Vibrotactile Stimulation Research Articles

Tactile Feedback in Upper Limb Prosthetics: A Pilot Study on Trans-Radial Amputees Comparing Different Haptic Modalities.

Despite technological advancements, upper limb prostheses still face high abandonment/rejection rates due to limitations in control interfaces and the absence of force/tactile feedback. Improving these aspects is crucial for enhancing user acceptance and optimizing functional performance. This pilot study, therefore, aims to understand which sensory feedback in combination with a soft robotic prosthetic hand could provide advantages for amputees, including performing everyday tasks. Tactile cues provided are contact information, grasping force, degree of hand opening, and combinations of this information. To transfer such feedback, different wearable systems are used, based on either vibrotactile or force stimulation in a non-invasive modality matching approach. Five volunteers with a trans-radial amputation controlling the new prosthetic hand SoftHand Pro performed a study protocol including everyday tasks. The results indicate the preference of amputees for a single, i.e. non-combined, feedback modality. The choice of appropriate haptic feedback seems to be subject and task-specific. Furthermore, in alignment with the participants' feedback, force feedback, with adequate granularity and clarity, could potentially be the most valuable feedback among those presented. Finally, the study suggests that prosthetic solutions should be preferred where amputees are able to choose their feedback system.

Simultaneous Emotional Stimuli Prolong the Timing of Vibrotactile Events.

Temporal information plays a crucial role in human everyday life. Yet, perceived time is subject to distortions. Emotion, for instance, is a powerful time modulator in that emotional events are perceived longer than neutral events of the same length. However, it is unknown how exposure to emotional stimuli influences the time perception of a simultaneous neutral tactile event. To fill this gap, we tested the effect of emotional auditory sounds on the perception of neutral vibrotactile feedback. We used neutral and emotional (i.e., pleasant-high arousal, pleasant-low arousal, unpleasant-high arousal, and unpleasant-low arousal) auditory stimuli from the International Digitized Sound System (IADS). Tactile information was a vibrotactile stimulus at a fixed intensity and presented through a custom-made vibrotactile sleeve. Participants listened to auditory stimuli which were temporally coupled with vibrotactile stimulation for 2,3,4, or 5 s. Their task was to focus on the duration of vibrotactile information and reproduce elapsed time. We tested the effects of valence and arousal of auditory stimuli on the perceived duration of vibrotactile information. Simultaneously presented auditory stimuli, in general, lengthened the perceived duration of the neutral vibrotactile information compared to neutral auditory stimuli. We conclude that emotional events influence time perception of simultaneous neutral haptic events.

The Role of Entrainment and Aperiodicity in Vibrotactile Discrimination

The extent to which entrainment – the phenomenon in neuroscience where neurons synchronize their firing patterns to external stimuli with rhythmic or periodic features – occurs in response to aperiodic or irregular flutter stimuli remains debatable. It has been proposed by Mountcastle et al. that information is processed in a periodic manner; however, more recently, Romo et al. challenged Mountcastle’s theory and proposed that flutter stimulus was encoded based on the rapidly adapting fibers, not the periodicity.1-5 Therefore, if Mountcastle et al. is correct, the brain should be more adept at discriminating frequency between periodic stimuli than between aperiodic stimuli; conversely, if Romo et al. is correct, the brain should be equally good at discriminating frequencies between periodic and aperiodic stimuli. In this study, a two-point vibrotactile stimulation device (The Brain Gauge, Cortical Metrics, USA) was used to stimulate digits II and III of 43 participants’ preferred hand to determine their difference limen (DL) for both amplitude (AD) and frequency (FD) discrimination tests, given aperiodic or periodic stimuli. The tests were performed in the following order: periodic AD, aperiodic AD, periodic FD, and aperiodic FD. The results suggest that the periodicity of the stimuli affects frequency discrimination more than amplitude discrimination and the participants were significantly better at discriminating stimuli with periodic frequencies than aperiodic frequencies. A paired, one-tailed t-test indicated that the subject DLs resulting from periodic stimuli were significantly different (p<0.05) from that resulting from aperiodic stimuli for frequency discrimination, while it was not statistically significant for amplitude discrimination. The results were in favor of Mountcastle’s theory; however, more trials with a more controlled experimental environment may be needed to definitively conclude.

