Journal of NeuroEngineering and Rehabilitation最新文献

{"title":"A review of concurrent sonified biofeedback in balance and gait training.","authors":"Antonia Zaferiou, Zahava Hirsch, Tristan Bacani, Luke Dahl","doi":"10.1186/s12984-025-01565-4","DOIUrl":"10.1186/s12984-025-01565-4","url":null,"abstract":"<p><strong>Background: </strong>Sonified biofeedback is a subtype of auditory biofeedback that conveys biological data through specific non-verbal sounds. It can be designed to provide augmented biomechanical feedback in near-real-time when provided as \"concurrent\" biofeedback. As a practice that developed spanning across engineering and the arts, sonified biofeedback can extend beyond simple tones and beeps, towards more fully incorporating music in movement training. Sonified biofeedback may leverage the motivational aspects of music in movement training, the neuroplasticity benefits demonstrated from participation in music-based interventions, and neurological auditory-motor coupling, all while providing task-relevant cues to facilitate motor (re)learning. Sonified biofeedback may also provide similar benefits as rhythmic cueing (e.g., rhythmic auditory stimulation), or added benefits because sonified biofeedback does not impose a strict isochronous rhythm when it follows rhythms that are driven by outputs of the motor control system. In this review paper, the unique opportunity presented by concurrent sonified biofeedback as a movement training tool for balance and gait is introduced and discussed.</p><p><strong>Results and discussion: </strong>This review paper brings together prior research from clinical, engineering, and artistic design sources using sonified biofeedback in balance and gait training across diverse end-users to highlight trends, reveal gaps in knowledge, and provide perspective for future work in the area. The goal was to review progress and critically assess research using sonified biofeedback during movement training for postural control or gait. 49 papers were selected based on their experimental investigation and statistical analyses of the effects of using sonified biofeedback to assist in movement training for feet-in-place balance tasks (20 papers) or gait tasks such as walking and running (29 papers). The sound design choices, experimental design features, and movement training results are summarized and reviewed. All but two studies reported at least one statistically significant positive effect of training with sonified biofeedback in biomechanical, clinical, or psychosocial measures. Conversely, only seven studies shared any negative effect on one biomechanical, clinical, or psychosocial measure (with five of these studies also reporting at least one other positive effect). After describing these encouraging findings, this review closes by sharing perspectives about future directions for designing and using sonified biofeedback in balance and gait training, and opportunities for more cohesive growth in this practice. One such suggestion is to pursue sonified designs and experimental designs that can translate to the neurorehabilitation field. This includes strategically selecting control groups and evaluation tasks to understand if improvements from training with one task transfer to additional relevant movement ","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":"22 1","pages":"38"},"PeriodicalIF":5.2,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11866693/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143515986","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quantifying arm swing in Parkinson's disease: a method accounting for arm activities during free-living gait.","authors":"Erik Post, Twan van Laarhoven, Yordan P Raykov, Max A Little, Jorik Nonnekes, Tom M Heskes, Bastiaan R Bloem, Luc J W Evers","doi":"10.1186/s12984-025-01578-z","DOIUrl":"10.1186/s12984-025-01578-z","url":null,"abstract":"<p><strong>Background: </strong>Accurately measuring hypokinetic arm swing during free-living gait in Parkinson's disease (PD) is challenging due to other concurrent arm activities. We developed a method to isolate gait segments without these arm activities.</p><p><strong>Methods: </strong>Wrist accelerometer and gyroscope data were collected from 25 individuals with PD and 25 age-matched controls while performing unscripted activities in their home environment. This was done after overnight withdrawal of dopaminergic medication ('pre-medication') and approximately one hour after intake ('post-medication'). Using video annotations as ground truth, we trained and evaluated two classifiers: one for detecting gait and one for detecting gait segments without other arm activities. Based on the filtered gait segments, arm swing was quantified using the median and 95th percentile range of motion (RoM). These arm swing parameters were evaluated in three ways: (1) the agreement between predicted and video-annotated gait segments without other arm activities, (2) the sensitivity to differences between PD and controls, and (3) the sensitivity to the effects of dopaminergic medication.