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Martinez-Peon D, Garcia-Hernandez NV, Benavides-Bravo FG, Parra-Vega V. Characterization and classification of kinesthetic motor imagery levels. J Neural Eng 2024; 21:046024. [PMID: 38963179 DOI: 10.1088/1741-2552/ad5f27] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 06/27/2024] [Indexed: 07/05/2024]
Abstract
Objective.Kinesthetic Motor Imagery (KMI) represents a robust brain paradigm intended for electroencephalography (EEG)-based commands in brain-computer interfaces (BCIs). However, ensuring high accuracy in multi-command execution remains challenging, with data from C3 and C4 electrodes reaching up to 92% accuracy. This paper aims to characterize and classify EEG-based KMI of multilevel muscle contraction without relying on primary motor cortex signals.Approach.A new method based on Hurst exponents is introduced to characterize EEG signals of multilevel KMI of muscle contraction from electrodes placed on the premotor, dorsolateral prefrontal, and inferior parietal cortices. EEG signals were recorded during a hand-grip task at four levels of muscle contraction (0%, 10%, 40%, and 70% of the maximal isometric voluntary contraction). The task was executed under two conditions: first, physically, to train subjects in achieving muscle contraction at each level, followed by mental imagery under the KMI paradigm for each contraction level. EMG signals were recorded in both conditions to correlate muscle contraction execution, whether correct or null accurately. Independent component analysis (ICA) maps EEG signals from the sensor to the source space for preprocessing. For characterization, three algorithms based on Hurst exponents were used: the original (HO), using partitions (HRS), and applying semivariogram (HV). Finally, seven classifiers were used: Bayes network (BN), naive Bayes (NB), support vector machine (SVM), random forest (RF), random tree (RT), multilayer perceptron (MP), and k-nearest neighbors (kNN).Main results.A combination of the three Hurst characterization algorithms produced the highest average accuracy of 96.42% from kNN, followed by MP (92.85%), SVM (92.85%), NB (91.07%), RF (91.07%), BN (91.07%), and RT (80.35%). of 96.42% for kNN.Significance.Results show the feasibility of KMI multilevel muscle contraction detection and, thus, the viability of non-binary EEG-based BCI applications without using signals from the motor cortex.
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Affiliation(s)
- D Martinez-Peon
- Department of Electrical and Electronic Engineering, National Technological Institute of Mexico (TecNM)- IT Nuevo Leon, Guadalupe, Mexico
| | - N V Garcia-Hernandez
- National Council on Science and Technology, Saltillo, Mexico
- Robotics and Advanced Manufacturing, Research Center for Advanced Studies (Cinvestav), Saltillo, Mexico
| | - F G Benavides-Bravo
- Department of Basic Sciences, National Technological Institute of Mexico (TecNM)- IT Nuevo Leon, Guadalupe, Mexico
| | - V Parra-Vega
- Robotics and Advanced Manufacturing, Research Center for Advanced Studies (Cinvestav), Saltillo, Mexico
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2
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Seebacher B, Helmlinger B, Pinter D, Heschl B, Ehling R, Hechenberger S, Reindl M, Khalil M, Enzinger C, Deisenhammer F, Brenneis Md C. Actual and Imagined Music-Cued Gait Training in People with Multiple Sclerosis: A Double-Blind Randomized Parallel Multicenter Trial. Neurorehabil Neural Repair 2024:15459683241260724. [PMID: 38873806 DOI: 10.1177/15459683241260724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2024]
Abstract
BACKGROUND Actual and imagined cued gait trainings have not been compared in people with multiple sclerosis (MS). OBJECTIVE To analyze the effects of cued motor imagery (CMI), cued gait training (CGT), and combined CMI and cued gait training (CMI-CGT) on motor, cognitive, and emotional functioning, and health-related quality of life in people with MS. METHODS In this double-blind randomized parallel-group multicenter trial, people with MS were randomized (1:1:1) to CMI, CMI-CGT, or CGT for 30 minutes, 4×/week for 4 weeks. Patients practiced at home, using recorded instructions, and supported by ≥6 phone calls. Data were collected at weeks 0, 4, and 13. Co-primary outcomes were walking speed and distance, analyzed by intention-to-treat. Secondary outcomes were global cognitive impairment, anxiety, depression, suicidality, fatigue, HRQoL, motor imagery ability, music-induced motivation, pleasure and arousal, self-efficacy, and cognitive function. Adverse events and falls were continuously monitored. RESULTS Of 1559 screened patients, 132 were randomized: 44 to CMI, 44 to CMI-CGT, and 44 to CGT. None of the interventions demonstrated superiority in influencing walking speed or distance, with negligible effects on walking speed (η2 = 0.019) and distance (η2 = 0.005) observed in the between-group comparison. Improvements in walking speed and walking distance over time corresponded to large effects for CMI, CMI-CGT, and CGT (η2 = 0.348 and η2 = 0.454 respectively). No severe study-related adverse events were reported. CONCLUSIONS CMI-GT did not lead to improved walking speed and distance compared with CMI and CGT alone in people with MS. Lack of a true control group represents a study limitation. TRIAL REGISTRATION German Clinical Trials Register, DRKS00023978.