Falling Out of Postural Instability: Evaluating the Contribution of Somatosensation to Standing Balance in Parkinson's Disease

People with PD (PwPD) experience a variety of motor symptoms, including postural instability, impaired gait, tremors, and falls. Falls among PwPD are especially debilitating, as they can result in fracture risk, increased progression of the disease, and even death. Previous research has demonstrated that the somatosensory system, consisting of tactile sensation (which is responsible for feelings of touch and pressure) and proprioceptive feedback (which is important in joint position sense), is crucial for reactive balance control. The primary goal of this project was to determine the unique contributions of the tactile and proprioceptive systems to standing balance control in PD. Participants at the Gait and Balance Disorders Lab at Arizona State University were asked to maintain their balance while experiencing 3 sensory vibration conditions from vibrotactile transducers 1) a control condition with no vibration, 2) vibration underneath the feet to disturb tactile sensation, and 3) vibration on top of their feet (dorsiflexor tendon) to manipulate proprioception. Another goal was to identify predictors of somatosensory impairment during standing balance (i.e., participants affected most by sensory vibration) by associating clinical characteristics with change scores in balance outcomes from the no vibration-control condition to the tactile and proprioceptive stimulation conditions. The results of this study indicate that vibrotactile stimulation had minimal impacts on standing balance responses. This study also found few predictors of somatosensory impairments. Further research is needed to enhance clinical efficiency in designing treatments that have the most impact on improving balance control and preventing falls.

Relief of post-stroke spasticity with acute vibrotactile stimulation: controlled crossover study of muscle and skin stimulus methods.

Prior work suggests that vibratory stimulation can reduce spasticity and hypertonia. It is unknown which of three predominant approaches (stimulation of the spastic muscle, antagonist muscle, or cutaneous regions) most reduces these symptoms. Determine which vibrotactile stimulation approach is most effective at reducing spastic hypertonia among post-stroke patients. Sham-controlled crossover study with random assignment of condition order in fourteen patients with post-stroke hand spasticity. All patients were studied in four conditions over four visits: three stimulation conditions and a sham control. The primary outcome measure was the Modified Ashworth Scale, and the secondary outcome measure was the Modified Tardieu Scale measured manually and using 3D motion capture. For each condition, measures of spastic hypertonia were taken at four time points: baseline, during stimulation, after stimulation was removed, and after a gripping exercise. A clinically meaningful difference in spastic hypertonia was found during and after cutaneous stimulation of the hand. Modified Ashworth and Modified Tardieu scores were reduced by a median of 1.1 (SD = 0.84, p = 0.001) and 0.75 (SD = 0.65, p = 0.003), respectively, during cutaneous stimulation, and by 1.25 (SD = 0.94, p = 0.001) and 0.71 (SD = 0.67, p = 0.003), respectively, at 15 min after cutaneous stimulation. Symptom reductions with spastic muscle stimulation and antagonist muscle stimulation were non-zero but not significant. There was no change with sham stimulation. Cutaneous vibrotactile stimulation of the hand provides significant reductions in spastic hypertonia, compared to muscle stimulation. www.ClinicalTrials.gov, identifier: NCT03814889.