</p><p><strong>Results: </strong>On the most affected side, the mean (SD) balanced accuracy for detecting gait without other arm activities was 0.84 (0.10) pre-medication and 0.88 (0.09) post-medication. The agreement between arm swing parameters of predicted and video-annotated gait segments without other arm activities was high irrespective of medication state (intra-class correlation coefficients: median RoM: 0.99; 95th percentile RoM: 0.97). Both the median and 95th percentile RoM were smaller in PD pre-medication compared to controls (median: <math><mrow><mi>Δ</mi> <mo>=</mo> <mo>-</mo> <mn>18</mn> <mo>.</mo> <msup><mn>80</mn> <mo>∘</mo></msup> </mrow> </math> , 95% CI [ <math><mo>-</mo></math> 30.63, <math><mo>-</mo></math> 10.60], p < 0.001; 95th percentile: <math><mrow><mi>Δ</mi> <mo>=</mo> <mo>-</mo> <mn>28</mn> <mo>.</mo> <msup><mn>34</mn> <mo>∘</mo></msup> </mrow> </math> , 95% CI [ <math><mo>-</mo></math> 38.26, <math><mo>-</mo></math> 18.18], p < 0.001), and smaller in pre- compared to post-medication (median: <math><mrow><mi>Δ</mi> <mo>=</mo> <mo>-</mo> <mn>12</mn> <mo>.</mo> <msup><mn>31</mn> <mo>∘</mo></msup> </mrow> </math> , 95% CI [ <math><mo>-</mo></math> 21.35, <math><mo>-</mo></math> 5.59], p < 0.001; 95th percentile: <math><mrow><mi>Δ</mi> <mo>=</mo> <mo>-</mo> <mn>19</mn> <mo>.</mo> <msup><mn>04</mn> <mo>∘</mo></msup> </mrow> </math> , 95% CI [ <math><mo>-</mo></math> 28.48, <math><mo>-</mo></math> 11.14], p < 0.001). The differences in RoM between pre- and post-medication were larger after filtering gait for the median (p < 0.01) and 95th percentile RoM (p = 0.01).</p><p><strong>Conclusions: </strong>Filtering out gait segments with other concurrent arm activities is feasible and increases the change in arm swing parameters following dopaminergic medica","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":"22 1","pages":"37"},"PeriodicalIF":5.2,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11863854/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143516050","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Post-stroke Stiff-Knee gait: are there different types or different severity levels?","authors":"Jeonghwan Lee, Bryant A Seamon, Robert K Lee, Steven A Kautz, Richard R Neptune, James S Sulzer","doi":"10.1186/s12984-025-01582-3","DOIUrl":"10.1186/s12984-025-01582-3","url":null,"abstract":"<p><p>Stiff-Knee gait (SKG) commonly occurs in individuals after stroke, loosely defined as reduced peak knee flexion angle during swing. The causes of SKG are multifaceted and debated. Further, clinical interventions have not been consistently effective, possibly resulting from multiple undiagnosed subtypes of SKG. Thus, our primary goal of this study is to explore the existence of potential subtypes associated with different levels of motor control complexity. We used retrospective kinematics, kinetics and muscle activity from 50 stroke survivors and 15 healthy, age-matched controls during treadmill walking. We used a time-series kernel k-means cluster analysis based on compensatory frontal plane kinematics associated with SKG to separate participants into three groups, Cluster A (hip hiking, lowest knee flexion, highest propulsion asymmetry, lowest gait speed), Cluster B (hip hiking and hip abduction, moderate knee flexion, middle gait speed) and Cluster C (highest knee flexion, highest gait speed). The highest proportion of individuals with SKG as diagnosed by a clinician were in Cluster A, but with a substantial proportion in Cluster B, indicating that these two clusters can be considered subtypes of SKG. Despite differences in kinematics and kinetics, we did not observe fundamental differences in underlying motor control between clusters as determined by non-negative matrix factorization of measured muscle activations. We conclude that the differences between clusters were most likely attributed to the severity of gait impairment, as reflected by slower gait speed and propulsion asymmetry, rather than being a different type of SKG.