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Affiliation(s)
- Barbara Seebacher
- Clinical Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
- Department of Rehabilitation Science, Clinic for Rehabilitation Muenster, Austria
- Karl Landsteiner Institute for Interdisciplinary Rehabilitation Research, Muenster, Austria
| | - Birgit Helmlinger
- Department of Neurology, Research Unit for Neuronal Plasticity and Repair, Medical University of Graz, Graz, Steiermark, Austria
- Department of Neurology, Medical University of Graz, Graz, Austria
| | - Daniela Pinter
- Department of Neurology, Research Unit for Neuronal Plasticity and Repair, Medical University of Graz, Graz, Steiermark, Austria
- Department of Neurology, Medical University of Graz, Graz, Austria
| | - Bettina Heschl
- Department of Neurology, Medical University of Graz, Graz, Austria
| | - Rainer Ehling
- Karl Landsteiner Institute for Interdisciplinary Rehabilitation Research, Muenster, Austria
- Department of Neurology, Clinic for Rehabilitation Muenster, Muenster, Austria
| | - Stefanie Hechenberger
- Department of Neurology, Research Unit for Neuronal Plasticity and Repair, Medical University of Graz, Graz, Steiermark, Austria
| | - Markus Reindl
- Clinical Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Michael Khalil
- Department of Neurology, Medical University of Graz, Graz, Austria
- Neurology Biomarker Research Unit, Medical University of Graz, Graz, Steiermark, Austria
| | - Christian Enzinger
- Department of Neurology, Research Unit for Neuronal Plasticity and Repair, Medical University of Graz, Graz, Steiermark, Austria
- Department of Neurology, Medical University of Graz, Graz, Austria
- Department of Radiology, Division of Neuroradiology, Vascular and Interventional Radiology, Medical University of Graz, Graz, Steiermark, Austria
| | - Florian Deisenhammer
- Clinical Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Christian Brenneis Md
- Karl Landsteiner Institute for Interdisciplinary Rehabilitation Research, Muenster, Austria
- Department of Neurology, Clinic for Rehabilitation Muenster, Muenster, Austria
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3
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Tacchino A, Pedullà L, Podda J, Monti Bragadin M, Battaglia MA, Bisio A, Bove M, Brichetto G. Motor imagery has a priming effect on motor execution in people with multiple sclerosis. Front Hum Neurosci 2023; 17:1179789. [PMID: 37746058 PMCID: PMC10512728 DOI: 10.3389/fnhum.2023.1179789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Accepted: 08/18/2023] [Indexed: 09/26/2023] Open
Abstract
Priming is a learning process that refers to behavioral changes caused by previous exposure to a similar stimulus. Motor imagery (MI), which involves the mental rehearsal of action representations in working memory without engaging in actual execution, could be a strategy for priming the motor system. This study investigates whether MI primes action execution in Multiple Sclerosis (MS). Here, 17 people with MS (PwMS) and 19 healthy subjects (HS), all right-handed and good imaginers, performed as accurately and quickly as possible, with a pencil, actual or mental pointing movements between targets of small (1.0 × 1.0 cm) or large (1.5 × 1.5 cm) size. In actual trials, they completed five pointing cycles between the left and right targets, whereas in mental trials, the first 4 cycles were imagined while the fifth was actually executed. The fifth cycle was introduced to assess the MI priming effect on actual execution. All conditions, presented randomly, were performed with both dominant (i.e., right) and non-dominant arms. Analysis of the duration of the first 4 cycles in both actual and mental trials confirmed previous findings, showing isochrony in HS with both arms and significantly faster mental than actual movements (anisochrony) in PwMS (p < 0.01) [time (s); HS right: actual: 4.23 ± 0.15, mental: 4.36 ± 0.16; left: actual: 4.32 ± 0.15, mental: 4.43 ± 0.18; PwMS right: actual: 5.85 ± 0.16, mental: 5.99 ± 0.21; left: actual: 6.68 ± 0.20, mental: 5.94 ± 0.23]; anisochrony in PwMS was present when the task was performed with the non-dominant arm. Of note, temporal analysis of the fifth actual cycle showed no differences between actual and mental trials for HS with both arms, whereas in PwMS the fifth actual cycle was significantly faster after the four actual cycles for the non-dominant arm (p < 0.05) [time (s); HS right: actual: 1.03 ± 0.04, mental: 1.03 ± 0.03; left: actual: 1.08 ± 0.04, mental: 1.05 ± 0.03; PwMS right: actual: 1.48 ± 0.04, mental: 1.48 ± 0.06; left: actual: 1.66 ± 0.05, mental: 1.48 ± 0.06]. These results seem to suggest that a few mental repetitions of an action might be sufficient to exert a priming effect on the actual execution of the same action in PwMS. This would indicate further investigation of the potential use of MI as a new motor-cognitive tool for MS neurorehabilitation.
