Journal of NeuroEngineering and Rehabilitation最新文献

{"title":"Acute effects of upper-limb blood flow restriction training on dual-task postural control and physiological correlates in older adults.","authors":"Yi-Ching Chen, Yu-Chen Sun, Yi-Ying Tsai, Chen-Guang Zhao, Ing-Shiou Hwang","doi":"10.1186/s12984-026-02008-4","DOIUrl":"https://doi.org/10.1186/s12984-026-02008-4","url":null,"abstract":"<p><strong>Background: </strong>Falls represent a major health concern in older adults, underscoring the need for interventions that enhance postural control. This study investigated whether applying blood flow restriction (BFR) during short-term arm ergometry training improves posture-cognition dual-task performance and adaptive changes in cortical-postural coupling.</p><p><strong>Methods: </strong>Twenty-six older adults (12 males, 14 females; 69.1 ± 3.0 years) completed a single 21-minute session of arm ergometry with gender-specific workloads, either combined with BFR at 80% systolic pressure or without restriction (control). Dual-task performance, balance dynamics, and cortico-postural phase-amplitude coupling (PAC) were assessed during concurrent light-pod tapping and stance on an unstable foam surface.</p><p><strong>Results: </strong>Compared with controls, the BFR condition resulted in greater reductions in center of pressure (COP) area (p = 0.002) and velocity (p = 0.003), indicating improved postural control. Stabilogram diffusion analysis further revealed reductions in critical displacement (CD, p < 0.001) and short-term diffusion coefficient (Ds, p = 0.002), suggesting decreased sway variability and enhanced postural regulation. Phase-amplitude coupling (PAC) analysis showed a significant between-condition difference in the theta band at the frontal region of interest, with greater negative modulation under BFR compared with NBFR (p = 0.016). In contrast, no significant between-condition differences were observed in the alpha or beta PAC (p > 0.05). These findings indicated frequency-specific modulation of cortico-postural coupling associated with upper-limb BFR training.</p><p><strong>Conclusion: </strong>Arm ergometry combined with BFR is associated with improved dual-task postural performance in older adults. These changes were accompanied by frequency-specific modulation of cortico-postural coupling, evident in the theta band at frontal regions. These findings suggest that upper-limb BFR training may represent a feasible and accessible intervention for improving balance under dual-task conditions in aging populations.</p>","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":" ","pages":""},"PeriodicalIF":5.2,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147856507","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Post-stroke lower limb rehabilitation: a comparative study between exoskeleton robots and traditional gait training.","authors":"Wenzhu Xu, Nai Yeen Gavin Lai, Kok-Hoong Wong, Hamza Azam, Wei Yang","doi":"10.1186/s12984-026-02006-6","DOIUrl":"https://doi.org/10.1186/s12984-026-02006-6","url":null,"abstract":"<p><strong>Purpose: </strong>This study systematically compares the efficacy of robotic-assisted gait training (RAGT) with exoskeletons to traditional gait training (TGT) for lower limb rehabilitation after stroke, focusing on motor recovery, neuroplasticity, and muscle function.</p><p><strong>Methods: </strong>A comprehensive systematic review was conducted across PubMed, Scopus, Web of Science, IEEE Xplore and Google Scholar for studies published between 2004 and 2024 following the PRISMA guidelines. A total of 86 studies were selected based on strict inclusion criteria, covering moderate to severe stroke patients undergoing RAGT, TGT, or combined interventions. Outcome metrics included gait symmetry, walking speed, neuroplasticity biomarkers (e.g., BDNF, fMRI), and muscle strength indicators. This systematic review was pre-registered with PROSPERO (ID: CRD420261333541).</p><p><strong>Results: </strong>RAGT demonstrated superior improvements in gait symmetry index (+ 99.8% trajectory accuracy), walking speed (+ 20%), and muscle strength via high-intensity, repeatable training. TGT excelled in promoting active participation, cortical engagement, and functional independence, particularly in activities of daily living. Neuroplasticity analysis revealed RAGT enhanced spinal-brainstem rhythmic-ity, while TGT reinforced cortical-cerebellar motor planning. Muscle recovery was accelerated by RAGT through anti-gravitational support, though TGT better preserved natural movement patterns and coordination.