Broad-band Gaussian noise is most effective in improving motor performance and is most pleasant

Application of vibration to the soles increases long-range correlations in the stride parameters during walking

Temporal fluctuations in the stride parameters during human walking exhibit long-range correlations, but these long-range correlations in the stride parameters decrease due to aging or neuromuscular diseases. These observations suggest that any quantified index of the long-range correlation can be regarded as an indicator of gait functionality. Considering the effect of task-relevant sensory feedback on augmenting human motor performance, we devised shoes with active insoles that could deliver noisy vibration to the soles of feet and assessed their efficacy in enhancing the long-range correlations in the stride parameters for healthy young adults. The vibration could be wirelessly controlled using a smartphone. The actuators, control unit, and battery in the devised shoes were light and embedded in the shoes. By virtue of this compactness, the shoes could be easily used for daily walking outside a laboratory. We performed walking experiments with 20 healthy adults and evaluated the effects of sub- and supra-threshold vibration on long-range correlations in stride interval and length. We performed detrended fluctuation analysis to quantify the long-range correlation of temporal changes in stride interval and length. We found that supra-threshold vibration, applied to the soles with the amplitude of 130 % of the sensory threshold, significantly increased the long-range correlations in stride interval and length by 10.3 % (p = 0.009) and 10.1 % (p = 0.021), respectively. On the other hand, sub-threshold vibration with the amplitude of 90 % of the sensory threshold had no significant effect. These results demonstrate that additional somatosensory feedback through barely detectable vibrations, which are supplied by compact shoes with active insoles, can enhance the indices of "healthy" complexity of locomotor function.

Application of vibration to the soles reduces minimum toe clearance variability during walking

Minimum toe clearance (MTC) is an important indicator of the risk of tripping. Aging and neuromuscular diseases often decrease MTC height and increase its variability, leading to a higher risk of tripping. Previous studies have developed visual feedback-based gait training systems to modify MTC. However, these systems are bulky and expensive, and the effects of the training continue only for a short time. We paid attention to the efficacy of vibration in decreasing the variability of gait parameters, and hypothesized that proper vibration applied to soles can reduce the MTC variability. Using shoes embedded with active vibrating insoles, we assessed the efficacy of both sub- and supra-threshold vibration in affecting MTC distribution. Experiment results with 17 young and healthy adults showed that vibration applied throughout the walking task with constant intensity of 130% of sensory threshold significantly decreased MTC variability, whereas sub-threshold vibration yielded no significant effect. These results demonstrate that a properly designed tactile sensory input which is controlled and delivered by a simple wearable device, the active insole, can reduce the MTC variability during walking.

Low-level, prediction-based sensory and motor processes are unimpaired in Autism

A new promising account of human brain function suggests that sensory cortices try to optimise information processing via predictions that are based on prior experiences. The brain is thus likened to a probabilistic prediction machine. There has been a growing - though inconsistent - literature to suggest that features of autism spectrum conditions (ASCs) are associated with a deficit in modelling the world through such prediction-based inference. However empirical evidence for differences in low-level sensorimotor predictions in autism is still lacking. One approach to examining predictive processing in the sensorimotor domain is in the context of self-generated (predictable) as opposed to externally-generated (less predictable) effects. We employed two complementary tasks - forcematching and intentional binding - which examine self-versus externally-generated action effects in terms of sensory attenuation and intentional binding respectively in adults with and without autism. The results show that autism was associated with normal levels of sensory attenuation of internally-generated force and with unaltered temporal attraction of voluntary actions and their outcomes. Thus, our results do not support a general deficit in predictive processing in autism.

