Enhancement of Event-Related Desynchronization in Motor Imagery Based on Transcranial Electrical Stimulation

Low-frequency sounds combined with motor imagery elicits a transient disruption of force performance: A path to neuromotor reprogramming?

The effectiveness of motor imagery (MI) training on sports performance is now well-documented. Recently, it has been proposed that a single session of MI combined with low frequency sound (LFS) might enhance muscle activation. However, the neural mechanisms underlying this effect remain unknown. We set up a test-retest intervention over the course of 2 consecutive days to evaluate the effect of (i) MI training (MI, n = 20), (ii) MI combined with LFS (MI + LFS, n = 20), and (iii) a control condition (CTRL, n = 20) on force torque produced across repeated maximal voluntary contractions of the quadriceps before (Pretest), after (Posttest) and at +12 h (Retention) post-intervention. We collected the integrated electromyograms of the quadriceps muscles, as well as brain electrical potentials during each experimental intervention. In the CTRL group, total force torque decreased from Pretest to Retention and from Posttest to Retention. By contrast, there was an increase between Posttest and Retention in both MI + LFS and MI groups (both ηP2 = 0.03, p < 0.05). Regression analyses further revealed a negative relationship between force performance and EEG activity in the MI + LFS group only. The data support a transient interference of LFS on cortical activity underlying the priming effects of MI practice on force performance. Findings are discussed in relation to the potential for motor reprogramming through MI combined with LFS.

Apathy scores in Parkinson's disease relate to EEG components in an incentivized motor task

Apathy is one of the most prevalent non-motor symptoms of Parkinson's disease and is characterized by decreased goal-directed behaviour due to a lack of motivation and/or impaired emotional reactivity. Despite its high prevalence, the neurophysiological mechanisms underlying apathy in Parkinson's disease, which may guide neuromodulation interventions, are poorly understood. Here, we investigated the neural oscillatory characteristics of apathy in Parkinson's disease using EEG data recorded during an incentivized motor task. Thirteen Parkinson's disease patients with apathy and 13 Parkinson's disease patients without apathy as well as 12 healthy controls were instructed to squeeze a hand grip device to earn a monetary reward proportional to the grip force they used. Event-related spectral perturbations during the presentation of a reward cue and squeezing were analysed using multiset canonical correlation analysis to detect different orthogonal components of temporally consistent event-related spectral perturbations across trials and participants. The first component, predominantly located over parietal regions, demonstrated suppression of low-beta (12-20 Hz) power (i.e. beta desynchronization) during reward cue presentation that was significantly smaller in Parkinson's disease patients with apathy compared with healthy controls. Unlike traditional event-related spectral perturbation analysis, the beta desynchronization in this component was significantly correlated with clinical apathy scores. Higher monetary rewards resulted in larger beta desynchronization in healthy controls but not Parkinson's disease patients. The second component contained gamma and theta frequencies and demonstrated exaggerated theta (4-8 Hz) power in Parkinson's disease patients with apathy during the reward cue and squeezing compared with healthy controls (HCs), and this was positively correlated with Montreal Cognitive Assessment scores. The third component, over central regions, demonstrated significantly different beta power across groups, with apathetic groups having the lowest beta power. Our results emphasize that altered low-beta and low-theta oscillations are critical for reward processing and motor planning in Parkinson's disease patients with apathy and these may provide a target for non-invasive neuromodulation.

Unraveling Transformative Effects after tDCS and BCI Intervention in Chronic Post-Stroke Patient Rehabilitation-An Alternative Treatment Design Study

