Synergistic Immediate Cortical Activation on Mirror Visual Feedback Combined With a Soft Robotic Bilateral Hand Rehabilitation System: A Functional Near Infrared Spectroscopy Study.

Yaxian Qiu,Benguo Wang,Anniwaer Yilifate,Siqi Huang,Yuxin Zheng,Yongchun Jiang,Yanni Zhang,Junjie Liang,Yaoyao You,Qiang Lin,Haining Ou,Jiahui Zhang,Aijia Chen,Yawen Liu,Wenxi Luo,Rongwei Du

doi:10.3389/fnins.2022.807045

Abstract

BackgroundMirror visual feedback (MVF) has been widely used in neurological rehabilitation. Due to the potential gain effect of the MVF combination therapy, the related mechanisms still need be further analyzed.MethodsOur self-controlled study recruited 20 healthy subjects (age 22.150 ± 2.661 years) were asked to perform four different visual feedback tasks with simultaneous functional near infrared spectroscopy (fNIRS) monitoring. The right hand of the subjects was set as the active hand (performing active movement), and the left hand was set as the observation hand (static or performing passive movement under soft robotic bilateral hand rehabilitation system). The four VF tasks were designed as RVF Task (real visual feedback task), MVF task (mirror visual feedback task), BRM task (bilateral robotic movement task), and MVF + BRM task (Mirror visual feedback combined with bilateral robotic movement task).ResultsThe beta value of the right pre-motor cortex (PMC) of MVF task was significantly higher than the RVF task (RVF task: -0.015 ± 0.029, MVF task: 0.011 ± 0.033, P = 0.033). The beta value right primary sensorimotor cortex (SM1) in MVF + BRM task was significantly higher than MVF task (MVF task: 0.006 ± 0.040, MVF + BRM task: 0.037 ± 0.036, P = 0.016).ConclusionOur study used the synchronous fNIRS to compare the immediate hemodynamics cortical activation of four visual feedback tasks in healthy subjects. The results showed the synergistic gain effect on cortical activation from MVF combined with a soft robotic bilateral hand rehabilitation system for the first time, which could be used to guide the clinical application and the future studies.

Highlights

Mirror therapy or mirror visual feedback (MVF) was first proposed by Ramachandran et al (1995) and applied to the treatment of limb phantom pain
The right hand of the subjects was set as the active hand, and the left hand was set as the observation hand
The statistical results showed that compared with RVF task, the beta value of the right pre-motor cortex (PMC) of MVF task (RVF task: -0.015 ± 0.029, MVF task: 0.011 ± 0.033, P = 0.033) was higher, and the difference was statistically significant

Summary

Introduction

Mirror therapy or mirror visual feedback (MVF) was first proposed by Ramachandran et al (1995) and applied to the treatment of limb phantom pain. Some MVF studies have combined it with electromyographic biofeedback (Kim and Lee, 2015; Liu et al, 2021), EMG-triggered electrical stimulation (Schick et al, 2017), electrical stimulation (Lee and Lee, 2019), robot-assisted therapy (Ji-feng et al, 2019), and other intervention methods. These results suggest that combination therapy has potential for improving moderate to severe upper limb dysfunction after stroke. Due to the potential gain effect of the MVF combination therapy, the related mechanisms still need be further analyzed

Methods

Results

Conclusion