Local Vibrational Therapy for Essential Tremor Reduction: A Clinical Study

Background and objectives: tremor is an unintentional and rhythmic movement of any part of the body that is a typical symptom of Essential Tremor (ET). ET impairs the quality of life of patients and is treated with pharmacotherapy. We investigated the tremor reduction efficacy of an innovative vibrational medical device (IMD) in ET patients. Materials and Methods: we conducted a prospective, single-center, single-arm, pragmatic study in ET patients with an extended safety study to evaluate the efficacy and safety of the Vilim Ball-a local hand-arm vibration device that produces vibrations in the frequency range of 8-18 Hz and amplitude from 0 to 2 mm. The primary endpoint was the decrease in the power spectrum after device use. The secondary endpoints were safety outcomes. Results: In total, 17 patients with ET were included in the main study, and no patients withdrew from the main study. The tremor power spectrum (m²/s³ Hz) was lower after the device use, represented as the mean (standard deviation): 0.106 (0.221); median (Md) 0.009 with the interquartile range; IQR, 0.087 vs. 0.042 (0.078); Md = 0.009 with the IQR 0.012; Wilcoxon signed-rank test V = 123; and p = 0.027. Seven patients reported that vibrational therapy was not effective. Two patients reported an increase in tremor after using the device. In the extended safety study, we included 51 patients: 31 patients with ET and 20 with Parkinsonian tremor, where 48 patients reported an improvement in tremor symptoms and 49 in function. No serious adverse events were reported, while two patients in the Parkinsonian tremor group reported a lack of efficacy of the proposed medical device. Conclusions: the device reduces essential tremor in some patients and is safe to use in ET.

Subthreshold Electrical Noise Applied to the Plantar Foot Enhances Lower-Limb Cutaneous Reflex Generation

Reflex responses generated by cutaneous mechanoreceptors of the plantar foot are important for the maintenance of balance during postural tasks and gait. With aging, reflex generation, particularly from fast adapting type I receptors, is reduced, which likely contributes to impaired postural stability in this population. Therefore, improving reflex generation from these receptors may serve as a tool to improve balance performance. A mechanism to enhance reflexes may lie in the phenomenon of stochastic resonance, whereby the addition of certain intensities and frequencies of noise stimuli improves the performance of a system. This study was conducted to determine whether tactile noise stimuli could improve cutaneous reflex generation. In 12 healthy young adults, we evoked cutaneous reflex responses using a 0–50 Hz Gaussian noise vibration applied to the plantar heel. Concurrently, we applied one of six subthreshold intensities of electrical tactile noise to the plantar heel [0%, 20%, 40%, 60%, 80% or 100% (threshold)] and were able to analyze data from 0%, 20% and 40% trials. Across participants, it was found that the addition of a 20% perceptual threshold (PT) noise resulted in enhanced reflex responses when analyzed in both the time and frequency domains. These data provide evidence that cutaneous reflex generation can be enhanced via a stochastic resonance effect and that 20% PT is the optimal intensity of noise to do so. Therefore, the addition of noise stimuli may be a valuable clinical intervention to improve reflex responses associated with postural balance in populations with impairments.

Neurophysiological correlates of force control improvement induced by sinusoidal vibrotactile stimulation

OBJECTIVE

An optimal level of vibrotactile stimulation has been shown to improve sensorimotor control in healthy and diseased individuals. However, the underlying neurophysiological mechanisms behind the enhanced motor performance caused by vibrotactile stimulation are yet to be fully understood. Therefore, here we aim to evaluate the effect of a cutaneous vibration on the firing behavior of motor units in a condition of improved force steadiness.

APPROACH

Participants performed a visuomotor task, which consisted of low-intensity isometric contractions of the first dorsal interosseous (FDI) muscle, while sinusoidal (175 Hz) vibrotactile stimuli with different intensities were applied to the index finger. High-density surface electromyogram was recorded from the FDI muscle, and a decomposition algorithm was used to extract the motor unit spike trains. Additionally, computer simulations were performed using a multiscale neuromuscular model to provide a potential explanation for the experimental findings.