</p>","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":"22 1","pages":"36"},"PeriodicalIF":5.2,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11863409/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143502000","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of transcranial direct current stimulation on paroxysmal sympathetic hyperexcitability with acquired brain injury and cortical excitability: a randomized, double-blind, sham-controlled pilot study.","authors":"Mingrui Liu, Yuanyuan Li, Jiayi Zhao, Baohu Liu, Guoping Duan, Qing Guo, Zelin Ye, Xu Zhang, Chaolu Wang, Dongyu Wu","doi":"10.1186/s12984-025-01583-2","DOIUrl":"10.1186/s12984-025-01583-2","url":null,"abstract":"<p><p>Paroxysmal sympathetic hyperexcitation (PSH) refers to a clinical syndrome characterized by a sudden increase in sympathetic excitability caused by severe brain injury. This study aims to investigate the effectiveness and practicality of combining transcranial direct current stimulation (tDCS) with medication to treat PSH and employ non-linear electroencephalography (EEG) to assess changes in cortical activation post-intervention. 40 PSH patients were randomly assigned to receive either active tDCS or sham tDCS treatment over an 8-week period. The tDCS stimulation targeted the prefrontal area, left frontal-temporal-parietal cortex, right frontal-temporal-parietal cortex, and left dorsolateral prefrontal cortex. Both patient groups also underwent medication and other conventional therapies. The Paroxysmal Sympathetic Hyperactivity Assessment Measure (PSH-AM), Coma Recovery Scale-Revised (CRS-R), medication dosage, and approximate entropy (ApEn) index were assessed before and after treatment. The active tDCS group exhibited more substantial improvements in changes of PSH-AM, changes of CRS-R, and medication reduction ratios compared to the sham tDCS group after the treatment. After treatment and during follow-up, a significantly greater number of patients in the active tDCS group demonstrated clinically important differences compared to the sham tDCS group. The active tDCS group showed significantly higher ApEn indices in the less affected frontal lobe compared to the control group. No significant differences in ApEn indices were noted in the sham tDCS group before and after treatment. Regression analysis revealed that the group (active tDCS/sham tDCS) was the primary factor associated with improving PSH-AM. Therefore, we believe that in patients with PSH, combining tDCS with medication therapy demonstrated superior clinical efficacy compared to medication therapy alone. Electrophysiological results also indicated enhanced cortical excitability. Therefore, this single-center pilot study suggests that multi-target, multi-session tDCS combined with medication may be an effective treatment protocol for PSH.</p>","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":"22 1","pages":"35"},"PeriodicalIF":5.2,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11852813/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143501987","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors associated with upper extremity use after stroke: a scoping review of accelerometry studies.","authors":"Léandre Gagné-Pelletier, Isabelle Poitras, Marc Roig, Catherine Mercier","doi":"10.1186/s12984-025-01568-1","DOIUrl":"10.1186/s12984-025-01568-1","url":null,"abstract":"<p><strong>Background: </strong>A discrepancy between the level of impairment at the upper extremity (UE) and its use in activities of daily life is frequently observed in individuals who have experienced a stroke. Wrist-worn accelerometers allow an objective and valid measure of UE use in everyday life. Accelerometer studies have shown that a wide range of factors beyond UE impairment can influence UE use. This scoping review aims to identify factors associated with UE use and to investigate the influence of different types of accelerometry metrics on these associations.</p><p><strong>Method: </strong>A search using CINHAL, Embase, MEDLINE, Compendex, and Web of Science Core Collection databases was performed. Studies that assessed the association between UE use quantified with accelerometers and factors related to the person or their environment in individuals with stroke were included. Data related to study design, participants characteristics, accelerometry methodology (absolute vs. relative UE use metrics), and associations with personal and environmental factors were extracted.</p><p><strong>Results: </strong>Fifty-four studies were included. Multiple studies consistently reported associations between relative UE use and stroke severity, UE motor impairment, unimanual capacity, bimanual capacity, and mobility. In contrast, there were inconsistent associations with factors such as neglect and concordance between dominance and side of paresis and a consistent lack of association between relative UE use and time since stroke, sex, and age. Metrics of absolute paretic UE use yielded different results regarding their association with personal and environmental factors, as they were more influenced by factors related to physical activity and less associated with factors related to UE capacity.