</p><p><strong>Conclusion: </strong>RAGT and TGT exhibit complementary strengths in stroke rehabilitation. Integrating RAGT's high-intensity, objective training with TGT's adaptive, patient-centered approach represents a promising direction for personalized, AI-enhanced neurorehabilitation strategies.</p>","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":" ","pages":""},"PeriodicalIF":5.2,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147856425","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reducing robotic upper-limb assessment time while maintaining precision: a time series foundation model approach.","authors":"Faranak Akbarifar, Nooshin Maghsoodi, Sean P Dukelow, Stephen H Scott, Parvin Mousavi","doi":"10.1186/s12984-026-02012-8","DOIUrl":"https://doi.org/10.1186/s12984-026-02012-8","url":null,"abstract":"<p><strong>Purpose: </strong>Visually Guided Reaching (VGR) on the Kinarm robot yields sensitive kinematic biomarkers but requires 40-64 reaches, imposing time and fatigue burdens. We evaluate whether time series foundation models can replace unrecorded trials from an early subset of reaches while preserving agreement with full-session estimates of standard Kinarm parameters.</p><p><strong>Methods: </strong>We analyzed VGR speed signals from 461 stroke and 599 control participants across 4- and 8-target reaching protocols. We withheld all but the first 8 or 16 reaching trials and used ARIMA, MOMENT, and Chronos models, fine-tuned on 70% of participants, to forecast synthetic trials. We recomputed four kinematic features of reaching (reaction time, movement time, posture speed, max speed) on combined recorded plus forecasted trials and compared to full-length references using ICC(2,1).</p><p><strong>Results: </strong>Chronos forecasts increased ICC values for all parameters ([Formula: see text]) when combining only 8 recorded trials with forecasted trials, achieving agreement comparable to that obtained using 24-28 recorded reaches ([Formula: see text]). MOMENT yielded intermediate gains, while ARIMA improvements were minimal. Across cohorts and protocols, synthetic trials replaced reaches without significantly compromising feature reliability.</p><p><strong>Conclusion: </strong>Foundation-model forecasting can greatly shorten Kinarm VGR assessment time. For the most impaired stroke survivors, sessions drop from 4-5 min to about 1 min while maintaining agreement with full-session Kinarm parameter estimates. This forecast-augmented paradigm promises efficient robotic evaluations for assessing motor impairments following stroke.</p>","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":" ","pages":""},"PeriodicalIF":5.2,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147839015","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of radial shock wave therapy for ankle spasticity in patients with stroke within 3 months of onset: a prospective quasi-experimental study.","authors":"Yuichi Hiramatsu, Hajime Yagura, Hiroaki Fujimoto, Megumi Hatakenaka, Teiji Kawano, Shota Segawa, Makiko Rai, Ryutaro Hayashi, Akihiko Nakae, Haruka Asano, Takuya Ogawa, Ichiro Miyai","doi":"10.1186/s12984-026-01983-y","DOIUrl":"https://doi.org/10.1186/s12984-026-01983-y","url":null,"abstract":"<p><strong>Background: </strong>Extracorporeal shock wave therapy (ESWT) is widely used to reduce poststroke spasticity (PSS). However, limited evidence exists regarding its efficacy in patients with stroke within 3 months of onset. Therefore, this study aimed to investigate the association between ESWT administered 1 to 3 months after stroke and changes in spasticity and joint mobility in patients with PSS.</p><p><strong>Methods: </strong>Prospective quasi-experimental study. Fifty-two patients with PSS affecting the ankle joint were enrolled from March 2023 to March 2025, and allocated into three groups based on the time elapsed from stroke onset: 1, 2, or 3 months. All patients underwent radial ESWT to the gastrocnemius and soleus muscles once weekly for 3 consecutive weeks. Spasticity and joint mobility were evaluated using the Modified Ashworth Scale (MAS) and passive range of motion (PROM) measurements before and after each session, and at 1 and 5 weeks post-treatment.</p><p><strong>Results: </strong>Except for the MAS score obtained after the first session, significant immediate reductions in the MAS scores and PROM measurements were observed after all shock wave therapy sessions. Compared to baseline, cumulative changes were greatest after the third session, with a mean reduction of 0.6 points in the MAS score and a 6.4° increase in the PROM. These changes were maintained for 5 weeks. No serious adverse events related to shock wave therapy were reported.