MAIN RESULTS

Experimental outcomes showed that an optimal level of vibration significantly improved force steadiness (estimated as the coefficient of variation of force). The decreased force variability was accompanied by a reduction in the variability of the smoothed cumulative spike train (as an estimation of the neural drive to the muscle), and the proportion of common inputs to the FDI motor nucleus. However, the interspike interval variability did not change significantly with the vibration. A mathematical approach, together with computer simulation results suggested that vibrotactile stimulation would reduce the variance of the common synaptic input to the motor neuron pool, thereby decreasing the low frequency fluctuations of the neural drive to the muscle and force steadiness.

SIGNIFICANCE

Our results demonstrate that the decreased variability in common input accounts for the enhancement in force control induced by vibrotactile stimulation.

Hacking the Brain: Dimensions of Cognitive Enhancement

In an increasingly complex information society, demands for cognitive functioning are growing steadily. In recent years, numerous strategies to augment brain function have been proposed. Evidence for their efficacy (or lack thereof) and side effects has prompted discussions about ethical, societal, and medical implications. In the public debate, cognitive enhancement is often seen as a monolithic phenomenon. On a closer look, however, cognitive enhancement turns out to be a multifaceted concept: There is not one cognitive enhancer that augments brain function per se, but a great variety of interventions that can be clustered into biochemical, physical, and behavioral enhancement strategies. These cognitive enhancers differ in their mode of action, the cognitive domain they target, the time scale they work on, their availability and side effects, and how they differentially affect different groups of subjects. Here we disentangle the dimensions of cognitive enhancement, review prominent examples of cognitive enhancers that differ across these dimensions, and thereby provide a framework for both theoretical discussions and empirical research.

The Promise of Stochastic Resonance in Falls Prevention

Multisensory integration is essential for maintenance of motor and cognitive abilities, thereby ensuring normal function and personal autonomy. Balance control is challenged during senescence or in motor disorders, leading to potential falls. Increased uncertainty in sensory signals is caused by a number of factors including noise, defined as a random and persistent disturbance that reduces the clarity of information. Counter-intuitively, noise can be beneficial in some conditions. Stochastic resonance is a mechanism whereby a particular level of noise actually enhances the response of non-linear systems to weak sensory signals. Here we review the effects of stochastic resonance on sensory modalities and systems directly involved in balance control. We highlight its potential for improving sensorimotor performance as well as cognitive and autonomic functions. These promising results demonstrate that stochastic resonance represents a flexible and non-invasive technique that can be applied to different modalities simultaneously. Finally we point out its benefits for a variety of scenarios including in ambulant elderly, skilled movements, sports and to patients with sensorimotor or autonomic dysfunctions.

Stochastic resonance stimulation improves balance in children with cerebral palsy: a case control study

Background

Stochastic Resonance (SR) Stimulation has been used to enhance balance in populations with sensory deficits by improving the detection and transmission of afferent information. Despite the potential promise of SR in improving postural control, its use in individuals with cerebral palsy (CP) is novel. The objective of this study was to investigate the immediate effects of electrical SR stimulation when applied in the ankle muscles and ligaments on postural stability in children with CP and their typically developing (TD) peers.

Methods

Ten children with spastic diplegia (GMFCS level I- III) and ten age-matched TD children participated in this study. For each participant the SR sensory threshold was determined. Then, five different SR intensity levels (no stimulation, 25, 50, 75, and 90% of sensory threshold) were used to identify the optimal SR intensity for each subject. The optimal SR and no stimulation condition were tested while children stood on top of 2 force plates with their eyes open and closed. To assess balance, the center of pressure velocity (COPV) in anteroposterior (A/P) and medial-lateral (M/L) direction, 95% COP confidence ellipse area (COPA), and A/P and M/L root mean square (RMS) measures were computed and compared.