</p><p><strong>Conclusion: </strong>Healthcare providers should recognize the complexity of the relationship between UE use and impairment and consider additional factors when selecting assessments during rehabilitation to identify patients at risk of underutilizing their paretic arm in daily life. Future research in this domain should preconize relative UE use metrics or multi-sensors method to control for the effect of physical activity.</p>","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":"22 1","pages":"33"},"PeriodicalIF":5.2,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11849390/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143492275","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Telerehabilitation for visual field defects with a multisensory training: a feasibility study.","authors":"Nadia Bolognini, Lorenzo Diana, Angela Rossetti, Lisa Melzi, Gianpaolo Basso, Vittorio Manzo, Francy Cruz-Sanabria, Gabriella Cammarata, Franco Cernigliaro, Stefania Bianchi Marzoli, Francesca Tinelli, Simona Fiori, Carlotta Casati","doi":"10.1186/s12984-025-01573-4","DOIUrl":"10.1186/s12984-025-01573-4","url":null,"abstract":"<p><strong>Background: </strong>Acquired homonymous visual field defects (HVFDs) result in significant disability, reducing quality of life. Spontaneous recovery occurs within the first months, then the likelihood of vision recovery decreases, making rehabilitation necessary. HVFDs rehabilitation is typically lengthy and intensive, done on an outpatient basis, hardly compatible with the return to everyday life. Telerehabilitation represents an option for continuing the therapy in the chronic phase of the disease, offering long-term support after hospital discharge. It also allows individuals with HVFDs to exercise independently, intensively, and actively at home, in a familiar environment, under remote supervision. However, the efficacy of telerehabilitation for chronic HVFDs in adults still requires empirical support.</p><p><strong>Methods: </strong>This single-arm clinical trial assesses the efficacy of a home-based, remote-supervised, compensatory audio-visual training (AVT) in 26 adults with chronic HVFDs following a brain lesion. Immediate and long-term (up to 6 months) effects on visual field scanning, reading, activities of daily living and mood were assessed. Predictors of treatment-induced gains were also investigated considering behavioral, neuro-ophthalmological (visual field perimetry and visual evoked potentials) and neuroradiological variables (structural imaging of grey- and white-matter damages). Finally, the efficacy of the home-based AVT was compared to that of its in-person version (16 new participants with chronic HVFDs).</p><p><strong>Results: </strong>Home-based AVT improves accuracy and speed of visual search, reading, mood, and disability in the activities of daily living, with improvements persisting up to 6 months after the end of the training (baseline vs. post-training assessments, all ps < 0.04). Post-treatment gains correlate with the severity of visual search deficit and the efficiency of multisensory integration (rs = -0.7/-0.5, all ps < 0.04). Neuro-ophthalmological and neuroradiological (structural connectivity) parameters are unaffected by the AVT, in line with its compensatory nature, although being associated to its efficacy (all ps < 0.03). Finally, the telerehabilitation version of the AVT produces effects comparable to the in-person AVT.</p><p><strong>Conclusion: </strong>Multisensory training delivered in telerehabilitation is feasible and effective for ameliorating oculomotor compensation of visual field loss, improving mood and reducing functional disabilities in adults with chronic HVFDs. Trial registration This study was retrospectively registered at clinicaltrials.gov (NCT06341777; 26/03/2024).</p>","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":"22 1","pages":"34"},"PeriodicalIF":5.2,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11849177/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143492322","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improving research and development of wearable assistive and rehabilitation technologies: a systematic review on diversity factors.","authors":"Mariya Lorke, Thekla Stefanou","doi":"10.1186/s12984-025-01562-7","DOIUrl":"10.1186/s12984-025-01562-7","url":null,"abstract":"<p><p>This paper analyses diversity and intersectionality aspects in the R&D of wearable assistive and rehabilitation technologies (WEARTechs). We advocate for inclusive, innovative research that we hope will help bridge the gap between laboratories and the real world and reduce disparities in healthcare and technology development. We