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Affiliation(s)
- Andrea Tacchino
- Scientific Research Area, Italian Multiple Sclerosis Foundation, Genoa, Italy
| | - Ludovico Pedullà
- Scientific Research Area, Italian Multiple Sclerosis Foundation, Genoa, Italy
| | - Jessica Podda
- Scientific Research Area, Italian Multiple Sclerosis Foundation, Genoa, Italy
| | | | - Mario Alberto Battaglia
- Department of Physiopathology, Experimental Medicine, and Public Health, University of Siena, Siena, Italy
| | - Ambra Bisio
- Section of Human Physiology, Department of Experimental Medicine, University of Genoa, Genoa, Italy
- Centro Polifunzionale di Scienze Motorie, University of Genoa, Genoa, Italy
| | - Marco Bove
- Section of Human Physiology, Department of Experimental Medicine, University of Genoa, Genoa, Italy
- IRCCS Policlinico San Martino, Genoa, Italy
| | - Giampaolo Brichetto
- Scientific Research Area, Italian Multiple Sclerosis Foundation, Genoa, Italy
- AISM Rehabilitation Service, Italian Multiple Sclerosis Society, Genoa, Italy
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Ikejiri I, Murakami T, Yamauchi R, Yamaguchi H, Kodama T. Development and Validation of the Body Cognition Assessment System. Brain Sci 2023; 13:1237. [PMID: 37759838 PMCID: PMC10526995 DOI: 10.3390/brainsci13091237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Revised: 08/21/2023] [Accepted: 08/22/2023] [Indexed: 09/29/2023] Open
Abstract
Body awareness, which comprises the sense of body possession and action ownership, is essential for the adaptive movement of humans in response to external environments. However, existing body cognition assessments include many overt elements of cognitive functional activity, but no assessment captures the latent body cognition necessary for exercise and daily life activities. Therefore, this study aimed to devise a body cognition assessment system (BCAS) to examine the functional basis of body cognition in healthy participants and investigate its usefulness. The BCAS was used to assess body cognition on three occasions, and BCAS values were calculated from the results of the assessment. The intraclass correlation coefficient (ICC) was used to determine reproducibility. Neural activity in the brain during somatocognition assessment while conducting the BCAS was measured by electroencephalogram. Moreover, the functional basis for somatocognition with the BCAS was also investigated. The results demonstrated that the BCAS values varied across the three administrations (ICC (1.3) = 0.372), and changes in the state of neural activity in the brain were observed. The results suggest that assessment using the BCAS may be a new indicator of ever-changing body cognition.
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Affiliation(s)
- Ikumi Ikejiri
- Graduate School of Health Sciences, Kyoto Tachibana University, Kyoto 607-8175, Japan; (I.I.); (R.Y.)
| | - Takashi Murakami
- Kyoto Tachibana University, Kyoto 607-8175, Japan; (T.M.); (H.Y.)
- Department of Rehabilitation, Kyoto Hakauikai Hospital, Kyoto 603-8041, Japan
| | - Ryosuke Yamauchi
- Graduate School of Health Sciences, Kyoto Tachibana University, Kyoto 607-8175, Japan; (I.I.); (R.Y.)
| | - Hideaki Yamaguchi
- Kyoto Tachibana University, Kyoto 607-8175, Japan; (T.M.); (H.Y.)
