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Suzuki Y, Jovanovic LI, Fadli RA, Yamanouchi Y, Marquez-Chin C, Popovic MR, Nomura T, Milosevic M. Evidence That Brain-Controlled Functional Electrical Stimulation Could Elicit Targeted Corticospinal Facilitation of Hand Muscles in Healthy Young Adults. Neuromodulation 2023; 26:1612-1621. [PMID: 35088740 DOI: 10.1016/j.neurom.2021.12.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Revised: 11/12/2021] [Accepted: 11/29/2021] [Indexed: 11/17/2022]
Abstract
OBJECTIVES Brain-computer interface (BCI)-controlled functional electrical stimulation (FES) has been used in rehabilitation for improving hand motor function. However, mechanisms of improvements are still not well understood. The objective of this study was to investigate how BCI-controlled FES affects hand muscle corticospinal excitability. MATERIALS AND METHODS A total of 12 healthy young adults were recruited in the study. During BCI calibration, a single electroencephalography channel from the motor cortex and a frequency band were chosen to detect event-related desynchronization (ERD) of cortical oscillatory activity during kinesthetic wrist motor imagery (MI). The MI-based BCI system was used to detect active states on the basis of ERD activity in real time and produce contralateral wrist extension movements through FES of the extensor carpi radialis (ECR) muscle. As a control condition, FES was used to generate wrist extension at random intervals. The two interventions were performed on separate days and lasted 25 minutes. Motor evoked potentials (MEPs) in ECR (intervention target) and flexor carpi radialis (FCR) muscles were elicited through single-pulse transcranial magnetic stimulation of the motor cortex to compare corticospinal excitability before (pre), immediately after (post0), and 30 minutes after (post30) the interventions. RESULTS After the BCI-FES intervention, ECR muscle MEPs were significantly facilitated at post0 and post30 time points compared with before the intervention (pre), whereas there were no changes in the FCR muscle corticospinal excitability. Conversely, after the random FES intervention, both ECR and FCR muscle MEPs were unaffected compared with before the intervention (pre). CONCLUSIONS Our results demonstrated evidence that BCI-FES intervention could elicit muscle-specific short-term corticospinal excitability facilitation of the intervention targeted (ECR) muscle only, whereas randomly applied FES was ineffective in eliciting any changes. Notably, these findings suggest that associative cortical and peripheral activations during BCI-FES can effectively elicit targeted muscle corticospinal excitability facilitation, implying possible rehabilitation mechanisms.
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Affiliation(s)
- Yoshiyuki Suzuki
- Graduate School of Engineering Science, Department of Mechanical Science and Bioengineering, Osaka University, Toyonaka, Osaka, Japan
| | - Lazar I Jovanovic
- Institute of Biomedical Engineering, University of Toronto, Toronto, Ontario, Canada; KITE Research Institute, Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, Canada
| | - Rizaldi A Fadli
- Graduate School of Engineering Science, Department of Mechanical Science and Bioengineering, Osaka University, Toyonaka, Osaka, Japan
| | - Yuki Yamanouchi
- Graduate School of Engineering Science, Department of Mechanical Science and Bioengineering, Osaka University, Toyonaka, Osaka, Japan
| | - Cesar Marquez-Chin
- Institute of Biomedical Engineering, University of Toronto, Toronto, Ontario, Canada; KITE Research Institute, Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, Canada; CRANIA, University Health Network and University of Toronto, Toronto, Ontario, Canada
| | - Milos R Popovic
- Institute of Biomedical Engineering, University of Toronto, Toronto, Ontario, Canada; KITE Research Institute, Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, Canada; CRANIA, University Health Network and University of Toronto, Toronto, Ontario, Canada
| | - Taishin Nomura
- Graduate School of Engineering Science, Department of Mechanical Science and Bioengineering, Osaka University, Toyonaka, Osaka, Japan
| | - Matija Milosevic
- Graduate School of Engineering Science, Department of Mechanical Science and Bioengineering, Osaka University, Toyonaka, Osaka, Japan.