performed a systematic literature review of the intersections between assistive technologies and diversity and conducted a thematic analysis of the diversity factors identified in the literature. In addition, we carried out a supplementary literature search on WEARTechs to discover which, if any, diversity aspects are currently being reported on. Our findings indicate that diversity has not been addressed in the field of WEARTechs. There is not sufficient knowledge to determine, which diversity-related aspects researchers must consider when evaluating the performance of any specific WEARTech device. Nor about how these can be properly addressed in the R&D process. We, therefore, provide actionable recommendations on how to integrate diversity-relevant aspects at different R&D stages. We hope that our review will help scientists rethink and reformulate approaches to the R&D of WEARTechs and build the way towards more inclusive solutions. It is our belief that this will spark innovation and enhance discovery potential in the field.</p>","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":"22 1","pages":"31"},"PeriodicalIF":5.2,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11844098/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143472564","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gait stability in virtual reality: effects of VR display modality in the presence of visual perturbations.","authors":"Elizabeth B Wilson, J Stephen Bergquist, W Geoffrey Wright, Daniel A Jacobs","doi":"10.1186/s12984-025-01558-3","DOIUrl":"10.1186/s12984-025-01558-3","url":null,"abstract":"<p><strong>Purpose: </strong>Virtual reality (VR) has emerged as a pivotal tool for studying balance and postural control mechanisms, leveraging unpredictable visual disturbances that dynamically challenge visuomotor processing. However, the quantity and quality of information available in the visual field may differ between VR systems, potentially introducing conflict with the intended perturbation inputs. Consequently, the extent to which a VR system used in a visual perturbation paradigm influences its ability to elicit compensatory gait behaviors remains unclear. Here we investigate the impact of (1) VR display modality and (2) the direction of visual perturbations on spatiotemporal gait parameters and measures of stability in VR.</p><p><strong>Methods: </strong>Participants were tasked with maintaining steady-state walking on a self-paced treadmill while viewing a VR scene presented in either a rear-projection curved screen immersive room (IR) or a head-mounted display (HMD). During trials with augmented visual perturbations, pseudorandom oscillations were combined with forward walking speed either in the anterior-posterior (AP), or medio-lateral (ML) direction. Linear mixed-effects models were used to analyze the impact of VR display type and visual perturbations on spatiotemporal gait parameters, stability measures, and joint kinematics.</p><p><strong>Results: </strong>For self-paced walking in matched VR optic flow, we found that the HMD increased the variability of several parameters related to walking speed control, but did not significantly impact any gait parameter average values. Superimposing visual perturbations along the ML axis increased gait variability and decreased walking stability in both VR systems, but the perturbations had stronger effects if presented in the HMD.</p><p><strong>Conclusion: </strong>Together, these findings suggest that portable light-weight HMD systems can provide affordable, reliable tools for studying and training balance control and locomotion.</p>","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":"22 1","pages":"32"},"PeriodicalIF":5.2,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11844080/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143472563","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Proficiency in motor imagery is linked to the lateralization of focused ERD patterns and beta PDC.","authors":"Irma Nayeli Angulo-Sherman, Umberto León-Domínguez, Antonio Martinez-Torteya, Gilberto Andrés Fragoso-González, Mayté Verónica Martínez-Pérez","doi":"10.1186/s12984-025-01571-6","DOIUrl":"10.1186/s12984-025-01571-6","url":null,"abstract":"<p><strong>Background: </strong>Motor imagery based brain-computer interfaces (MI-BCIs) are systems that detect the mental rehearsal of movement from brain activity signals (EEG) for controlling devices that can potentiate motor neurorehabilitation. Considering the problem that MI proficiency requires training and it is not always achieved, EEG desirable features should be investigated to propose indicators of successful MI training.