Stroke is a debilitating clinical condition resulting from a brain infarction or hemorrhage that poses significant challenges for motor function restoration. Previous studies have shown the potential of applying transcranial direct current stimulation (tDCS) to improve neuroplasticity in patients with neurological diseases or disorders. By modulating the cortical excitability, tDCS can enhance the effects of conventional therapies. While upper-limb recovery has been extensively studied, research on lower limbs is still limited, despite their important role in locomotion, independence, and good quality of life. As the life and social costs due to neuromuscular disability are significant, the relatively low cost, safety, and portability of tDCS devices, combined with low-cost robotic systems, can optimize therapy and reduce rehabilitation costs, increasing access to cutting-edge technologies for neuromuscular rehabilitation. This study explores a novel approach by utilizing the following processes in sequence: tDCS, a motor imagery (MI)-based brain-computer interface (BCI) with virtual reality (VR), and a motorized pedal end-effector. These are applied to enhance the brain plasticity and accelerate the motor recovery of post-stroke patients. The results are particularly relevant for post-stroke patients with severe lower-limb impairments, as the system proposed here provides motor training in a real-time closed-loop design, promoting cortical excitability around the foot area (Cz) while the patient directly commands with his/her brain signals the motorized pedal. This strategy has the potential to significantly improve rehabilitation outcomes. The study design follows an alternating treatment design (ATD), which involves a double-blind approach to measure improvements in both physical function and brain activity in post-stroke patients. The results indicate positive trends in the motor function, coordination, and speed of the affected limb, as well as sensory improvements. The analysis of event-related desynchronization (ERD) from EEG signals reveals significant modulations in Mu, low beta, and high beta rhythms. Although this study does not provide conclusive evidence for the superiority of adjuvant mental practice training over conventional therapy alone, it highlights the need for larger-scale investigations.

A Review on Motor Imagery with Transcranial Alternating Current Stimulation: Bridging Motor and Cognitive Welfare for Patient Rehabilitation

Research has shown the effectiveness of motor imagery in patient motor rehabilitation. Transcranial electrical stimulation has also demonstrated to improve patient motor and non-motor performance. However, mixed findings from motor imagery studies that involved transcranial electrical stimulation suggest that current experimental protocols can be further improved towards a unified design for consistent and effective results. This paper aims to review, with some clinical and neuroscientific findings from literature as support, studies of motor imagery coupled with different types of transcranial electrical stimulation and their experiments onhealthy and patient subjects. This review also includes the cognitive domains of working memory, attention, and fatigue, which are important for designing consistent and effective therapy protocols. Finally, we propose a theoretical all-inclusive framework that synergizes the three cognitive domains with motor imagery and transcranial electrical stimulation for patient rehabilitation, which holds promise of benefiting patients suffering from neuromuscular and cognitive disorders.

Swallow-related Brain Activity in Post-total Laryngectomy Patients: A Case Series Study

Background

Total laryngectomy is a surgical procedure to completely remove the hyoid bone, larynx, and associated muscles as a curative treatment for laryngeal cancer. This leads to insufficient swallowing function with compensative movements of the residual tongue to propel the food bolus to the pharynx and esophagus. However, the neurophysiological mechanisms of compensative swallowing after total laryngectomy remain unclear. Recently, swallowing-related cortical activation such as event-related desynchronization (ERD) during swallowing has been reported in healthy participants and neurological patients with dysphagia. Abnormal ERD elucidates the pathophysiological cortical activities that are related to swallowing. No report has investigated ERD in post-total laryngectomy patients.

Case

We investigated ERD during volitional swallowing using electroencephalography in three male patients after total laryngectomy for laryngeal cancer (age and time after surgery: Case 1, 75 years, 10 years; Case 2, 85 years, 19 years; Case 3, 73 years, 19 years). In video fluorographic swallowing studies, we observed compensatory tongue movements such as posterior-inferior retraction of the tongue and contact on the posterior pharyngeal wall in all three cases. Significant ERD was localized in the bilateral medial sensorimotor areas and the left lateral parietal area in Case 1, in the bilateral frontal and left temporal areas in Case 2, and in the left prefrontal and premotor areas in Case 3.

Discussion

These results suggest that cortical activities related to swallowing might reflect cortical reorganization for modified swallowing movements of residual tongue muscles to compensate for reduced swallowing pressure in patients after total laryngectomy.