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Repetitive Peripheral Magnetic Stimulation Combined with Motor Imagery Changes Resting-State EEG Activity: A Randomized Controlled Trial. Brain Sci 2022; 12:brainsci12111548. [DOI: 10.3390/brainsci12111548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 11/12/2022] [Accepted: 11/14/2022] [Indexed: 11/16/2022] Open
Abstract
Repetitive peripheral magnetic stimulation is a novel non-invasive technique for applying repetitive magnetic stimulation to the peripheral nerves and muscles. Contrarily, a person imagines that he/she is exercising during motor imagery. Resting-state electroencephalography can evaluate the ability of motor imagery; however, the effects of motor imagery and repetitive peripheral magnetic stimulation on resting-state electroencephalography are unknown. We examined the effects of motor imagery and repetitive peripheral magnetic stimulation on the vividness of motor imagery and resting-state electroencephalography. The participants were divided into a motor imagery group and motor imagery and repetitive peripheral magnetic stimulation group. They performed 60 motor imagery tasks involving wrist dorsiflexion movement. In the motor imagery and repetitive peripheral magnetic stimulation group, we applied repetitive peripheral magnetic stimulation to the extensor carpi radialis longus muscle during motor imagery. We measured the vividness of motor imagery and resting-state electroencephalography before and after the task. Both groups displayed a significant increase in the vividness of motor imagery. The motor imagery and repetitive peripheral magnetic stimulation group exhibited increased β activity in the anterior cingulate cortex by source localization for electroencephalography. Hence, combined motor imagery and repetitive peripheral magnetic stimulation changes the resting-state electroencephalography activity and may promote motor imagery.
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Engler B, Tselmin S, Ziehl D, Weigmann I, Birkenfeld A, Bornstein SR, Barthel A, Drechsel T, Zippenfennig C, Milani T, Perakakis N. The Potential of Electrical Stimulation and Smart Textiles for Patients with Diabetes Mellitus. Horm Metab Res 2022; 54:583-586. [PMID: 35793708 PMCID: PMC9451947 DOI: 10.1055/a-1892-6489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Diabetes mellitus is one of the most frequent diseases in the general population. Electrical stimulation is a treatment modality based on the transmission of electrical pulses into the body that has been widely used for improving wound healing and for managing acute and chronic pain. Here, we discuss recent advancements in electroceuticals and haptic/smart devices for quality of life and present in which patients and how electrical stimulation may prove to be useful for the treatment of diabetes-related complications.
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Affiliation(s)
- Babette Engler
- Department of Medicine III, University Hospital Carl Gustav Carus,
Dresden, Germany
| | - Sergey Tselmin
- Lipidology and Center for Extracorporeal Therapy, Department of
Medicine III, Technical University Dresden, Medical Faculty Carl Gustav Carus,
Dresden, Germany
| | - Doreen Ziehl
- Department of Medicine III, University Hospital Carl Gustav Carus,
Dresden, Germany
| | - Ingo Weigmann
- Department of Medicine III, University Hospital Carl Gustav Carus,
Dresden, Germany
| | - Andreas Birkenfeld
- Department of Medicine III, University Hospital Carl Gustav Carus,
Dresden, Germany
- Medical Clinic IV, University Hospital Tübingen,
Tübingen, Germany
| | - Stefan R. Bornstein
- Department of Medicine, Carl Gustav Carus, University of Dresden,
Dresden, Germany
- Division of Diabetes & Nutritional Sciences, Faculty of Life
Sciences & Medicine, King’s College London, London, United
Kingdom of Great Britain and Northern Ireland
- Klinik für Endokrinologie, Diabetologie und Klinische
Ernährung, University Hospital Zürich, Zurich,
Switzerland
- Correspondence Prof. Stefan R.
Bornstein University of
DresdenDepartment of Medicine, Carl Gustav
CarusFetscherstrasse 7401307
DresdenGermany0049351458595500493514586398
| | - Andreas Barthel
- Department of Medicine III, University Hospital Carl Gustav Carus,
Dresden, Germany
- Medicover, Bochum, Medicover, Bochum, Bochum, Germany
| | - Tina Drechsel
- Department of Human Locomotion, Faculty of Behavioral and Social
Sciences, Institute of Human Movement Science and Health, Chemnitz University of
Technology, Chemnitz, Germany
| | - Claudio Zippenfennig
- Department of Human Locomotion, Faculty of Behavioral and Social
Sciences, Institute of Human Movement Science and Health, Chemnitz University of
Technology, Chemnitz, Germany
| | - Thomas Milani
- Department of Human Locomotion, Faculty of Behavioral and Social
Sciences, Institute of Human Movement Science and Health, Chemnitz University of
Technology, Chemnitz, Germany
| | - Nikolaos Perakakis
- Department of Medicine III, University Hospital Carl Gustav Carus,
Dresden, Germany