The role of ongoing oscillation in pain perception: Absence of modulation by a concomitant arithmetic task

Sustained nociceptive stimuli have been shown to modulate the amplitude of ongoing neural oscillations in the theta, alpha and beta frequency bands at the frequency of stimulation, suggesting a relationship between these ongoing oscillations and pain perception. Yet, whether these ongoing oscillations are actually related to the pain experience remains unclear. If it were the case, then cognitive processes that are known to affect pain intensity should also affect these ongoing oscillations. To this end, we used electroencephalography (EEG) to investigate whether distraction – an attentional state known to affect pain perception – also modulates the amplitude of these neural oscillations. More specifically, we hypothesized that performing an unrelated arithmetic task during sustained nociceptive stimulation would lead to a decrease in the modulations of ongoing oscillations exerted by the stimulation. To assess the selectivity of this modulation for nociception, we compared the modulations of ongoing oscillations exerted by sustained periodic thermonociceptive and non-nociceptive vibrotactile stimulation (.2 Hz, 75 sec), while participants were either asked to solve an unrelated arithmetic task (distraction task) or received no specific instruction (baseline). The intensity of perception was significantly reduced by the arithmetic task in both the thermonociceptive and the vibrotactile modality, and the sustained periodic stimulation elicited a periodic response at the frequency of stimulation in both modalities. However, the distraction task did not show a differential effect for the two stimulation modalities in any of the frequency bands. The fact that, unlike pain perception, these oscillations did not appear to be affected by the task suggests that they are dissociable from pain perception. Whether a different task (leading to a stronger degree of distraction) could lead to different results is unclear.

Keep your finger on the pulse: Better rate perception and gap detection with vibrotactile compared to visual stimuli

Important characteristics of the environment can be represented in the temporal pattern of sensory stimulation. In two experiments, we compared accuracy of temporal processing by different modalities. Experiment 1 examined binary categorization of rate for visual (V) or vibrotactile (T) stimulus pulses presented at either 4 or 6 Hz. Inter-pulse intervals were either constant or variable, perturbed by random Gaussian variates. Subjects categorized the rate of T pulse sequences more accurately than V sequences. In V conditions only, subjects disproportionately tended to mis-categorize 4-Hz pulse rates, for all but the most variable sequences. In Experiment 2, we compared gap detection thresholds across modalities, using the same V and T pulses from Experiment 1, as well as with bimodal (VT) pulses. Visual gap detection thresholds were larger (3times ) than tactile thresholds. Additionally, performance with VT stimuli seemed to be nearly completely dominated by their T components. Together, these results suggest (i) that vibrotactile temporal acuity surpasses visual temporal acuity, and (ii) that vibrotactile stimulation has considerable, untapped potential to convey temporal information like that needed for eyes-free alerting signals.

Towards non-invasive peripheral stimulation as a treatment for Parkinson's disease gait.

Non-invasive coordinated reset stimulation (CRS) to the hands has been shown to improve motor ability in Parkinson's patients, but not specific for gait disturbances. The overall aim of the project is the application of vibrotactile CRS to the feet to improve gait impairments in Parkinson's disease. As a first step towards this objective, we showed that vibrotactile stimulation to the feet can elicit a cortical response and have identified differences in younger and older individuals. Our findings suggest the potential for non-invasive peripheral stimulation as a therapeutic technique.Clinical Relevance- This is an important step towards developing a non-invasive stimulation technique for the management of gait disturbances in Parkinson's disease.

A direct comparison of sound and vibration as sources of stimulation for a sensory substitution glove

Sensory substitution devices (SSDs) facilitate the detection of environmental information through enhancement of touch and/or hearing capabilities. Research has demonstrated that several tasks can be successfully completed using acoustic, vibrotactile, and multimodal devices. The suitability of a substituting modality is also mediated by the type of information required to perform the specific task. The present study tested the adequacy of touch and hearing in a grasping task by utilizing a sensory substitution glove. The substituting modalities inform, through increases in stimulation intensity, about the distance between the fingers and the objects. A psychophysical experiment of magnitude estimation was conducted. Forty blindfolded sighted participants discriminated equivalently the intensity of both vibrotactile and acoustic stimulation, although they experienced some difficulty with the more intense stimuli. Additionally, a grasping task involving cylindrical objects of varying diameters, distances and orientations was performed. Thirty blindfolded sighted participants were divided into vibration, sound, or multimodal groups. High performance was achieved (84% correct grasps) with equivalent success rate between groups. Movement variables showed more precision and confidence in the multimodal condition. Through a questionnaire, the multimodal group indicated their preference for using a multimodal SSD in daily life and identified vibration as their primary source of stimulation. These results demonstrate that there is an improvement in performance with specific-purpose SSDs, when the necessary information for a task is identified and coupled with the delivered stimulation. Furthermore, the results suggest that it is possible to achieve functional equivalence between substituting modalities when these previous steps are met.