Motor-Related Mu/Beta Rhythm in Older Adults: A Comprehensive Review

Mu rhythm, also known as the mu wave, occurs on sensorimotor cortex activity at rest, and the frequency range is defined as 8-13Hz, the same frequency as the alpha band. Mu rhythm is a cortical oscillation that can be recorded from the scalp over the primary sensorimotor cortex by electroencephalogram (EEG) and magnetoencephalography (MEG). The subjects of previous mu/beta rhythm studies ranged widely from infants to young and older adults. Furthermore, these subjects were not only healthy people but also patients with various neurological and psychiatric diseases. However, very few studies have referred to the effect of mu/beta rhythm with aging, and there was no literature review about this theme. It is important to review the details of the characteristics of mu/beta rhythm activity in older adults compared with young adults, focusing on age-related mu rhythm changes. By comprehensive review, we found that, compared with young adults, older adults showed mu/beta activity change in four characteristics during voluntary movement, increased event-related desynchronization (ERD), earlier beginning and later end, symmetric pattern of ERD and increased recruitment of cortical areas, and substantially reduced beta event-related desynchronization (ERS). It was also found that mu/beta rhythm patterns of action observation were changing with aging. Future work is needed in order to investigate not only the localization but also the network of mu/beta rhythm in older adults.

Effects of neurofeedback training combined with transcranial direct current stimulation on motor imagery: A randomized controlled trial

Introduction

Neurofeedback (NFB) training and transcranial direct current stimulation (tDCS) have been shown to individually improve motor imagery (MI) abilities. However, the effect of combining both of them with MI has not been verified. Therefore, the aim of this study was to examine the effect of applying tDCS directly before MI with NFB.

Methods

Participants were divided into an NFB group (n = 10) that performed MI with NFB and an NFB + tDCS group (n = 10) that received tDCS for 10 min before MI with NFB. Both groups performed 60 MI trials with NFB. The MI task was performed 20 times without NFB before and after training, and μ-event-related desynchronization (ERD) and vividness MI were evaluated.

Results

μ-ERD increased significantly in the NFB + tDCS group compared to the NFB group. MI vividness significantly increased before and after training.

Discussion

Transcranial direct current stimulation and NFB modulate different processes with respect to MI ability improvement; hence, their combination might further improve MI performance. The results of this study indicate that the combination of NFB and tDCS for MI is more effective in improving MI abilities than applying them individually.

Effects of Transcranial Direct Current Stimulation on Upper Limb Muscle Strength and Endurance in Healthy Individuals: A Systematic Review and Meta-Analysis

Objective

Whether transcranial direct current stimulation (tDCS) can improve upper limb muscle strength and endurance in healthy subjects is still controversial. This article reviews the relevant literature on the use of tDCS to improve upper limb muscle strength and endurance in healthy individuals.

Methods

We systematically searched the Cochrane Library, PubMed, EMBASE, and the Web of Science until September 4, 2021. Randomized parallel or crossover experimental studies on the effects of tDCS on upper limb muscle strength and endurance in healthy individuals were included. Review Manager 5.3 software was used to evaluate methodological quality and analyze the combined effect of the included literature.

Results

Twelve studies (189 participants) were included in the qualitative synthesis, and nine studies (146 participants) were included in the meta-analysis. Compared with the control group, the tDCS intervention had no significant effect on improving upper limb muscle strength [I² = 0%, 95% CI (−0.79, 0.23), p = 0.98, MD = 0.01]. In this analysis, tDCS had a significant heterogeneity (I² = 87%) in improving upper limb muscle endurance compared with the control group. After the subgroup analysis and the sensitivity analysis, the source of heterogeneity was excluded. The final results showed that tDCS had a significant effect on improving upper limb muscle endurance [I² = 0%, 95% CI (1.91, 4.83), p < 0.00001, MD = 3.37].

Conclusions

tDCS has no significant effect on improvement of upper limb muscle strength, but has a significant effect on improving upper limb endurance performance (especially on the non-dominant side).

Case Report: Event-Related Desynchronization Observed During Volitional Swallow by Electroencephalography Recordings in ALS Patients With Dysphagia