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Segning CM, Harvey J, Ezzaidi H, Fernandes KBP, da Silva RA, Ngomo S. Towards the Objective Identification of the Presence of Pain Based on Electroencephalography Signals' Analysis: A Proof-of-Concept. SENSORS (BASEL, SWITZERLAND) 2022; 22:6272. [PMID: 36016032 PMCID: PMC9413583 DOI: 10.3390/s22166272] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 08/17/2022] [Accepted: 08/18/2022] [Indexed: 06/15/2023]
Abstract
This proof-of-concept study explores the potential of developing objective pain identification based on the analysis of electroencephalography (EEG) signals. Data were collected from participants living with chronic fibromyalgia pain (n = 4) and from healthy volunteers (n = 7) submitted to experimental pain by the application of capsaicin cream (1%) on the right upper trapezius. This data collection was conducted in two parts: (1) baseline measures including pain intensity and EEG signals, with the participant at rest; (2) active measures collected under the execution of a visuo-motor task, including EEG signals and the task performance index. The main measure for the objective identification of the presence of pain was the coefficient of variation of the upper envelope (CVUE) of the EEG signal from left fronto-central (FC5) and left temporal (T7) electrodes, in alpha (8-12 Hz), beta (12-30 Hz) and gamma (30-43 Hz) frequency bands. The task performance index was also calculated. CVUE (%) was compared between groups: those with chronic fibromyalgia pain, healthy volunteers with "No pain" and healthy volunteers with experimentally-induced pain. The identification of the presence of pain was determined by an increased CVUE in beta (CVUEβ) from the EEG signals captured at the left FC5 electrode. More specifically, CVUEβ increased up to 20% in the pain condition at rest. In addition, no correlation was found between CVUEβ and pain intensity or the task performance index. These results support the objective identification of the presence of pain based on the quantification of the coefficient of variation of the upper envelope of the EEG signal.
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Affiliation(s)
- Colince Meli Segning
- Department of Applied Sciences, Université du Québec à Chicoutimi (UQAC), Saguenay, QC G7H 2B1, Canada
- Laboratoire de Recherche Biomécanique et Neurophysiologique en Réadaptation Neuro-Musculo-Squelettique (Lab BioNR), Université du Québec à Chicoutimi (UQAC), Saguenay, QC G7H 2B1, Canada
| | | | - Hassan Ezzaidi
- Department of Applied Sciences, Université du Québec à Chicoutimi (UQAC), Saguenay, QC G7H 2B1, Canada
| | - Karen Barros Parron Fernandes
- Department of Health Sciences, Université du Québec à Chicoutimi (UQAC), Saguenay, QC G7H 2B1, Canada
- School of Medicine, Pontifical Catholic University of Parana (PUCPR), 485-Hipica, Londrina 86072-360, PR, Brazil
| | - Rubens A. da Silva
- Laboratoire de Recherche Biomécanique et Neurophysiologique en Réadaptation Neuro-Musculo-Squelettique (Lab BioNR), Université du Québec à Chicoutimi (UQAC), Saguenay, QC G7H 2B1, Canada
- Department of Health Sciences, Université du Québec à Chicoutimi (UQAC), Saguenay, QC G7H 2B1, Canada
- Centre Intégré de Santé et Services Sociaux du Saguenay-Lac-Saint-Jean (CIUSSS SLSJ), Specialized Geriatrics, Services-Hôpital de La Baie, Saguenay, QC G7H 7K9, Canada
| | - Suzy Ngomo
- Laboratoire de Recherche Biomécanique et Neurophysiologique en Réadaptation Neuro-Musculo-Squelettique (Lab BioNR), Université du Québec à Chicoutimi (UQAC), Saguenay, QC G7H 2B1, Canada
- Department of Health Sciences, Université du Québec à Chicoutimi (UQAC), Saguenay, QC G7H 2B1, Canada
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Zhou H, Han R, Chen L, Zhang Z, Zhang X, Wang J, Liu Z, Huang D. Effect of Implantable Electrical Nerve Stimulation on Cortical Dynamics in Patients With Herpes Zoster–Related Pain: A Prospective Pilot Study. Front Bioeng Biotechnol 2022; 10:862353. [PMID: 35651542 PMCID: PMC9149165 DOI: 10.3389/fbioe.2022.862353] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 04/08/2022] [Indexed: 02/05/2023] Open
Abstract
Implantable electrical nerve stimulation (ENS) can be used to treat neuropathic pain caused by herpes zoster. However, little is known about the cortical mechanism underlying neuromodulation therapy. Here, we recorded a 16-channel resting-state electroencephalogram after the application of spinal cord stimulation (n = 5) or peripheral nerve stimulation (n = 3). The neuromodulatory effect was compared between specific conditions (active ENS versus rest). To capture the cortical responses of ENS, spectral power and coherence analysis were performed. ENS therapy achieved satisfactory relief from pain with a mean visual analog scale score reduction of 5.9 ± 1.1. The spectral analysis indicated that theta and alpha oscillations increased significantly during active neuromodulation compared with the resting state. Furthermore, ENS administration significantly increased frontal-frontal coherence in the alpha band. Our findings demonstrate that, despite methodological differences, both spinal cord and peripheral nerve stimulation can induce cortical alpha oscillation changes in patients with zoster-related pain. The dynamic change may, in part, mediate the analgesic effect of ENS on herpes zoster–related pain.