</p><p><strong>Conclusions: </strong>ESWT during the early subacute stage was associated with improvements in spasticity and joint mobility in patients with PSS. Repeated sessions showed greater cumulative changes compared with a single session. Trial registration UMIN-CTR000050477.</p>","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":" ","pages":""},"PeriodicalIF":5.2,"publicationDate":"2026-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147816315","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lateral armrest support improves postural alignment, respiratory mechanics, and shoulder girdle loading during seated eating in healthy young adults: a multidimensional biomechanical evaluation.","authors":"Daisuke Tashiro, Kaito Tou, Ikoi Okano, Sayaka Nishiguchi","doi":"10.1186/s12984-026-01960-5","DOIUrl":"https://doi.org/10.1186/s12984-026-01960-5","url":null,"abstract":"<p><strong>Background: </strong>Postural collapse and increased reliance on accessory respiratory muscles during meals can compromise ventilatory efficiency, particularly in individuals with respiratory impairment. Forward elbow-supported sitting is commonly used to unload the upper limbs; however, this posture often induces trunk flexion and cervical extension, which may adversely affect respiratory mechanics. To date, the effects of lateral armrest support on posture and respiratory function during seated eating have not been quantitatively investigated.</p><p><strong>Objective: </strong>To examine the effects of lateral armrest support on thoracic alignment, cervical posture (cervical inclination angle), shoulder muscle stiffness (upper trapezius and middle deltoid), vital capacity, and subjective comfort during seated eating in healthy young adults, compared with unsupported sitting and anterior elbow-supported sitting.</p><p><strong>Methods: </strong>Forty healthy young adults completed three randomized sitting conditions: (A) unsupported sitting, (B) anterior elbow-supported sitting, and (C) lateral armrest-supported sitting using a side-mounted armrest. Thoracic kyphosis index, cervical inclination angle, muscle stiffness of the upper trapezius and middle deltoid, vital capacity (VC), and subjective comfort were assessed. Data were analyzed using Friedman tests, with post-hoc pairwise comparisons performed using the Durbin-Conover test with Bonferroni correction.</p><p><strong>Results: </strong>Thoracic kyphosis index differed significantly across conditions (p = .002), with both forward elbow-supported and lateral armrest-supported sitting showing lower values than unsupported sitting. Cervical inclination angle also differed significantly (p < .001), with forward elbow-supported sitting demonstrating greater cervical extension than the other conditions. Upper trapezius muscle stiffness was significantly reduced in the lateral armrest-supported condition compared with unsupported and forward elbow-supported sitting (both p < .01). Vital capacity was significantly greater in the lateral armrest-supported condition than in unsupported sitting (p = .003). Subjective comfort ratings were highest in the lateral armrest-supported condition (p < .001).</p><p><strong>Conclusion: </strong>Lateral armrest support demonstrated biomechanical advantages in healthy young adults, including improved spinal alignment, reduced shoulder girdle loading, and greater vital capacity compared with unsupported sitting. These findings provide preliminary mechanistic insight and may inform future investigations in clinical populations; however, direct extrapolation to individuals with respiratory or neurological impairment requires further study.</p>","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":" ","pages":""},"PeriodicalIF":5.2,"publicationDate":"2026-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147816401","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of multi-sensory virtual reality training on gait adaptability and somatomotor network remodeling in patients with stroke: a randomized controlled trial.","authors":"Qiurong Xie, Xiao Xiong, Mingchao Liu, Yuxin Huang, Bo Sheng, Yanxin Zhang, Jia Huang, Qi Zhang","doi":"10.1186/s12984-026-02003-9","DOIUrl":"https://doi.org/10.1186/s12984-026-02003-9","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the effects of multisensory-integrated virtual reality (VR) training on gait adaptability and its regulatory mechanisms on the somatomotor network (SMN) in patients with stroke.