected group compared to the healthy group (P < 0.05). The effective connectivity from the ipsilateral motor cortex to the contralateral motor cortex during elbow movements in the affected group showed a meaningful positive association with the Fugl-Meyer Assessment (FMA) scale. Additionally, the transfer entropy from the contralateral motor cortex to the agonist muscle in the affected group demonstrated a significant positive correlation with the FMA scale at 70% MVC during elbow flexion. This research identified differences in intermuscular coordination, brain network connectivity, and corticomuscular coupling between stroke survivors and healthy individuals during motor tasks and our findings suggest that it can serve as a potential quantitative marker for assessing upper limb motor function post-stroke. The relationship between these characteristics and clinical scales signifies potential quantitative assessment parameters for stroke rehabilitation, underscoring the importance of exploring corticomuscular coupling in the recovery of upper limb motor function post-stroke.

Brain near-infrared study of upstairs movement after anterior cruciate ligament reconstruction

Objective

After anterior cruciate ligament reconstruction (ACLR), patients undergo specific changes in body and specific brain functions, which stem from neuroplasticity. In this study, we employed functional near-infrared spectroscopy (fNIRS) to investigate the characteristics of brain activation in patients after ACLR during a repetitive upstairs task, and compared them with healthy individuals. We aimed to provide a new theoretical basis for the changes in brain function after ACLR and neurorehabilitation of sports injuries.

Methods

A total of 27 patients who undergoing right ACLR and 27 healthy controls participated in the study. We utilized fNIRS to collect hemodynamic data from the frontal and parietal cortices of both groups during a repetitive upstairs task. The Lysholm scale assessment was conducted prior to the commencement of the task. Compare the functional characteristics of the brain in post-operative patients and healthy subjects during upstairs tasks, and examine the functional differences between the two groups.

Results

(1) Patients undergoing ACLR demonstrated a significant negative change in β-value for Channel 25 (t = 4.0461, p = 0.0067) during the repetitive upstairs task. (2) In contrast, the healthy control group exhibited a significant increase in β-value across Channel 6 (t = -3.0489, p = 0.0066), Channel 7 (t = -4.5723, p = 0.0002), Channel 8 (t = -3.0089, p = 0.0072), Channel 13 (t = -2.8789, p = 0.0096), Channel 20 (t = -3.4200, p = 0.0029), and Channel 33 (t = -2.6974, p = 0.0143) during the task. (3) When compared to the healthy control group, ACLR patients exhibited a significant negative change in β-value for Channel 25 (t = 2.7583, p = 0.0089), and Channel 33 (t = 3.0618, p = 0.0040).

Conclusion

Patients with ACLR exhibited a significant negative activation in a specific brain region during upward stair movements. In contrast, healthy individuals demonstrated activation in two particular brain areas during the same task. Interventions targeting these brain regions may represent a novel rehabilitation approach. This provides a theoretical basis for incorporating fNIRS into the rehabilitation assessment of patients undergoing ACLR. In conclusion, this study provides a theoretical framework for potential interventions and assessments of brain regions following ACLR.

Hybrid Functional Near-Infrared Spectroscopy System and Electromyography for Prosthetic Knee Control

The increasing number of individuals with limb loss worldwide highlights the need for advancements in prosthetic knee technology. To improve control and quality of life, integrating brain-computer communication with motor imagery offers a promising solution. This study introduces a hybrid system that combines electromyography (EMG) and functional near-infrared spectroscopy (fNIRS) to address these limitations and enhance the control of knee movements for individuals with above-knee amputations. The study involved an experiment with nine healthy male participants, consisting of two sessions: real execution and imagined execution using motor imagery. The OpenBCI Cyton board collected EMG signals corresponding to the desired movements, while fNIRS monitored brain activity in the prefrontal and motor cortices. The analysis of the simultaneous measurement of the muscular and hemodynamic responses demonstrated that combining these data sources significantly improved the classification accuracy compared to using each dataset alone. The results showed that integrating both the EMG and fNIRS data consistently achieved a higher classification accuracy. More specifically, the Support Vector Machine performed the best during the motor imagery tasks, with an average accuracy of 49.61%, while the Linear Discriminant Analysis excelled in the real execution tasks, achieving an average accuracy of 89.67%. This research validates the feasibility of using a hybrid approach with EMG and fNIRS to enable prosthetic knee control through motor imagery, representing a significant advancement potential in prosthetic technology.

Early screening of post-stroke fall risk: A simultaneous multimodal fNIRs-EMG study

BACKGROUND

Stroke is the third-leading cause of death and disability, and poststroke falls (PSF) are common at all stages after stroke and could even lead to injuries or death. Brain information from functional near-infrared spectroscopy (fNIRs) may precede conventional imaging and clinical symptoms but has not been systematically considered in PSF risk prediction. This study investigated the difference in brain activation between stroke patients and healthy subjects, and this study was aimed to explore fNIRs biomarkers for early screening of PSF risk by comparing the brain activation in patients at and not at PSF risk.