Results

For the CP group, SR significantly decreased COPV in A/P direction, and COPA measures compared to the no stimulation condition for the eyes open condition. In the eyes closed condition, SR significantly decreased COPV only in M/L direction. Children with CP demonstrated greater reduction in all the COP measures but the RMS in M/L direction during the eyes open condition compared to their TD peers. The only significant difference between groups in the eyes closed condition was in the COPV in M/L direction.

Conclusions

SR electrical stimulation may be an effective stimulation approach for decreasing postural sway and has the potential to be used as a therapeutic tool to improve balance. Applying subject-specific SR stimulation intensities is recommended to maximize balance improvements. Overall, balance rehabilitation interventions in CP might be more effective if sensory facilitation methods, like SR, are utilized by the clinicians.

Trial registration

ClinicalTrials.gov identifier NCT02456376; 28 May 2015 (Retrospectively registered); https://clinicaltrials.gov/ct2/show/NCT02456376.

Improved proprioceptive function by application of subsensory electrical noise: Effects of aging and task-demand

The application of subsensory noise stimulation over the lower limbs has been shown to improve proprioception and postural control under certain conditions. Whereas the effect specificity seems to depend on several factors, studies are still needed to determine the appropriate method for training and rehabilitation purposes. In the current study, we investigated whether the application of subsensory electrical noise over the legs improves proprioceptive function in young and older adults. We aimed to provide evidence that stronger and age-related differential effects occur in more demanding tasks. Proprioceptive function was initially assessed by testing the detection of passive ankle movement (kinesthetic perception) in twenty-eight subjects (14 young and 14 older adults). Thereafter, postural control was assessed during tasks with different sensory challenges: i) by removing visual information (eyes closed) and; ii) by moving the visual scene (moving room paradigm). Tests performed with the application of electrical noise stimulation were compared to those performed without noise. The results showed that electrical noise applied over the legs led to a reduction in the response time to kinesthetic perception in both young and older adults. On the other hand, the magnitude of postural sway was reduced by noise stimulation only during a more challenging task, namely, when the optical flow was changing in an unpredictable (nonperiodic) manner. No differential effects of stimulation between groups were observed. These findings suggest that the relevance of proprioceptive inputs in tasks with different challenges, but not the subjects' age, is a determining factor for sensorimotor improvements due to electrical noise stimulation.

Inter- and Intradigit Somatotopic Map of High-Frequency Vibration Stimulations in Human Primary Somatosensory Cortex

Although more about the somatotopic mapping of fingers continues to be uncovered, there is lack of mapping attempts regarding the integration of within-finger and across-finger somatotopic coordinates in Broadmann area (BA) 3. This study aimed to address the issue by finding an inter-/intradigit somatotopic map with high-frequency (250 Hz) vibrotactile stimulation. Functional magnetic resonance imaging (fMRI) data were acquired while stimulation was applied to 3 phalanxes (distal [p1], intermediate [p2], and proximal [p3] phalanx) of 4 fingers (index, middle, ring, and little finger) for a total of 12 finger-phalanx combinations for a human. Inter-, intra-, and inter-/intradigit distances were calculated from peak activation coordinates in BA 3 for each combination. With regard to interdigit dimensions, the somatotopic coordinates proceeded in the lateral-to-medial direction for the index, middle, ring, and little fingers consecutively. This trend is comparable to that generated from low-frequency stimulation modalities (flutter stimulation). The somatotopic distances between fingers were greatest when p1 was compared across fingers. From an intradigit perspective, stimulation on p1, p2, and p3 yielded BA 3 peak coordinates aligned along the anterior-to-posterior and inferior-to-superior directions for all fingers. An inter-/intradigit map exhibited a radially propagating trend of distances calculated with respect to index p1 as a reference point; this provided an integrated view of inter- and intradigit somatotopies, which are traditionally discussed separately. We expect such an inter-/intradigit somatotopic map approach to contribute in generating a comprehensive somatotopic model of fingers.