481-P: 10kHz SCS Restores Mechanical and Thermal Neural Processing in a Rodent Model of Painful Diabetic Neuropathy

A recent randomized controlled trial of 10 kHz spinal cord stimulation (SCS) in patients with painful diabetic neuropathy (PDN) has demonstrated significant and durable improvements in neurologic status, particularly sensory restoration of the foot (Petersen et al 2021, Argoff et al 2023). In order to gain further mechanistic insight into the improvements in sensory processing by 10kHz SCS, we analyzed the receptive field (RF) size and responses of spinal dorsal horn (DH) neurons to mechanical and thermal stimuli of the paw in a PDN rat model. For PDN-model, Rats were given a single effective dose of streptozotocin (STZ), while Naïve animals were injected with 0.9% saline. Four groups were studied: Naïve, STZ, STZ+ShamSCS, and STZ+10kHzSCS. Rats were anesthetized with urethane and a laminectomy was performed for DH neurons recording. We analyzed RF size and the response of DH neurons to vibrotactile stimulation and thermal sensation. Both the Naïve and STZ+10kHzSCS groups had significantly smaller RFs than the STZ Control and STZ+ShamSCS groups. In response to a 1 Hz vibration frequency, Naïve and STZ+10kHzSCS groups had higher peak power spectral density (PSD) of DH firing than STZ+ShamSCS, and PSD for the STZ+10kHzSCS group was statistically higher than for the STZ Control group. Response of DH neurons showed no significant differences between groups during the thermal stimulation, but the post-stimulus firing rates for the STZ+10kHzSCS group were significantly higher compared to STZ Control and STZ+ShamSCS. These data suggest that 10 kHz SCS amplified the DH response to large fiber (vibration) and small fiber (warm) signals and normalized the receptive field of the paw (acuity) in PDN rats. In diabetes, where peripheral sensory compromise from chronic hyperglycemia can lead to loss of protective sensation, such ‘tuned amplification’ as provided by 10 kHz SCS in the central nervous system may compensate for the reduced functionality seen in the peripheral sensory systems. Disclosure K.Lee: Employee; Nevro Corp. D.Lee: Employee; Nevro Corp. D.Wang: Employee; Nevro Corp. Z.B.Kagan: Employee; Nevro Corp. K.Bradley: Employee; Nevro Corp.

Enhanced motor imagery of digits within the same hand via vibrotactile stimulation.

The aim of the present study is to evaluate the effect of vibrotactile stimulation prior to repeated complex motor imagery of finger movements using the non-dominant hand on motor imagery (MI) performance. Ten healthy right-handed adults (4 females and 6 males) participated in the study. The subjects performed motor imagery tasks with and without a brief vibrotactile sensory stimulation prior to performing motor imagery using either their left-hand index, middle, or thumb digits. Mu- and beta-band event-related desynchronization (ERD) at the sensorimotor cortex and an artificial neural network-based digit classification was evaluated. The ERD and digit discrimination results from our study showed that ERD was significantly different between the vibration conditions for the index, middle, and thumb. It was also found that digit classification accuracy with-vibration (mean ± SD = 66.31 ± 3.79%) was significantly higher than without-vibration (mean ± SD = 62.68 ± 6.58%). The results showed that a brief vibration was more effective at improving MI-based brain-computer interface classification of digits within a single limb through increased ERD compared to performing MI without vibrotactile stimulation.