</p><p><strong>Methods: </strong>In this randomized controlled trial, 68 patients with stroke were allocated to a VR group (multisensory-integrated VR training) or a control group (conventional rehabilitation). Both groups received 30-minute sessions, 5 days/week for 4 weeks. The primary outcome was gait adaptability assessed by the Dynamic Gait Index (DGI). Secondary outcomes included the Timed Up and Go Test (TUGT), Berg Balance Scale (BBS), and Fugl-Meyer Assessment for Lower Extremity (FMA-LE). Functional near-infrared spectroscopy (fNIRS) measured resting-state functional connectivity within the SMN and task-evoked activation during stepping and obstacle crossing.</p><p><strong>Results: </strong>The VR group showed significantly greater improvements than the control group in DGI total score (P = 0.010), TUGT (P = 0.005), and BBS (P < 0.001 ). fNIRS analysis revealed that the VR group exhibited significantly greater increases in task-evoked activation in the right posterior parietal cortex (PPC) and supplementary motor area (SMA) during stepping (P = 0.029 and P = 0.032, respectively), and in the right SMA during unaffected-limb obstacle crossing (P = 0.048). Resting-state functional connectivity analysis showed significantly enhanced connections within the SMN, including left SMA-right PPC and right PPC-left dorsolateral prefrontal cortex (DLPFC) (both P < 0.05). Correlation analyses revealed that increased right SMA activation during obstacle crossing was positively correlated with TUGT improvement (r = 0.590, P = 0.001), while enhanced right PPC-left DLPFC connectivity was positively correlated with DGI improvement (r = 0.403, P = 0.041).</p><p><strong>Conclusion: </strong>Multisensory-integrated VR training was associated with improvements in gait adaptability and balance in patients with stroke. The underlying mechanisms may involve enhanced activation in the SMA and PPC, along with changes in functional connectivity within the SMN and between the SMN and cognitive control networks. However, given that the significant improvements in DGI, TUGT, and BBS were not sustained under the most conservative assumptions about missing data, these findings should be considered preliminary and warrant confirmation in studies with lower attrition rates.</p><p><strong>Trial registration: </strong>Chinese Clinical Trial Registry, ChiCTR2500111919 (retrospectively registered). Registered 7 November 2025. Available from https//www.chictr.org.cn (registration number ChiCTR2500111919). Protocol The full trial protocol is available from the corresponding author upon reasonable request.</p>","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":" ","pages":""},"PeriodicalIF":5.2,"publicationDate":"2026-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147816382","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Muscle synergy asymmetry between the affected and unaffected limbs during the stance phase in unilateral flatfoot.","authors":"Jianqi Pan, Zixiang Gao, Zhanyi Zhou, Dongxu Wang, Fengping Li, Diwei Chen, Zsolt Radak, Yaodong Gu","doi":"10.1186/s12984-026-01995-8","DOIUrl":"https://doi.org/10.1186/s12984-026-01995-8","url":null,"abstract":"<p><strong>Background: </strong>Musculoskeletal conditions can disrupt neuromuscular coordination during gait, leading to asymmetry and altered muscle synergy patterns. Understanding how the nervous system reorganizes synergies in individuals with unilateral flatfoot (UF) is essential for improving clinical assessment and rehabilitation strategies.</p><p><strong>Methods: </strong>Surface electromyography (sEMG) of major lower-limb muscles during the stance phase was collected from 24 individuals with UF. Synergists were extracted by non-negative matrix factorization (NMF) and analyzed with vector coding (VC) to examine bilateral phase relationships. Independent t-tests compared muscle weights within synergies, paired t-tests compared temporal waveforms between sides, and chi-square tests examined differences in dominant quadrant distribution.</p><p><strong>Results: </strong>Both affected (AFF) and unaffected (UNAFF) sides exhibited two synergies. The tibialis anterior (TA) (Syn1: AFF = 0.47 ± 0.40, UNAFF = 0.46 ± 0.38; Syn2: AFF = 0.36 ± 0.38, UNAFF = 0.46 ± 0.39) and medial gastrocnemius (MG) (Syn1: AFF = 0.41 ± 0.40, UNAFF = 0.49 ± 0.43; Syn2: AFF = 0.52 ± 0.41, UNAFF = 0.45 ± 0.41) showed significantly higher weights than the mean value within each respective synergy (p < 0.001). Both sides mainly exhibited an In-phase pattern, with Syn1 more prevalent on the UNAFF side (p < 0.05) and Syn2 on the AFF side (p < 0.05).