METHODS

In this study, we explored the differences in brain activation and connectivity between stroke and healthy subjects by synchronizing the detection of fNIRs and EMG tests during simple (usual sit-to-stand) and difficult tasks (sit-to-stand based on EMG feedback). Thereby further screened for neuroimaging biomarkers for early prediction of PSF risk by comparing brain activation variability in poststroke patients at and not at fall risk during simple and difficult tasks. The area under the ROC curve (AUROC), sensitivity, and specificity were used to compare the diagnostic effect.

RESULTS

A total of 40 patients (22 not at and 18 at PSF risk) and 38 healthy subjects were enrolled. As the difficulty of standing task increased, stroke patients compared with healthy subjects further increased the activation of the unaffected side of supplementary motor area (H-SMA) and dorsolateral prefrontal cortex-Brodmann area 46 (H-DLFC-BA46) but were unable to increase functional connectivity (Group*Task: p < 0.05). More importantly, the novel finding showed that hyperactivation of the H-SMA during a simple standing task was a valid fNIRs predictor of PSF risk [AUROC 0.74, p = 0.010, sensitivity 77.8%, specificity 63.6%].

CONCLUSIONS

This study provided novel evidence that fNIR-derived biomarkers could early predict PSF risk that can facilitate the widespread use of real-time assessment tools in early screening and rehabilitation. Meanwhile, this study demonstrated that the higher brain activation and inability to increase the brain functional connectivity in stroke patients during difficult task indicated the inefficient use of brain resources.

Cerebral hemodynamics underlying ankle force sense modulated by high-definition transcranial direct current stimulation

This study aimed to investigate the effects of high-definition transcranial direct current stimulation on ankle force sense and underlying cerebral hemodynamics. Sixteen healthy adults (8 males and 8 females) were recruited in the study. Each participant received either real or sham high-definition transcranial direct current stimulation interventions in a randomly assigned order on 2 visits. An isokinetic dynamometer was used to assess the force sense of the dominant ankle; while the functional near-infrared spectroscopy was employed to monitor the hemodynamics of the sensorimotor cortex. Two-way analyses of variance with repeated measures and Pearson correlation analyses were performed. The results showed that the absolute error and root mean square error of ankle force sense dropped more after real stimulation than after sham stimulation (dropped by 23.4% vs. 14.9% for absolute error, and 20.0% vs. 10.2% for root mean square error). The supplementary motor area activation significantly increased after real high-definition transcranial direct current stimulation. The decrease in interhemispheric functional connectivity within the Brodmann's areas 6 was significantly correlated with ankle force sense improvement after real high-definition transcranial direct current stimulation. In conclusion, high-definition transcranial direct current stimulation can be used as a potential intervention for improving ankle force sense. Changes in cerebral hemodynamics could be one of the explanations for the energetic effect of high-definition transcranial direct current stimulation.

Effects of different frequencies music on cortical responses and functional connectivity in patients with minimal conscious state

The objective of this study was to investigate brain activation and functional network patterns during musical interventions in different frequency bands using functional near-infrared spectroscopy, and to provide a basis for more effective music therapy strategy selection for patients in minimally conscious state (MCS). Twenty six MCS patients and 20 healthy people were given music intervention with low frequency (31-180 Hz), medium frequency (180-4k Hz), and high frequency (4k-22k Hz) audio. In MCS patients, low frequency music intervention induced activation of left prefrontal cortex and left primary sensory cortex (S1), also a left-hemisphere lateralization effect of dorsolateral prefrontal cortex (DLPFC). And the functional connectivity of right DLPFC-right S1 was significantly improved by high frequency music intervention. The low frequency and high frequency music may contribute more than medium frequency music to the recovery of consciousness. This study also validated the effectiveness of fNIRS in studies of brain function in MCS patients.

Upper limb motor assessment for stroke with force, muscle activation and interhemispheric balance indices based on sEMG and fNIRS

Introduction

Upper limb rehabilitation assessment plays a pivotal role in the recovery process of stroke patients. The current clinical assessment tools often rely on subjective judgments of healthcare professionals. Some existing research studies have utilized physiological signals for quantitative assessments. However, most studies used single index to assess the motor functions of upper limb. The fusion of surface electromyography (sEMG) and functional near-infrared spectroscopy (fNIRS) presents an innovative approach, offering simultaneous insights into the central and peripheral nervous systems.

Methods

We concurrently collected sEMG signals and brain hemodynamic signals during bilateral elbow flexion in 15 stroke patients with subacute and chronic stages and 15 healthy control subjects. The sEMG signals were analyzed to obtain muscle synergy based indexes including synergy stability index (SSI), closeness of individual vector (CV) and closeness of time profile (CT). The fNIRS signals were calculated to extract laterality index (LI).

Results

The primary findings were that CV, SSI and LI in posterior motor cortex (PMC) and primary motor cortex (M1) on the affected hemisphere of stroke patients were significantly lower than those in the control group (p < 0.05). Moreover, CV, SSI and LI in PMC were also significantly different between affected and unaffected upper limb movements (p < 0.05). Furthermore, a linear regression model was used to predict the value of the Fugl-Meyer score of upper limb (FMul) (R2 = 0.860, p < 0.001).