- CARETECH plus, Nagoya 462-0847, Japan
| | - Takayuki Kodama
- Graduate School of Health Sciences, Kyoto Tachibana University, Kyoto 607-8175, Japan; (I.I.); (R.Y.)
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Seebacher B, Reindl M, Kahraman T. Factors and strategies affecting motor imagery ability in people with multiple sclerosis: a systematic review. Physiotherapy 2023; 118:64-78. [PMID: 36184292 DOI: 10.1016/j.physio.2022.09.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2021] [Revised: 07/03/2022] [Accepted: 09/13/2022] [Indexed: 02/04/2023]
Abstract
BACKGROUND Although growing evidence has shown beneficial effects of motor imagery (MI) training in different populations including people with multiple sclerosis (pwMS), not all patients with neurological diseases may benefit from MI. OBJECTIVES To investigate factors and strategies affecting and enhancing MI ability in pwMS. DATA SOURCES MEDLINE/PubMed, PsycINFO, Cochrane Library, Scopus, EMBASE, EBSCOhost, Web of Science and REHABDATA databases, clinical trials registries, dissertation repositories, study bibliographies and internet search engines were searched through August 2021. STUDY SELECTION Any study type but single case studies investigating factors or strategies contributing to MI ability in pwMS. STUDY APPRAISAL AND SYNTHESIS METHODS Risk of bias (RoB) was assessed using the Joanna Briggs Institute Checklist for Case-Control and Analytical Cross-Sectional Studies and Cochrane RoB-2.0 tool for randomised trials. A qualitative synthesis was performed summarising main results. RESULTS Eight databases, 4 trial registries, 9 dissertation repositories, and 1 internet search engine were searched. Fourteen studies including 366 pwMS and 236 healthy controls were included. Most frequently, cognitive impairment was reported as a negative factor influencing MI ability in pwMS. Other negative factors were cognitive fatigue and disability. Inconsistent evidence was found on the contribution of MS phenotype, anxiety, and depression. Using a theory-based MI framework and familiarisation to MI and external cueing may enhance MI ability. LIMITATIONS Eligible studies were highly heterogeneous. CONCLUSION AND IMPLICATIONS OF KEY FINDINGS Cognitive impairment, cognitive fatigue and disability negatively influence MI ability in pwMS. Visual and/or auditory cueing of MI are strategies for facilitating MI ability. SYSTEMATIC REVIEW REGISTRATION NUMBER PROSPERO CRD42020173081 CONTRIBUTION OF THE PAPER.
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Affiliation(s)
- Barbara Seebacher
- Clinical Department of Neurology, Medical University of Innsbruck, Austria; Department of Rehabilitation Research, Rehab Centre Münster, Austria.
| | - Markus Reindl
- Clinical Department of Neurology, Medical University of Innsbruck, Austria
| | - Turhan Kahraman
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Izmir Katip Celebi University, Turkey
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Zhang H, Liu Q, Yao M, Zhang Z, Chen X, Luo H, Ruan L, Liu T, Chen Y, Ruan J. Neural oscillations during acupuncture imagery partially parallel that of real needling. Front Neurosci 2023; 17:1123466. [PMID: 37090802 PMCID: PMC10115979 DOI: 10.3389/fnins.2023.1123466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Accepted: 03/20/2023] [Indexed: 04/25/2023] Open
Abstract
Introduction Tasks involving mental practice, relying on the cognitive rehearsal of physical motors or other activities, have been reported to have similar patterns of brain activity to overt execution. In this study, we introduced a novel imagination task called, acupuncture imagery and aimed to investigate the neural oscillations during acupuncture imagery. Methods Healthy volunteers were guided to watch a video of real needling in the left and right KI3 (Taixi point). The subjects were then asked to perform tasks to keep their thoughts in three 1-min states alternately: resting state, needling imagery left KI3, and needling imagery right KI3. Another group experienced real needling in the right KI3. A 31-channel-electroencephalography was synchronously recorded for each subject. Microstate analyses were performed to depict the brain dynamics during these tasks. Results Compared to the resting state, both acupuncture needling imagination and real needling in KI3 could introduce significant changes in neural dynamic oscillations. Moreover, the parameters involving microstate A of needling imagery in the right KI3 showed similar changes as real needling in the right KI3. Discussion These results confirm that needling imagination and real needling have similar brain activation patterns. Needling imagery may change brain network activity and play a role in neural regulation. Further studies are needed to explore the effects of acupuncture imagery and the potential application of acupuncture imagery in disease recovery.
