Movement-Related EEG Oscillations of Contralesional Hemisphere Discloses Compensation Mechanisms of Severely Affected Motor Chronic Stroke Patients

ArmVR: Innovative Design Combining Virtual Reality Technology and Mechanical Equipment in Stroke Rehabilitation Therapy

The rising incidence of stroke has created a significant global public health challenge. The immersive qualities of virtual reality (VR) technology, along with its distinct advantages, make it a promising tool for stroke rehabilitation. To address this challenge, developing VR-based upper limb rehabilitation systems has become a critical research focus. This study developed and evaluated an innovative ArmVR system that combines VR technology with rehabilitation hardware to improve recovery outcomes for stroke patients. Through comprehensive assessments, including neurofeedback, pressure feedback, and subjective feedback, the results suggest that VR technology has the potential to positively support the recovery of cognitive and motor functions. Different VR environments affect rehabilitation outcomes: forest scenarios aid emotional relaxation, while city scenarios better activate motor centers in stroke patients. The study also identified variations in responses among different user groups. Normal users showed significant changes in cognitive function, whereas stroke patients primarily experienced motor function recovery. These findings suggest that VR-integrated rehabilitation systems possess great potential, and personalized design can further enhance recovery outcomes, meet diverse patient needs, and ultimately improve quality of life.

Exploring virtual reality as an anxiety-inducing paradigm: Multimodal insights from subjective, behavioral and neurophysiological measures

Anxiety results from the complex interplay between innate defensive responses to perceived threats and higher-order cognitive processes, mediated by specialized circuits in the human neocortex. Traditional methods of anxiety induction often fail to replicate the inherent unpredictability of threats or maintain ecological validity, thereby limiting their ability to fully elucidate the underlying mechanisms of anxiety. To overcome these limitations, this study aimed to explore the effectiveness of virtual reality (VR) as an innovative anxiety-inducing tool. By further using its ability to simulate real world scenes, the neural activities inducing anxiety in VR scenes were studied. VR is used to induce anxiety through customized scenarios, while a range of data, including subjective self-reports, objective performance measures, eye movement data, and EEG signals, are collected. The findings indicate that VR is efficacious in induced anxiety, which manifests through the arousal of anxious emotions, alterations in cognitive processes, and distinct neurophysiological patterns, particularly increased theta and alpha activity in the frontal and parietal regions. This research reinforces the ecological validity of VR as a research tool, contributing to a deeper understanding of the neurophysiological basis of anxiety and providing a more nuanced framework for both anxiety research and interventions in real-world contexts.

Cortical Activation Patterns Determine Effectiveness of rTMS-Induced Motor Imagery Decoding Enhancement in Stroke Patients

Combination therapy with motor imagery (MI)-based brain-computer interface (BCI) and repetitive transcranial magnetic stimulation (rTMS) is a promising therapy for poststroke neurorehabilitation. However, with patients' individual differences, the clinical effects vary greatly. This study aims to explore the hypothesis that stroke patients show individualized cortical response to rTMS treatments, which determine the effectiveness of rTMS-induced MI decoding enhancement. We applied four kinds of rTMS treatments respectively to four groups of subacute stroke patients, twenty-six patients in total, and observed their EEG dynamics, MI decoding performance, and Fugl-Meyer assessment changes following 2-week neuromodulation. Four treatments consisted of ipsilesional 10 Hz rTMS, contralesional 1 Hz rTMS, ipsilesional 1 Hz rTMS, and sham stimulation. Results showed stroke patients with different neural reorganization patterns responded individually to rTMS therapy. Patients with cortical lesions mostly showed contralesional recruitment and patients without cortical lesions mostly presented ipsilesional focusing. Significant activation increases in the ipsilesional hemisphere (pre: -15.7% ∓ 8.2%, post: -17.3% ∓ 8.1%, p = 0.037) and MI decoding accuracy enhancement (pre: 76.3 ± 13.8%, post: 86.6 ± 8.2%, p = 0.037) were concurrently found in no-cortical-lesion patients with ipsilesional activation treatment. In the group of patients without cortical lesions, recovery rate in those receiving ipsilesional activation therapy (23.5 ± 10.4%) was higher than those receiving ipsilesional suppression therapy (9.9 ± 9.3%) (p = 0.041). This study reveals that tailoring neuromodulation therapy by recognizing cortical activation patterns is promising for improving effectiveness of the combination therapy with BCI and rTMS.