Comparing end-effector position and joint angle feedback for online robotic limb tracking.

Somatosensation greatly increases the ability to control our natural body. This suggests that supplementing vision with haptic sensory feedback would also be helpful when a user aims at controlling a robotic arm proficiently. However, whether the position of the robot and its continuous update should be coded in a extrinsic or intrinsic reference frame is not known. Here we compared two different supplementary feedback contents concerning the status of a robotic limb in 2-DoFs configuration: one encoding the Cartesian coordinates of the end-effector of the robotic arm (i.e., Task-space feedback) and another and encoding the robot joints angles (i.e., Joint-space feedback). Feedback was delivered to blindfolded participants through vibrotactile stimulation applied on participants' leg. After a 1.5-hour training with both feedbacks, participants were significantly more accurate with Task compared to Joint-space feedback, as shown by lower position and aiming errors, albeit not faster (i.e., similar onset delay). However, learning index during training was significantly higher in Joint space feedback compared to Task-space feedback. These results suggest that Task-space feedback is probably more intuitive and more suited for activities which require short training sessions, while Joint space feedback showed potential for long-term improvement. We speculate that the latter, despite performing worse in the present work, might be ultimately more suited for applications requiring long training, such as the control of supernumerary robotic limbs for surgical robotics, heavy industrial manufacturing, or more generally, in the context of human movement augmentation.

Event-Related Desynchronization induced by Tactile Imagery: an EEG Study.

It is well-known that both hand movements and mental representations of movement lead to event-related desynchronization (ERD) of the electroencephalogram (EEG) recorded over the corresponding cortical motor areas. However, the relationship between ERD in somatosensory cortical areas and mental representations of tactile sensations is not well-understood. In this study, we employed EEG recordings in healthy humans to compare the effects of real and imagined vibrotactile stimulation of the right hand. Both real and imagined sensations produced contralateral ERD patterns, particularly in the μ-band and most significantly in the C3 region. Building on these results and the previous literature, we discuss the role of tactile imagery as part of the complex body image and the potential for using EEG patterns induced by tactile imagery as control signals in brain-computer interfaces (BCIs). Combining this approach with motor imagery could improve the performance of BCIs intended for rehabilitation of sensorimotor function after stroke and neural trauma.Significance StatementIn this study, we address the issue of mental representations in the somatosensory domain. By assessing the dynamics of sensorimotor EEG rhythms and the distribution of topographical EEG patterns, we demonstrate that tactile imagery produces event-related desynchronization in the contralateral EEG, even in the absence of physical stimulation. Our results clarify the neurophysiological mechanisms underlying the occurrence of ERD in the mu rhythm and its relationship to somatosensory cortical processing.

Effects of Stimulus Frequency and Location on Vibrotactile Discrimination Performance Using Voice Coil Actuators on the Forearm

What are the effects of frequency variation of vibrotactile stimuli on localization acuity? The precise localization of vibrotactile stimuli is crucial for applications that are aimed at conveying vibrotactile information. In order to evaluate the ability to distinguish between vibrotactile stimuli based on their frequency and location on the forearm, we used a relative point localization method. Participants were presented with pairs of sequential vibrotactile stimuli at three possible locations on the forearm and asked to determine whether the second stimulation occurred at the same location as the first one in the pair or not. The stimulation frequency varied between 100 Hz, 150 Hz, 200 Hz and 250 Hz, which covers the range of frequencies that human observers are most sensitive to. The amplitude was kept constant. Our results revealed that the ability to discriminate between actuators remained unaffected by variations in the frequency of vibrotactile stimulation within the tested frequency range. The accuracy of the tactile discrimination task was heavily dependent on the location of the stimulation on the forearm, with the highest accuracy close to the wrist and elbow, locations that may serve as tactile anchor points. Our results highlight the critical role of stimulation location in precise vibrotactile localization and the importance of careful consideration of location in the design of forearm-mounted vibrotactile devices.