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Affiliation(s)
- Hao Zhang
- Department of Neurology, The Affiliated Hospital of Southwest Medical University, Luzhou, China
- Laboratory of Neurological Diseases and Brain Function, Luzhou, China
| | - Qingxia Liu
- Department of Neurology, The Affiliated Hospital of Southwest Medical University, Luzhou, China
- Laboratory of Neurological Diseases and Brain Function, Luzhou, China
| | - Menglin Yao
- School of Integrated Traditional Chinese and Western Medicine, Southwest Medical University, Luzhou, China
| | - Zhiling Zhang
- School of Integrated Traditional Chinese and Western Medicine, Southwest Medical University, Luzhou, China
| | - Xiu Chen
- Department of Neurology, The Affiliated Hospital of Southwest Medical University, Luzhou, China
- Laboratory of Neurological Diseases and Brain Function, Luzhou, China
| | - Hua Luo
- Department of Neurology, The Affiliated Hospital of Southwest Medical University, Luzhou, China
- Laboratory of Neurological Diseases and Brain Function, Luzhou, China
| | - Lili Ruan
- Department of Neurology, The Affiliated Hospital of Southwest Medical University, Luzhou, China
- Laboratory of Neurological Diseases and Brain Function, Luzhou, China
| | - Tianpeng Liu
- Shaanxi University of Chinese Medicine, Xianyang, China
| | - Yingshuang Chen
- School of Integrated Traditional Chinese and Western Medicine, Southwest Medical University, Luzhou, China
| | - Jianghai Ruan
- Department of Neurology, The Affiliated Hospital of Southwest Medical University, Luzhou, China
- Laboratory of Neurological Diseases and Brain Function, Luzhou, China
- *Correspondence: Jianghai Ruan,
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Paolucci T, de Sire A, Agostini F, Bernetti A, Salomè A, Altieri M, Di Piero V, Ammendolia A, Mangone M, Paoloni M. Efficacy of interoceptive and embodied rehabilitative training protocol in patients with mild multiple sclerosis: A randomized controlled trial. Front Neurol 2022; 13:1095180. [PMID: 36619928 PMCID: PMC9812570 DOI: 10.3389/fneur.2022.1095180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Accepted: 12/02/2022] [Indexed: 12/24/2022] Open
Abstract
Introduction The aim of this randomized controlled trial was to evaluate the effect of an embodied rehabilitative protocol, in improving interoceptive awareness respect balance and motor performance in patients with mild multiple sclerosis (pwMS). Methods In this study patients with relapsing-remitting multiple sclerosis were enrolled. The rehabilitative treatment group (TG) participated in an embodied physiotherapy program consisting of 8 one-hour sessions in groups of 4 patients at a time, 1 per week and 2 one-hour sessions of neuro-cognitive exercise in single session during the rehabilitation program. All pwMS underwent a clinical assessment to measure the interoception sense for the Multidimensional Assessment of Interoceptive Awareness scale, balance for the Tinetti Mobility test and stabilometry, quality of life for the Short Form Health Survey-12 and body image perception for Trunk Appearance Perception Scale and Body Image Scale. All previous scales and tests were performed at baseline (T0), at the end of treatment (T1) and after 2 months of follow up (T2). Results Sixty patients were enrolled and randomized into two groups: TG (n = 30), aged 43.0 ± 10.2 years, and a control/waiting list (WLG) group (n = 30), aged 40.7 ± 10.4 years. Statistically significant improvements in interoceptive awareness, body image perception, balance and quality of life were reported in TG versus WLG (p < 0.05). Discussion This study suggests that enhancing interoceptive awareness could improve postural balance. Future studies with a larger sample of patients will be needed to better quantify the effects of an embodied rehabilitation.