Tailoring brain-machine interface rehabilitation training based on neural reorganization: towards personalized treatment for stroke patients

Electroencephalogram (EEG)-based brain-machine interface (BMI) has the potential to enhance rehabilitation training efficiency, but it still remains elusive regarding how to design BMI training for heterogeneous stroke patients with varied neural reorganization. Here, we hypothesize that tailoring BMI training according to different patterns of neural reorganization can contribute to a personalized rehabilitation trajectory. Thirteen stroke patients were recruited in a 2-week personalized BMI training experiment. Clinical and behavioral measurements, as well as cortical and muscular activities, were assessed before and after training. Following treatment, significant improvements were found in motor function assessment. Three types of brain activation patterns were identified during BMI tasks, namely, bilateral widespread activation, ipsilesional focusing activation, and contralesional recruitment activation. Patients with either ipsilesional dominance or contralesional dominance can achieve recovery through personalized BMI training. Results indicate that personalized BMI training tends to connect the potentially reorganized brain areas with event-contingent proprioceptive feedback. It can also be inferred that personalization plays an important role in establishing the sensorimotor loop in BMI training. With further understanding of neural rehabilitation mechanisms, personalized treatment strategy is a promising way to improve the rehabilitation efficacy and promote the clinical use of rehabilitation robots and other neurotechnologies.

Transcranial Doppler analysis based on computer and artificial intelligence for acute cerebrovascular disease

Cerebrovascular disease refers to damage to brain tissue caused by impaired intracranial blood circulation. It usually presents clinically as an acute nonfatal event and is characterized by high morbidity, disability, and mortality. Transcranial Doppler (TCD) ultrasonography is a non-invasive method for the diagnosis of cerebrovascular disease that uses the Doppler effect to detect the hemodynamic and physiological parameters of the major intracranial basilar arteries. It can provide important hemodynamic information that cannot be measured by other diagnostic imaging techniques for cerebrovascular disease. And the result parameters of TCD ultrasonography such as blood flow velocity and beat index can reflect the type of cerebrovascular disease and serve as a basis to assist physicians in the treatment of cerebrovascular diseases. Artificial intelligence (AI) is a branch of computer science which is used in a wide range of applications in agriculture, communications, medicine, finance, and other fields. In recent years, there are much research devoted to the application of AI to TCD. The review and summary of related technologies is an important work to promote the development of this field, which can provide an intuitive technical summary for future researchers. In this paper, we first review the development, principles, and applications of TCD ultrasonography and other related knowledge, and briefly introduce the development of AI in the field of medicine and emergency medicine. Finally, we summarize in detail the applications and advantages of AI technology in TCD ultrasonography including the establishment of an examination system combining brain computer interface (BCI) and TCD ultrasonography, the classification and noise cancellation of TCD ultrasonography signals using AI algorithms, and the use of intelligent robots to assist physicians in TCD ultrasonography and discuss the prospects for the development of AI in TCD ultrasonography.

EEG-Based Brain Network Analysis of Chronic Stroke Patients After BCI Rehabilitation Training

Traditional rehabilitation strategies become difficult in the chronic phase stage of stroke prognosis. Brain–computer interface (BCI) combined with external devices may improve motor function in chronic stroke patients, but it lacks comprehensive assessments of neurological changes regarding functional rehabilitation. This study aimed to comprehensively and quantitatively investigate the changes in brain activity induced by BCI–FES training in patients with chronic stroke. We analyzed the EEG of two groups of patients with chronic stroke, one group received functional electrical stimulation (FES) rehabilitation training (FES group) and the other group received BCI combined with FES training (BCI–FES group). We constructed functional networks in both groups of patients based on direct directed transfer function (dDTF) and assessed the changes in brain activity using graph theory analysis. The results of this study can be summarized as follows: (i) after rehabilitation training, the Fugl–Meyer assessment scale (FMA) score was significantly improved in the BCI–FES group (p < 0.05), and there was no significant difference in the FES group. (ii) Both the global and local graph theory measures of the brain network of patients with chronic stroke in the BCI–FES group were improved after rehabilitation training. (iii) The node strength in the contralesional hemisphere and central region of patients in the BCI–FES group was significantly higher than that in the FES group after the intervention (p < 0.05), and a significant increase in the node strength of C4 in the contralesional sensorimotor cortex region could be observed in the BCI–FES group (p < 0.05). These results suggest that BCI–FES rehabilitation training can induce clinically significant improvements in motor function of patients with chronic stroke. It can improve the functional integration and functional separation of brain networks and boost compensatory activity in the contralesional hemisphere to a certain extent. The findings of our study may provide new insights into understanding the plastic changes of brain activity in patients with chronic stroke induced by BCI–FES rehabilitation training.