</p><p><strong>Methods: </strong>Nine healthy right-handed subjects trained with a MI-BCI for four sessions. In each session, EEG was recorded for 30 trials that consisted of a rest and a dominant-hand MI sequence, which were used for calibrating the system. Then, the subject participated in 160 trials in which a cursor was displaced on a screen by performing MI or relaxing to hit a target. The session's accuracy was calculated. For each trial from the calibration phase of the first session, the power spectral density (PSD) and the partial directed coherence (PDC) of the rest and MI EEG segments were obtained to estimate the event-related synchronization changes (ERS) and the connectivity patterns of the <math><mi>θ</mi></math> , <math><mi>α</mi></math> , <math><mi>β</mi></math> and <math><mi>γ</mi></math> bands that are associated with high BCI control (accuracy above 70% in at least one session). Finally, t-tests and rank-sum tests ( <math><mrow><mi>p</mi> <mo><</mo> <mn>0.05</mn></mrow> </math> , with Benjamini-Hochberg correction) were used to compare the ERS/ERD and PDC values of subjects with high and low accuracy, respectively.</p><p><strong>Results: </strong>Proficient users showed greater <math><mi>α</mi></math> ERD on the right-hand motor cortex (left hemisphere). Furthermore, the <math><mi>β</mi></math> PDC related to the ipsilateral motor cortex is commonly weakened during motor imagery, while the contralateral motor cortex <math><mi>γ</mi></math> PDC is enhanced.</p><p><strong>Conclusions: </strong>Motor imagery proficiency is related to the focused and lateralized event-related <math><mi>α</mi></math> desynchronization patterns and the lateralization of <math><mi>β</mi></math> and <math><mi>γ</mi></math> PDC. Future analysis of these features could allow complimenting the information for assessment of subject-specific BCI control and the prediction of the effectiveness of motor-imagery training.</p>","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":"22 1","pages":"30"},"PeriodicalIF":5.2,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11844094/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143468323","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sway frequencies may predict postural instability in Parkinson's disease: a novel convolutional neural network approach.","authors":"David Engel, R Stefan Greulich, Alberto Parola, Kaleb Vinehout, Justus Student, Josefine Waldthaler, Lars Timmermann, Frank Bremmer","doi":"10.1186/s12984-025-01570-7","DOIUrl":"10.1186/s12984-025-01570-7","url":null,"abstract":"<p><strong>Background: </strong>Postural instability greatly reduces quality of life in people with Parkinson's disease (PD). Early and objective detection of postural impairments is crucial to facilitate interventions. Our aim was to use a convolutional neural network (CNN) to differentiate people with early to mid-stage PD from healthy age-matched individuals based on spectrogram images obtained from their body sway. We hypothesized the time-frequency content of body sway to be predictive of PD, even when impairments are not yet clinically apparent.</p><p><strong>Methods: </strong>18 people with idiopathic PD and 15 healthy controls (HC) participated in the study. We tracked participants' center of pressure (COP) using a Wii Balance Board and their full-body motion using a Microsoft Kinect, out of which we calculated the trajectory of their center of mass (COM). We used 30 s-snippets of motion data from which we acquired wavelet-based time-frequency spectrograms that were fed into a custom-built CNN as labeled images. We used binary classification to have the network differentiate between individuals with PD and controls (n = 15, respectively).</p><p><strong>Results: </strong>Classification performance was best when the medio-lateral motion of the COM was considered. Here, our network reached a predictive accuracy, sensitivity, specificity, precision and F1-score of 100%, respectively, with a receiver operating characteristic area under the curve of 1.0. Moreover, an explainable AI approach revealed high frequencies in the postural sway data to be most distinct between both groups.</p><p><strong>Conclusion: </strong>Heeding our small and heterogeneous sample, our findings suggest a CNN classifier based on cost-effective and conveniently obtainable posturographic data to be a promising approach to detect postural impairments in early to mid-stage PD and to gain novel insight into the subtle characteristics of impairments at this stage of the disease.</p>","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":"22 1","pages":"29"},"PeriodicalIF":5.2,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11837685/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143449361","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}