Dysphagia is a severe disability affecting daily life in patients with amyotrophic lateral sclerosis (ALS). It is caused by degeneration of both the bulbar motor neurons and cortical motoneurons projecting to the oropharyngeal areas. A previous report showed decreased event-related desynchronization (ERD) in the medial sensorimotor areas in ALS dysphagic patients. In the process of degeneration, brain reorganization may also be induced in other areas than the sensorimotor cortices. Furthermore, ALS patients with dysphagia often show a longer duration of swallowing. However, there have been no reports on brain activity in other cortical areas and the time course of brain activity during prolonged swallowing in these patients. In this case report, we investigated the distribution and the time course of ERD and corticomuscular coherence (CMC) in the beta (15–25 Hz) frequency band during volitional swallow using electroencephalography (EEG) in two patients with ALS. Case 1 (a 71-year-old man) was diagnosed 2 years before the evaluation. His first symptom was muscle weakness in the right hand; 5 months later, dysphagia developed and exacerbated. Since his dietary intake decreased, he was given an implantable venous access port. Case 2 (a 64-year-old woman) was diagnosed 1 year before the evaluation. Her first symptom was open-nasal voice and dysarthria; 3 months later, dysphagia developed and exacerbated. She was given a percutaneous endoscopic gastrostomy. EEG recordings were performed during volitional swallowing, and the ERD was calculated. The average swallow durations were 7.6 ± 3.0 s in Case 1 and 8.3 ± 2.9 s in Case 2. The significant ERD was localized in the prefrontal and premotor areas and lasted from a few seconds after the initiation of swallowing to the end in Case 1. The ERD was localized in the lateral sensorimotor areas only at the initiation of swallowing in Case 2. CMC was not observed in either case. These results suggest that compensatory processes for cortical motor outputs might depend on individual patients and that a new therapeutic approach using ERD should be developed according to the individuality of ALS patients with dysphagia.

tACS facilitates flickering driving by boosting steady-state visual evoked potentials

Objective.There has become of increasing interest in transcranial alternating current stimulation (tACS) since its inception nearly a decade ago. tACS in modulating brain state is an active area of research and has been demonstrated effective in various neuropsychological and clinical domains. In the visual domain, much effort has been dedicated to brain rhythms and rhythmic stimulation, i.e. tACS. However, less is known about the interplay between the rhythmic stimulation and visual stimulation.Approach.Here, we used steady-state visual evoked potential (SSVEP), induced by flickering driving as a widely used technique for frequency-tagging, to investigate the aftereffect of tACS in healthy human subjects. Seven blocks of 64-channel electroencephalogram were recorded before and after the administration of 20min 10Hz tACS, while subjects performed several blocks of SSVEP tasks. We characterized the physiological properties of tACS aftereffect by comparing and validating the temporal, spatial, spatiotemporal and signal-to-noise ratio (SNR) patterns between and within blocks in real tACS and sham tACS.Main results.Our result revealed that tACS boosted the 10Hz SSVEP significantly. Besides, the aftereffect on SSVEP was mitigated with time and lasted up to 5 min.Significance.Our results demonstrate the feasibility of facilitating the flickering driving by external rhythmic stimulation and open a new possibility to alter the brain state in a direction by noninvasive transcranial brain stimulation.

Event-Related Desynchronization and Corticomuscular Coherence Observed During Volitional Swallow by Electroencephalography Recordings in Humans

Swallowing in humans involves many cortical areas although it is partly mediated by a series of brainstem reflexes. Cortical motor commands are sent to muscles during swallow. Previous works using magnetoencephalography showed event-related desynchronization (ERD) during swallow and corticomuscular coherence (CMC) during tongue movements in the bilateral sensorimotor and motor-related areas. However, there have been few analogous works that use electroencephalography (EEG). We investigated the ERD and CMC in the bilateral sensorimotor, premotor, and inferior prefrontal areas during volitional swallow by EEG recordings in 18 healthy human subjects. As a result, we found a significant ERD in the beta frequency band and CMC in the theta, alpha, and beta frequency bands during swallow in those cortical areas. These results suggest that EEG can detect the desynchronized activity and oscillatory interaction between the cortex and pharyngeal muscles in the bilateral sensorimotor, premotor, and inferior prefrontal areas during volitional swallow in humans.

[Brain-computer interface: from lab to real scene]

Brain-computer interface (BCI) can be summarized as a system that uses online brain information to realize communication between brain and computer. BCI has experienced nearly half a century of development, although it now has a high degree of awareness in the public, but the application of BCI in the actual scene is still very limited. This collection invited some BCI teams in China to report their efforts to promote BCI from laboratory to real scene. This paper summarizes the main contents of the invited papers, and looks forward to the future of BCI.