Abstract
BackgroundWe developed an electroencephalogram-based brain computer interface system to modulate functional electrical stimulation (FES) to the affected tibialis anterior muscle in a stroke patient. The intensity of FES current increased in a stepwise manner when the event-related desynchronization (ERD) reflecting motor intent was continuously detected from the primary cortical motor area.MethodsWe tested the feasibility of the ERD-modulated FES system in comparison with FES without ERD modulation. The stroke patient who presented with severe hemiparesis attempted to perform dorsiflexion of the paralyzed ankle during which FES was applied either with or without ERD modulation.ResultsAfter 20 minutes of training, the range of movement at the ankle joint and the electromyography amplitude of the affected tibialis anterior muscle were significantly increased following the ERD-modulated FES compared with the FES alone.ConclusionsThe proposed rehabilitation technique using ERD-modulated FES for stroke patients was feasible. The system holds potentials to improve the limb function and to benefit stroke patients.
Highlights
We developed an electroencephalogram-based brain computer interface system to modulate functional electrical stimulation (FES) to the affected tibialis anterior muscle in a stroke patient
Cauraugh et al used an electromyogram (EMG)-triggered FES to synchronize the motor intent and FES, and reported benefits of this paradigm compared with non
As a tool to detect motor intent, brain computer interface (BCI) systems based on event-related desynchronization (ERD) of electroencephalogram (EEG), which is interpreted as desynchronized activities of the activated neurons, have been viewed with an interest by neurorehabilitation researchers
Summary
We developed an electroencephalogram-based brain computer interface system to modulate functional electrical stimulation (FES) to the affected tibialis anterior muscle in a stroke patient. As a tool to detect motor intent, brain computer interface (BCI) systems based on event-related desynchronization (ERD) of electroencephalogram (EEG), which is interpreted as desynchronized activities of the activated neurons, have been viewed with an interest by neurorehabilitation researchers. Several other groups have combined BCI with robotic or FES systems to provide a proprioceptive feedback [12,13,14,15,16,17] Some of these studies have led to improvements in the upper limb function of stroke patients, the studies are typically lacking the appropriately matched controls. These systems provide a binary feedback as a measure of success or failure in the motor imagery training after the imagery period is completed. Considering the activity-dependent and signal timing-dependent plasticity of the brain, improving the synchronicity and correlation between motor intent and stimulation may increase the chance of inducing changes in the brain, especially following neurological deficit such as stroke [18,19,20]
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