</p><p><strong>Conclusion: </strong>The combined NMF-VC analysis effectively captured the structural and temporal features of muscle synergies. UF individuals exhibited MG compensation on the AFF side, suggesting that nervous system may maintaining stability through strengthening synergy patterns dominated by major muscles. This study revealed the neuromuscular reorganization in UF gait and provided a quantitative method for synergy-based rehabilitation assessment.</p>","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":" ","pages":""},"PeriodicalIF":5.2,"publicationDate":"2026-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147816385","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"On the correlation between training modalities and recovery stages in poststroke robotic rehabilitation of the upper limb: a systematic review.","authors":"Francesca Alvaro, Michele Perrelli, Rocco Adduci, Francesco Tedesco, Domenico Mundo","doi":"10.1186/s12984-026-02005-7","DOIUrl":"https://doi.org/10.1186/s12984-026-02005-7","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Robot-assisted therapy for poststroke rehabilitation of the upper limb is rapidly spreading. The need comes from the reduced number of therapists and the aim of defining a more involving therapy for the patients. Previous studies report the effectiveness of robotic therapy to provide intensive, repetitive and task-specific rehabilitation, as well as the ability to provide different modalities of training. However, it is not always clear how these modes are implemented and how they are defined, since different labels are sometimes used. As a consequence, it is difficult to define a universal protocol to follow. This leads to non-comparable outcomes, making even harder for the therapists to understand which is the most efficient way of administering therapy. The proposed work aims at putting together available information reported in literature, linking two main variables influencing rehabilitation, i.e., poststroke stage and training modality, with the purpose of updating the state of the art, categorising and analysing the modalities involved, extracting the most effective relationships and approaches in terms of results reported in the scientific community.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Scopus was chosen as reference database for the systematic review. The studies refer to the last decade, that is from the year of the latest review published in relation to the topic of interest. Studies clearly referencing training modalities and poststroke stages were included.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The assistive modality is the one that catches more attention in the scientific community, highlighting the tendency to prefer approaches in which the patients are more actively involved. In terms of relevance inferable from clinical scales reported in the included studies, the assistive modality appears to be the most effective in the chronic phase, active-assistive approaches during the subacute one, whereas no significant conclusions can be drawn for the acute stage. For what concerns robotic devices, some considerations can be drawn as well: exoskeletons are applied during the chronic phase predominantly, whereas end-effectors during the subacute one. No significant distinctions are detected in the acute stage. Improvements in ADLs are mostly achieved in experiments involving exoskeletons, but studies show that subjects may also benefit from end-effectors, when applied in earlier recovery stages.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;It is evident that some connections are present between training modalities and recovery stages, influencing the outcomes of experimental trials. Evaluation metrics exploited in tests report enhanced outcomes when the association between training modality and poststroke stage is optimized. Nevertheless, future developments will possibly extend this study to other factors that may have influenced outcomes, such as intensity of the exercises, frequency and duration of the therapy, and impairme","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":" ","pages":""},"PeriodicalIF":5.2,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147816395","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Microstate permutation complexity of EEG signals distinguishes minimally conscious state plus from minimally conscious state minus.","authors":"Zhibin Zhao, Zhenhu Liang, Yong Wang, Xiaoli Li, He Chen","doi":"10.1186/s12984-026-01993-w","DOIUrl":"https://doi.org/10.1186/s12984-026-01993-w","url":null,"abstract":"<p><strong>Background: </strong>Accurately distinguishing minimally conscious state plus (MCS+) from minimally conscious state minus (MCS-) is critical for prognosis and treatment planning. Microstate analysis decomposes multichannel electroencephalography (EEG) into a sequence of brief, relatively stable scalp electric-field topographies, offering a unique spatiotemporal perspective on brain activity. Yet applications of microstate methods to the assessment of disorders of consciousness remain scarce. Moreover, most state-of-the-art studies focus on characterizing the complexity of microstate sequences, while conventional complexity measures overlook transitions between microstates. To address this gap, we propose Microstate Permutation Lempel-Ziv Complexity (MS-PLZC), an extension of Lempel-Ziv complexity that explicitly encodes ordinal permutation information to more sensitively capture the temporal organization of microstate sequences.