Discussion

This study established a linear regression model using force, CV, and LI features to predict FMul scale values, which suggests that the combination of force, sEMG and fNIRS hold promise as a novel method for assessing stroke rehabilitation.

Cortical activity associated with focal muscle vibration applied directly to the affected forearm flexor muscle in post-stroke patients: an fNIRS study

Objective

The purpose of this study was to utilize functional near-infrared spectroscopy (fNIRS) to identify changes in cortical activity caused by focal muscle vibration (FMV), which was directly administered to the affected forearm flexor muscles of hemiplegic stroke patients. Additionally, the study aimed to investigate the correlation between these changes and the clinical characteristics of the patients, thereby expanding the understanding of potential neurophysiological mechanisms linked to these effects.

Methods

Twenty-two stroke patients with right hemiplegia who were admitted to our ward for rehabilitation were selected for this study. The fNIRS data were collected from subjects using a block-design paradigm. Subsequently, the collected data were analyzed using the NirSpark software to determine the mean Oxyhemoglobin (Hbo) concentrations for each cortical region of interest (ROI) in the task and rest states for every subject. The stimulation task was FMV (frequency 60 Hz, amplitude 6 mm) directly applied to belly of the flexor carpi radialis muscle (FCR) on the affected side. Hbo was measured in six regions of interest (ROIs) in the cerebral cortex, which included the bilateral prefrontal cortex (PFC), sensorimotor cortex (SMC), and occipital cortex (OC). The clinical characteristics of the patients were assessed concurrently, including Lovett's 6-level muscle strength assessment, clinical muscle tone assessment, the upper extremity function items of the Fugl-Meyer Assessment (FMA-UE), Bruunstrom staging scale (BRS), and Modified Barthel index (MBI). Statistical analyses were conducted to determine the activation in the ROIs and to comprehend its correlation with the clinical characteristics of the patients.

Results

Statistical analysis revealed that, except for right OC, there were statistically significant differences between the mean Hbo in the task state and rest state for bilateral SMC, PFC, and left OC. A positive correlation was observed between the muscle strength of the affected wrist flexor group and the change values of Hbo (Hbo-CV), as well as the beta values in the left SMC, PFC, and OC. However, no statistical correlation was found between muscle strength and Hbo-CV or beta values in the right SMC, PFC, and OC. The BRS of the affected upper limb exhibited a positive correlation with the Hbo-CV or beta values in the left SMC and PFC. In contrast, no statistical correlation was observed in the right SMC, PFC, and bilateral OC. No significant correlation was found between the muscle tone of the affected wrist flexor group, FMA-UE, MBI, and Hbo-CV or beta values of cortical ROIs.

Conclusion

FMV-evoked sensory stimulation applied directly to the FCR belly on the paralyzed side activated additional brain cortices, including bilateral PFC and ipsilesional OC, along with bilateral SMC in stroke patients. However, the clinical characteristics of the patients were only correlated with the intensity of ipsilesional SMC and PFC activation. The results of this study provide neurophysiological theoretical support for the expanded clinical application of FMV.

Transcutaneous auricular vagus nerve stimulation on upper limb motor function with stroke: a functional near-infrared spectroscopy pilot study

BACKGROUND

Transcutaneous auricular vagus nerve stimulation (taVNS) emerges as a promising neuromodulatory technique. However, taVNS uses left ear stimulation in stroke survivors with either left or right hemiparesis. Understanding its influence on the cortical responses is pivotal for optimizing post-stroke rehabilitation protocols.

OBJECTIVE

The primary objective of this study was to elucidate the influence of taVNS on cortical responses in stroke patients presenting with either left or right hemiparesis and to discern its potential ramifications for upper limb rehabilitative processes.

METHODS

We employed functional near-infrared spectroscopy (fNIRS) to ascertain patterns of cerebral activation in stroke patients as they engaged in a "block transfer" task. Additionally, the Lateralization Index (LI) was utilized to quantify the lateralization dynamics of cerebral functions.

RESULTS

In patients exhibiting left-side hemiplegia, there was a notable increase in activation within the pre-motor and supplementary motor cortex (PMC-SMC) of the unaffected hemisphere as well as in the left Broca area. Conversely, those with right-side hemiplegia displayed heightened activation in the affected primary somatosensory cortex (PSC) region following treatment.Significantly, taVNS markedly amplified cerebral activation, with a pronounced impact on the left motor cortical network across both cohorts. Intriguingly, the LI showcased consistency, suggesting a harmonized enhancement across both compromised and uncompromised cerebral regions.

CONCLUSION

TaVNS can significantly bolster the activation within compromised cerebral territories, particularly within the left motor cortical domain, without destabilizing cerebral lateralization. TaVNS could play a pivotal role in enhancing upper limb functional restoration post-stroke through precise neuromodulatory and neuroplastic interventions.