Talking with hands and feet: Selective somatosensory attention and fMRI enable robust and convenient brain-based communication

In brain-based communication, voluntarily modulated brain signals (instead of motor output) are utilized to interact with the outside world. The possibility to circumvent the motor system constitutes an important alternative option for severely paralyzed. Most communication brain-computer interface (BCI) paradigms require intact visual capabilities and impose a high cognitive load, but for some patients, these requirements are not given. In these situations, a better-suited, less cognitively demanding information-encoding approach may exploit auditorily-cued selective somatosensory attention to vibrotactile stimulation. Here, we propose, validate and optimize a novel communication-BCI paradigm using differential fMRI activation patterns evoked by selective somatosensory attention to tactile stimulation of the right hand or left foot. Using cytoarchitectonic probability maps and multi-voxel pattern analysis (MVPA), we show that the locus of selective somatosensory attention can be decoded from fMRI-signal patterns in (especially primary) somatosensory cortex with high accuracy and reliability, with the highest classification accuracy (85.93%) achieved when using Brodmann area 2 (SI-BA2) at a probability level of 0.2. Based on this outcome, we developed and validated a novel somatosensory attention-based yes/no communication procedure and demonstrated its high effectiveness even when using only a limited amount of (MVPA) training data. For the BCI user, the paradigm is straightforward, eye-independent, and requires only limited cognitive functioning. In addition, it is BCI-operator friendly given its objective and expertise-independent procedure. For these reasons, our novel communication paradigm has high potential for clinical applications.

Vibrotactile stimulation at gamma frequency mitigates pathology related to neurodegeneration and improves motor function.

The risk for neurodegenerative diseases increases with aging, with various pathological conditions and functional deficits accompanying these diseases. We have previously demonstrated that non-invasive visual stimulation using 40 Hz light flicker ameliorated pathology and modified cognitive function in mouse models of neurodegeneration, but whether 40 Hz stimulation using another sensory modality can impact neurodegeneration and motor function has not been studied. Here, we show that whole-body vibrotactile stimulation at 40 Hz leads to increased neural activity in the primary somatosensory cortex (SSp) and primary motor cortex (MOp). In two different mouse models of neurodegeneration, Tau P301S and CK-p25 mice, daily exposure to 40 Hz vibrotactile stimulation across multiple weeks also led to decreased brain pathology in SSp and MOp. Furthermore, both Tau P301S and CK-p25 mice showed improved motor performance after multiple weeks of daily 40 Hz vibrotactile stimulation. Vibrotactile stimulation at 40 Hz may thus be considered as a promising therapeutic strategy for neurodegenerative diseases with motor deficits.

Efficacy of a Vibrating Crib Mattress to Reduce Pharmacologic Treatment in Opioid-Exposed Newborns