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Affiliation(s)
- Teresa Paolucci
- Department of Medical, Oral and Biotechnological Sciences (DSMOB), Physical Medicine and Rehabilitation Unit, G. D'Annunzio University, Chieti-Pescara, Chieti, Italy
| | - Alessandro de Sire
- Department of Medical and Surgical Sciences, University of Catanzaro “Magna Graecia”, Catanzaro, Italy,*Correspondence: Alessandro de Sire ✉
| | - Francesco Agostini
- Department of Anatomical and Histological Sciences, Legal Medicine and Orthopedics', Sapienza University, Rome, Italy,Department of Neurological and Rehabilitation Science, IRCCS San Raffaele, Rome, Italy
| | - Andrea Bernetti
- Department of Anatomical and Histological Sciences, Legal Medicine and Orthopedics', Sapienza University, Rome, Italy
| | - Angela Salomè
- Department of Anatomical and Histological Sciences, Legal Medicine and Orthopedics', Sapienza University, Rome, Italy
| | - Marta Altieri
- Multiple Sclerosis Center, Sapienza University, Rome, Italy
| | | | - Antonio Ammendolia
- Department of Medical and Surgical Sciences, University of Catanzaro “Magna Graecia”, Catanzaro, Italy
| | - Massimiliano Mangone
- Department of Anatomical and Histological Sciences, Legal Medicine and Orthopedics', Sapienza University, Rome, Italy
| | - Marco Paoloni
- Department of Anatomical and Histological Sciences, Legal Medicine and Orthopedics', Sapienza University, Rome, Italy
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Rizzi B, Nuresi C, Rovacchi C, Bacchini M, Savi F, Falco L, Schianchi L, Scaglioni A, Ciracì C, Costantino C, Buccino G. Motor imagery and action-observation in neurorehabilitation: A study protocol in Parkinson's disease patients. Front Neurol 2022; 13:990618. [PMID: 36267882 PMCID: PMC9577192 DOI: 10.3389/fneur.2022.990618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2022] [Accepted: 09/15/2022] [Indexed: 11/13/2022] Open
Abstract
IntroductionAction Observation Treatment (AOT) and Motor Imagery (MI) represent very promising cognitive strategies in neuro-rehabilitation. This study aims to compare the effectiveness of the two cognitive strategies, taken alone or combined, in Parkinson's disease patients.Material and methodsThis study is designed as a prospective randomized controlled trial, with four arms. We estimated a sample size of 64 patients (16 in each treatment group) to be able to detect an effect size of F = 0.4 with a statistical significance of 0.05. Primary outcomes will be functional gains in the FIM and UPDRS scales. Secondary outcome measure will be functional gain as revealed by kinematic parameters measured at Gait Analysis.DiscussionThe results of this trial will provide insights into the use of AOT and MI, taken alone or combined, in the rehabilitation of Parkinson's disease patients.Ethics and disseminationThe study protocol was approved by the Ethics Committee of the Don Gnocchi Foundation. The study will be conducted in accordance with the 1996 World Medical Association guidelines and according to good clinical practice. The study has been registered on clinicaltrial.gov under the following code: AOTPRFDG. Dissemination will include both submission of the study to peer-reviewed journals and discussion of the study protocol at conferences.
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Affiliation(s)
- Beatrice Rizzi
- Department of Neuromotor Rehabilitation, Santa Maria ai Servi Center, Don Carlo Gnocchi Foundation ONLUS, Parma, Italy
| | - Christian Nuresi
- Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Claudio Rovacchi
- Department of Neuromotor Rehabilitation, Santa Maria ai Servi Center, Don Carlo Gnocchi Foundation ONLUS, Parma, Italy
| | - Massimo Bacchini
- Department of Neuromotor Rehabilitation, Santa Maria ai Servi Center, Don Carlo Gnocchi Foundation ONLUS, Parma, Italy
| | - Federica Savi
- Department of Neuromotor Rehabilitation, Santa Maria ai Servi Center, Don Carlo Gnocchi Foundation ONLUS, Parma, Italy
| | - Lucia Falco
- Department of Neuromotor Rehabilitation, Santa Maria ai Servi Center, Don Carlo Gnocchi Foundation ONLUS, Parma, Italy
| | - Luca Schianchi
- Department of Neuromotor Rehabilitation, Santa Maria ai Servi Center, Don Carlo Gnocchi Foundation ONLUS, Parma, Italy
| | - Augusto Scaglioni
- Department of Neuromotor Rehabilitation, Santa Maria ai Servi Center, Don Carlo Gnocchi Foundation ONLUS, Parma, Italy
| | - Chiara Ciracì
- Department of Neuromotor Rehabilitation, Santa Maria ai Servi Center, Don Carlo Gnocchi Foundation ONLUS, Parma, Italy
| | - Cosimo Costantino
- Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Giovanni Buccino
- Division of Neuroscience, Università Vita-Salute San Raffaele, Milan, Italy
- IRCCS San Raffaele, Milan, Italy
- *Correspondence: Giovanni Buccino
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Galli J, Garofalo G, Brunetti S, Loi E, Portesi M, Pelizzari G, Rossi A, Fazzi E, Buccino G. Children with Cerebral Palsy can imagine actions like their normally developed peers. Front Neurol 2022; 13:951152. [PMID: 36147045 PMCID: PMC9488128 DOI: 10.3389/fneur.2022.951152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Accepted: 08/01/2022] [Indexed: 11/16/2022] Open
Abstract
The present study aimed at assessing whether children with Cerebral Palsy (CP) can imagine object directed actions similarly to their normally developed peers. We asked children with CP (n = 12) and paired healthy controls (n = 12) to imagine in first person perspective eight daily actions, after observing them through videoclips presented on a computer screen. During motor imagery (MI) children were interrupted at a specific timepoint (e.g., at 2.5 s) from the start. Two frames extracted from the videoclips were then presented on the screen. One of the two depicted the correct timepoint at which the imagined action was interrupted, while the other represented an earlier or later timepoint. Children had to respond by pressing the key associated to the correct frame. Children also underwent VMIQ-2 questionnaire. Both groups performed similarly in the questionnaire and in the requested task, where they showed the same error rate. Errors mainly concerned the later frame, suggesting a similar strategy to solve the task in the two groups. The results support the view that children with CP can imagine actions similarly to their normally developed peers. This encourages the use of MI as a rehabilitative tool in children with motor impairment.