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Affiliation(s)
- Haocheng Zhou
- Department of Pain, The Third Xiangya Hospital and Institute of Pain Medicine, Central South University, Changsha, China
- Hunan Key Laboratory of Brain Homeostasis, Central South University, Changsha, China
| | - Rui Han
- Department of Pain, The Third Xiangya Hospital and Institute of Pain Medicine, Central South University, Changsha, China
| | - Li Chen
- Department of Pain, The Third Xiangya Hospital and Institute of Pain Medicine, Central South University, Changsha, China
| | - Zhen Zhang
- Department of Pain, The Third Xiangya Hospital and Institute of Pain Medicine, Central South University, Changsha, China
| | - Xiaobo Zhang
- Department of Orthopedics, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Jianlong Wang
- Department of Orthopedics, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Zuoliang Liu
- Department of Critical Care Medicine, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Dong Huang
- Department of Pain, The Third Xiangya Hospital and Institute of Pain Medicine, Central South University, Changsha, China
- Hunan Key Laboratory of Brain Homeostasis, Central South University, Changsha, China
- *Correspondence: Dong Huang,
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Scano A, Mira RM, Gabbrielli G, Molteni F, Terekhov V. Whole-Body Adaptive Functional Electrical Stimulation Kinesitherapy Can Promote the Restoring of Physiological Muscle Synergies for Neurological Patients. SENSORS 2022; 22:s22041443. [PMID: 35214345 PMCID: PMC8877830 DOI: 10.3390/s22041443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 01/28/2022] [Accepted: 02/11/2022] [Indexed: 12/03/2022]
Abstract
Background: Neurological diseases and traumas are major factors that may reduce motor functionality. Functional electrical stimulation is a technique that helps regain motor function, assisting patients in daily life activities and in rehabilitation practices. In this study, we evaluated the efficacy of a treatment based on whole-body Adaptive Functional Electrical Stimulation Kinesitherapy (AFESK™) with the use of muscle synergies, a well-established method for evaluation of motor coordination. The evaluation is performed on retrospectively gathered data of neurological patients executing whole-body movements before and after AFESK-based treatments. Methods: Twenty-four chronic neurologic patients and 9 healthy subjects were recruited in this study. The patient group was further subdivided in 3 subgroups: hemiplegic, tetraplegic and paraplegic. All patients underwent two acquisition sessions: before treatment and after a FES based rehabilitation treatment at the VIKTOR Physio Lab. Patients followed whole-body exercise protocols tailored to their needs. The control group of healthy subjects performed all movements in a single session and provided reference data for evaluating patients’ performance. sEMG was recorded on relevant muscles and muscle synergies were extracted for each patient’s EMG data and then compared to the ones extracted from the healthy volunteers. To evaluate the effect of the treatment, the motricity index was measured and patients’ extracted synergies were compared to the control group before and after treatment. Results: After the treatment, patients’ motricity index increased for many of the screened body segments. Muscle synergies were more similar to those of healthy people. Globally, the normalized synergy similarity in respect to the control group was 0.50 before the treatment and 0.60 after (p < 0.001), with improvements for each subgroup of patients. Conclusions: AFESK treatment induced favorable changes in muscle activation patterns in chronic neurologic patients, partially restoring muscular patterns similar to healthy people. The evaluation of the synergic relationships of muscle activity when performing test exercises allows to assess the results of rehabilitation measures in patients with impaired locomotor functions.
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Affiliation(s)
- Alessandro Scano
- UOS STIIMA Lecco—Human-Centered, Smart & Safe, Living Environment, Italian National Research Council (CNR), Via Previati 1/E, 23900 Lecco, Italy;
- Correspondence: (A.S.); (V.T.)
| | - Robert Mihai Mira
- UOS STIIMA Lecco—Human-Centered, Smart & Safe, Living Environment, Italian National Research Council (CNR), Via Previati 1/E, 23900 Lecco, Italy;
| | | | - Franco Molteni
- Villa Beretta Rehabilitation Center, Ospedale Valduce, Via N. Sauro 17, 23845 Costa Masnaga, Italy;
| | - Viktor Terekhov
- VIKTOR S.r.l.—Via Pasubio, 5, 24044 Dalmine (BG), Italy;
- Correspondence: (A.S.); (V.T.)
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