Pharmacologic agents are often used to treat newborns with prenatal opioid exposure (POE) despite known adverse effects on neurodevelopment. Alternative nonpharmacological interventions are needed. To examine efficacy of a vibrating crib mattress for treating newborns with POE. In this dual-site randomized clinical trial, 208 term newborns with POE, enrolled from March 9, 2017, to March 10, 2020, were studied at their bedside throughout hospitalization. Half the cohort received treatment as usual (TAU) and half received standard care plus low-level stochastic (random) vibrotactile stimulation (SVS) using a uniquely constructed crib mattress with a 3-hour on-off cycle. Study initiated in the newborn unit where newborns were randomized to TAU or SVS within 48 hours of birth. All infants whose symptoms met clinical criteria for pharmacologic treatment received morphine in the neonatal intensive care unit per standard care. The a priori primary outcomes analyzed were pharmacotherapy (administration of morphine treatment [AMT], first-line medication at both study sites [number of infants treated], and cumulative morphine dose) and hospital length of stay. Intention-to-treat analysis was conducted. Analyses were performed on 181 newborns who completed hospitalization at the study sites (mean [SD] gestational age, 39.0 [1.2] weeks; mean [SD] birth weight, 3076 (489) g; 100 [55.2%] were female). Of the 181 analyzed infants, 121 (66.9%) were discharged without medication and 60 (33.1%) were transferred to the NICU for morphine treatment (31 [51.7%] TAU and 29 [48.3%] SVS). Treatment rate was not significantly different in the 2 groups: 35.6% (31 of 87 infants who received TAU) and 30.9% (29 of 94 infants who received SVS) (P = .60). Adjusting for site, sex, birth weight, opioid exposure, and feed type, infant duration on the vibrating mattress in the newborn unit was associated with reduction in AMT (adjusted odds ratio, 0.88 hours per day; 95% CI, 0.81-0.93 hours per day). This translated to a 50% relative reduction in AMT for infants who received SVS on average 6 hours per day. Among 32 infants transferred to the neonatal intensive care unit for morphine treatment who completed treatment within 3 weeks, those assigned to SVS finished treatment nearly twice as fast (hazard ratio, 1.96; 95% CI, 1.01-3.81), resulting in 3.18 fewer treatment days (95% CI, -0.47 to -0.04 days) and receiving a mean 1.76 mg/kg less morphine (95% CI, -3.02 to -0.50 mg/kg) than the TAU cohort. No effects of condition were observed among infants treated for more than 3 weeks (n = 28). The findings of this clinical trial suggest that SVS may serve as a complementary nonpharmacologic intervention for newborns with POE. Reducing pharmacotherapy with SVS has implications for reduced hospitalization stays and costs, and possibly improved infant outcomes given the known adverse effects of morphine on neurodevelopment. ClinicalTrials.gov Identifier: NCT02801331.

Can vibrotactile stimulation and tDCS help inefficient BCI users?

Brain-computer interface (BCI) has helped people by allowing them to control a computer or machine through brain activity without actual body movement. Despite this advantage, BCI cannot be used widely because some people cannot achieve controllable performance. To solve this problem, researchers have proposed stimulation methods to modulate relevant brain activity to improve BCI performance. However, multiple studies have reported mixed results following stimulation, and the comparative study of different stimulation modalities has been overlooked. Accordingly, this study was designed to compare vibrotactile stimulation and transcranial direct current stimulation’s (tDCS) effects on brain activity modulation and motor imagery BCI performance among inefficient BCI users. We recruited 44 subjects and divided them into sham, vibrotactile stimulation, and tDCS groups, and low performers were selected from each stimulation group. We found that the latter’s BCI performance in the vibrotactile stimulation group increased significantly by 9.13% (p < 0.01), and while the tDCS group subjects’ performance increased by 5.13%, it was not significant. In contrast, sham group subjects showed no increased performance. In addition to BCI performance, pre-stimulus alpha band power and the phase locking values (PLVs) averaged over sensory motor areas showed significant increases in low performers following stimulation in the vibrotactile stimulation and tDCS groups, while sham stimulation group subjects and high performers showed no significant stimulation effects across all groups. Our findings suggest that stimulation effects may differ depending upon BCI efficiency, and inefficient BCI users have greater plasticity than efficient BCI users.

Daily Vibrotactile Stimulation Exhibits Equal or Greater Spasticity Relief Than Botulinum Toxin in Stroke