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Affiliation(s)
- Jessica Galli
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
- Unit of Child Neurology and Psychiatry, ASST Spedali Civili of Brescia, Brescia, Italy
| | - Gioacchino Garofalo
- Division of Neuroscience, Università Vita-Salute San Raffaele, Milano, Italy
- IRCCS San Raffaele, Milano, Italy
| | - Sara Brunetti
- Unit of Child Neurology and Psychiatry, ASST Spedali Civili of Brescia, Brescia, Italy
| | - Erika Loi
- Unit of Child Neurology and Psychiatry, ASST Spedali Civili of Brescia, Brescia, Italy
- Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
| | - Michela Portesi
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Giovanni Pelizzari
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Andrea Rossi
- Unit of Child Neurology and Psychiatry, ASST Spedali Civili of Brescia, Brescia, Italy
| | - Elisa Fazzi
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
- Unit of Child Neurology and Psychiatry, ASST Spedali Civili of Brescia, Brescia, Italy
| | - Giovanni Buccino
- Division of Neuroscience, Università Vita-Salute San Raffaele, Milano, Italy
- IRCCS San Raffaele, Milano, Italy
- *Correspondence: Giovanni Buccino
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Abstract
Studies conducted in healthy subjects have clearly shown that different hypnotic susceptibility, which is measured by scales, is associated with different functional equivalence between imagery and perception/action (FE), cortical excitability, and information processing. Of note, physiological differences among individuals with high (highs), medium (mediums), and low hypnotizability scores (lows) have been observed in the ordinary state of consciousness, thus independently from the induction of the hypnotic state, and in the absence of specific suggestions. The potential role of hypnotic assessment and its relevance to neurological diseases have not been fully explored. While current knowledge and therapies allow a better survival rate, there is a constant need to optimize rehabilitation treatments and quality of life. The aim of this paper is to provide an overview of hypnotizability-related features and, specifically, to discuss the hypothesis that the stronger FE, the different mode of information processing, and the greater proneness to control pain and the activity of the immune system observed in individuals with medium-to-high hypnotizability scores have potential applications to neurology. Current evidence of the outcome of treatments based on hypnotic induction and suggestions administration is not consistent, mainly owing to the small sample size in clinical trials and inadequate control groups. We propose that hypnotic assessment may be feasible in clinical routine and give additional cues into the treatment and rehabilitation of neurological diseases.