</p><p><strong>Methods: </strong>Resting-state EEG was recorded from 45 individuals with disorders of consciousness (15 unresponsive wakefulness syndrome, 15 MCS-, 15 MCS+) and 15 neurologically healthy controls. MS-PLZC, conventional microstate LZC, spectral power, sample entropy, and classical LZC were calculated and statistically compared. These features were assessed using a nested leave-one-out cross-validated (LOOCV) SVM with exhaustive hyper-parameter search.</p><p><strong>Results: </strong>Both MS-LZC and MS-PLZC showed statistically significant group differences (Kruskal-Wallis test: MS-LZC: H = 26.92, p < 0.0000, η²=0.2099; MS-PLZC: H = 35.11, p < 0.0000, η²=0.2816), with MS-PLZC exhibiting greater statistical power. Notably, MS-PLZC successfully distinguished between MCS- and MCS+ patients (p _adj < 0.05) with a large effect size (Cliff's Delta = -0.6178), whereas MS-LZC demonstrated only a medium effect size (Cliff's Delta = -0.3067). In the machine-learning analysis MS-PLZC achieved the highest leave-one-out accuracy (0.733) and ROC-AUC (0.733).</p><p><strong>Conclusions: </strong>These results indicate that MS-PLZC sensitively captures subtle shifts in microstate dynamics and offers a reliable single-feature discriminator of MCS+ versus MCS-, with translational potential for detecting key recovery windows during routine assessment of consciousness.</p>","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":" ","pages":""},"PeriodicalIF":5.2,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147816337","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sensory and cortical biomarkers unveil pain modulation mechanisms induced by targeted multisensory neurostimulation.","authors":"Giuseppe Valerio Aurucci, Noemi Gozzi, Andrea Cimolato, Markus Wagner, Carl Moritz Zipser, Stanisa Raspopovic","doi":"10.1186/s12984-026-01998-5","DOIUrl":"https://doi.org/10.1186/s12984-026-01998-5","url":null,"abstract":"<p><strong>Background: </strong>Chronic neuropathic pain is a complex experience that poses a major challenge in personalized treatment. Identifying objective biomarkers of pain modulation is critical to validate emerging non-pharmacological therapies with reliable endpoints, overcoming the limitations of simplified subjective scales.</p><p><strong>Methods: </strong>Here, we introduce a multimodal monitoring framework that integrates behavioral, sensory, and cortical assessments to provide a comprehensive evaluation of a multisensory neurostimulation treatment combining immersive VR with targeted neurostimulation (VR+tSTIM). We compared the effects of this intervention with an active control in 18 participants with chronic neuropathic pain over multiple days.</p><p><strong>Results: </strong>VR+tSTIM led to a clinically significant reduction in self-reported pain intensity. This reduction was accompanied by sensory measures, with participants in the VR+tSTIM group showing enhanced tactile acuity and improved proprioceptive accuracy, effects that did not appear in the control group. Treatment effectiveness was further associated with cortical EEG signatures of decreased gamma and delta power together with increased alpha power.</p><p><strong>Conclusions: </strong>These findings identify potential sensory and cortical biomarkers associated with analgesia and suggest that pain relief in neuropathy may involve the modulation of both peripheral and central mechanisms. This comprehensive assessment paradigm establishes a foundation for the objective monitoring of treatment efficacy and advances the search for mechanistic biomarkers of pain modulation in clinical neuroengineering.</p><p><strong>Trial registration: </strong>This study was approved by the Kantonale Ethikkommission Zürich (Nr. 2021-02258).</p>","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":" ","pages":""},"PeriodicalIF":5.2,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147774129","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}