ObjectiveTo test the feasibility and efficacy of the VibroTactile Stimulation (VTS) Glove, a wearable device that provides VTS to the impaired limb to reduce spastic hypertonia. DesignProspective 2-arm intervention study—including 1 group of patients who use Botulinum toxin (BTX-A) for spasticity and 1 group of patients who do not use BTX-A. SettingParticipants were recruited through rehabilitation and neurology clinics. ParticipantsPatients with chronic stroke (N=20; mean age=54 years, mean time since stroke=6.9 years). Patients who were previously receiving the standard of care (BTX-A injection) were eligible to participate and started the intervention 12 weeks after their last injection. InterventionParticipants were instructed to use the VTS Glove for 3 hours daily, at home or during everyday activities, for 8 weeks. Main Outcome MeasuresSpasticity was assessed with the Modified Ashworth Scale and the Modified Tardieu Scale at baseline and then at 2-week intervals for 12 weeks. Primary outcomes were the difference from baseline and at week 8 (end of VTS Glove use) and week 12 (4 weeks after stopping VTS Glove use). Patients who were receiving BTX-A were also assessed during the 12 weeks preceding the start of VTS Glove use to monitor the effect of BTX-A on spastic hypertonia. Range of motion and participant feedback were also studied. ResultsA clinically meaningful difference in spastic hypertonia was found during and after daily VTS Glove use. Modified Ashworth and Modified Tardieu scores were reduced by an average of 0.9 (P=.0014) and 0.7 (P=.0003), respectively, at week 8 of daily VTS Glove use, and by 1.1 (P=.00025) and 0.9 (P=.0001), respectively, 1 month after stopping VTS Glove use. For participants who used BTX-A, 6 out of 11 showed greater change in Modified Ashworth ratings during VTS Glove use (mean=-1.8 vs mean=-1.6 with BTX-A) and 8 out of 11 showed their lowest level of symptoms during VTS Glove use (vs BTX-A). ConclusionsDaily stimulation from the VTS Glove provides relief of spasticity and hypertonia. For more than half of the participants who had regularly used BTX-A, the VTS Glove provided equal or greater symptom relief.

The Effect of Gaitlike Plantar Stimulation During Walking

The plantar surfaces of the feet are a vital source of information for balance and locomotion control. They use the location of the center of pressure (CoP) to aid in the control of standing and walking balance. However, during gait this CoP traverses along the foot from the heel to the toe. Stimulating the plantar surfaces in a manner that can positively affect the perception of this CoP movement could increase balance control during walking tasks in the presence of plantar sensory deficits. In individuals with such deficits, applying vibro-tactile stimulation to increase this CoP movement perception may lead to enhanced relearning of balance during gait. The purpose of this study was to investigate the effects of different patterns of vibro-tactile stimulation on balance control during different walking tasks in healthy subjects. We hypothesized that vibro-tactile stimulation in an abnormal pattern will result in gait and balance deficits, when compared to stimulation that follows a natural walking pattern. Additionally, that walking on an inclined surface would exaggerate the effects of these stimulation patterns. In this on-going study we tested three stimulation patterns at three different inclines (0, 5, and 10-degrees) of treadmill walking. These patterns included no stimulation (NS), a gait-like stimulation (GS), and a reverse gait-like stimulation (RGS). Minimal differences from these patterns were observed in spatiotemporal measures (&lt;2% from NS in step time and length; &lt;5% from NS in step width) at each incline. However, RGS compared to NS led to ~ 30% decrease in foot placement distribution during level and 5-degrees of incline. The GS pattern however remained similar to regular walking at both 0 and 5-degrees of incline (both ~5%). These foot placement effects did not lead to decreases in stability when measured with margin of stability changes. Stimulating the plantar surfaces in different patterns, therefore, alters how the body uses plantar afferents during gait through the control of foot placements. Stimulation in the regular sequence (GS) is important for maintaining natural foot placement during level walking and small inclines while disrupted tactile patterns (RGS) can restrict such natural locomotion. Currently ongoing brain imaging studies are expected to provide in-depth understanding of how such regular walking patterns influence sensorimotor organization and control. This project was supported by grants from NASA and AHA. The content is solely the responsibility of the authors and does not necessarily represent the official views of NASA or AHA. In addition, funding was provided by the Graduate Research and Creative Activity fund (GRACA) and Fund for Undergraduate Scholarly experience (FUSE) at the University of Nebraska at Omaha. This is the full abstract presented at the American Physiology Summit 2023 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.