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Zhang K, Xu G, Du C, Liang R, Han C, Zheng X, Zhang S, Wang J, Tian P, Jia Y. Enhancement of capability for motor imagery using vestibular imbalance stimulation during brain computer interface. J Neural Eng 2021; 18. [PMID: 34571497 DOI: 10.1088/1741-2552/ac2a6f] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Accepted: 09/27/2021] [Indexed: 01/07/2023]
Abstract
Objective.Motor imagery (MI), based on the theory of mirror neurons and neuroplasticity, can promote motor cortical activation in neurorehabilitation. The strategy of MI based on brain-computer interface (BCI) has been used in rehabilitation training and daily assistance for patients with hemiplegia in recent years. However, it is difficult to maintain the consistency and timeliness of receiving external stimulation to neural activation in most subjects owing to the high variability of electroencephalogram (EEG) representation across trials/subjects. Moreover, in practical application, MI-BCI cannot highly activate the motor cortex and provide stable interaction owing to the weakness of the EEG feature and lack of an effective mode of activation.Approach.In this study, a novel hybrid BCI paradigm based on MI and vestibular stimulation motor imagery (VSMI) was proposed to enhance the capability of feature response for MI. Twelve subjects participated in a group of controlled experiments containing VSMI and MI. Three indicators, namely, activation degree, timeliness, and classification accuracy, were adopted to evaluate the performance of the task.Main results.Vestibular stimulation could significantly strengthen the suppression ofαandβbands of contralateral brain regions during MI, that is, enhance the activation degree of the motor cortex (p< 0.01). Compared with MI, the timeliness of EEG feature-response achieved obvious improvements in VSMI experiments. Moreover, the averaged classification accuracy of VSMI and MI was 80.56% and 69.38%, respectively.Significance.The experimental results indicate that specific vestibular activity contributes to the oscillations of the motor cortex and has a positive effect on spontaneous imagery, which provides a novel MI paradigm and enables the preliminary exploration of sensorimotor integration of MI.
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Affiliation(s)
- Kai Zhang
- School of Mechanical Engineering, Xi'an Jiaotong University, Xi'an, People's Republic of China
| | - Guanghua Xu
- School of Mechanical Engineering, Xi'an Jiaotong University, Xi'an, People's Republic of China.,State Key Laboratory for Manufacturing Systems Engineering, Xi'an Jiaotong University, Xi'an, People's Republic of China
| | - Chenghang Du
- School of Mechanical Engineering, Xi'an Jiaotong University, Xi'an, People's Republic of China
| | - Renghao Liang
- School of Mechanical Engineering, Xi'an Jiaotong University, Xi'an, People's Republic of China
| | - Chenchen Han
- School of Mechanical Engineering, Xi'an Jiaotong University, Xi'an, People's Republic of China
| | - Xiaowei Zheng
- School of Mechanical Engineering, Xi'an Jiaotong University, Xi'an, People's Republic of China
| | - Sicong Zhang
- School of Mechanical Engineering, Xi'an Jiaotong University, Xi'an, People's Republic of China
| | - Jiahuan Wang
- School of Mechanical Engineering, Xi'an Jiaotong University, Xi'an, People's Republic of China
| | - Peiyuan Tian
- School of Mechanical Engineering, Xi'an Jiaotong University, Xi'an, People's Republic of China
| | - Yaguang Jia
- School of Mechanical Engineering, Xi'an Jiaotong University, Xi'an, People's Republic of China
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Motor Imagery of Walking in People Living with and without Multiple Sclerosis: A Cross-Sectional Comparison of Mental Chronometry. Brain Sci 2021; 11:brainsci11091131. [PMID: 34573154 PMCID: PMC8466525 DOI: 10.3390/brainsci11091131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 08/19/2021] [Accepted: 08/24/2021] [Indexed: 11/21/2022] Open
Abstract
Motor imagery represents the ability to simulate anticipated movements mentally prior to their actual execution and has been proposed as a tool to assess both individuals’ perception of task difficulty as well as their perception of their own abilities. People with multiple sclerosis (pwMS) often present with motor and cognitive dysfunction, which may negatively affect motor imagery. In this cross-sectional study, we explored differences in motor imagery of walking performance between pwMS (n = 20, age = 57.1 (SD = 8.6) years, 55% female) and age- and sex-matched healthy controls (n = 20, age = 58.1 (SD = 7.0) years, 60% female). Participants underwent mental chronometry assessments, a subset of motor imagery, which evaluated the difference between imagined and actual walking times across four walking tasks of increasing difficulty (i.e., large/narrow-width walkway with/without obstacles). Raw and absolute mental chronometry (A-MC) measures were recorded in single- (ST) and dual-task (DT) conditions. In ST conditions, pwMS had higher A-MC scores across all walking conditions (p ≤ 0.031, η2 ≥ 0.119), indicating lower motor imagery ability compared to healthy controls. During DT, all participants tended to underestimate their walking ability (3.38 ± 6.72 to 5.63 ± 9.17 s). However, after physical practice, pwMS were less able to adjust their imagined walking performance compared to healthy controls. In pwMS, A-MC scores were correlated with measures of balance confidence (ρ = −0.629, p < 0.01) and the self-reported expanded disability status scale (ρ = 0.747, p < 0.01). While the current study revealed that pwMS have lower motor imagery of walking performance compared to healthy individuals, further work is necessary to examine how the disassociation between mental chronometry and actual performance relates to quality of life and well-being.
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