Differential effects of white noise in cognitive and perceptual tasks

Beneficial effects of noise on higher cognition have recently attracted attention. Hypothesizing an involvement of the mesolimbic dopamine system and its functional interactions with cortical areas, the current study aimed to demonstrate a facilitation of dopamine-dependent attentional and mnemonic functions by externally applying white noise in five behavioral experiments including a total sample of 167 healthy human subjects. During working memory, acoustic white noise impaired accuracy when presented during the maintenance period (Experiments 1-3). In a reward based long-term memory task, white noise accelerated perceptual judgments for scene images during encoding but left subsequent recognition memory unaffected (Experiment 4). In a modified Posner task (Experiment 5), the benefit due to white noise in attentional orienting correlated weakly with reward dependence, a personality trait that has been associated with the dopaminergic system. These results suggest that white noise has no general effect on cognitive functions. Instead, they indicate differential effects on perception and cognition depending on a variety of factors such as task demands and timing of white noise presentation.

Effect of mechanical tactile noise on amplitude of visual evoked potentials: multisensory stochastic resonance

The present investigation documents the electrophysiological occurrence of multisensory stochastic resonance in the human visual pathway elicited by tactile noise. We define multisensory stochastic resonance of brain evoked potentials as the phenomenon in which an intermediate level of input noise of one sensory modality enhances the brain evoked response of another sensory modality. Here we examined this phenomenon in visual evoked potentials (VEPs) modulated by the addition of tactile noise. Specifically, we examined whether a particular level of mechanical Gaussian noise applied to the index finger can improve the amplitude of the VEP. We compared the amplitude of the positive P100 VEP component between zero noise (ZN), optimal noise (ON), and high mechanical noise (HN). The data disclosed an inverted U-like graph for all the subjects, thus demonstrating the occurrence of a multisensory stochastic resonance in the P100 VEP.

EEG gamma-band activity during audiovisual speech comprehension in different noise environments

The presence of cross-modal stochastic resonance in different noise environments has been proved in previous behavioral and event-related potential studies, while it was still unclear whether the gamma-band oscillation study was another evidence of cross-modal stochastic resonance. The multisensory gain of gamma-band activity between the audiovisual (AV) and auditory-only conditions in different noise environments was analyzed. Videos of face motion articulating words concordant with different levels of pink noise were used as stimuli. Signal-to-noise ratios (SNRs) of 0, -4, -8, -12 and -16 dB were selected to measure the speech recognition accuracy and EEG activity for 20 healthy subjects. The power and phase of EEG gamma-band oscillations increased in a time window of 50-90 ms. The multisensory gains of evoked and total activity, as well as phase-locking factor, were greatest at the -12 dB SNR, which were consistent with the behavioral result. The multisensory gain of gamma-band activity showed an inverted U-shaped curve as a function of SNR. This finding confirmed the presence of cross-modal stochastic resonance. In addition, there was a significant correlation between evoked activity and phase-locking factor of gamma-band at five different SNRs. Gamma-band oscillation was believed to play a role in the rapid processing and information linkage strengthening of AV modalities in the early stage of cognitive processes.

Suppression of enhanced physiological tremor via stochastic noise: initial observations

Enhanced physiological tremor is a disabling condition that arises because of unstable interactions between central tremor generators and the biomechanics of the spinal stretch reflex. Previous work has shown that peripheral input may push the tremor-related spinal and cortical systems closer to anti-phase firing, potentially leading to a reduction in tremor through phase cancellation. The aim of the present study was to investigate whether peripherally applied mechanical stochastic noise can attenuate enhanced physiological tremor and improve motor performance. Eight subjects with enhanced physiological tremor performed a visuomotor task requiring the right index finger to compensate a static force generated by a manipulandum to which Gaussian noise (3–35 Hz) was applied. The finger position was displayed on-line on a monitor as a small white dot which the subjects had to maintain in the center of a larger green circle. Electromyogram (EMG) from the active hand muscles and finger position were recorded. Performance was measured by the mean absolute deviation of the white dot from the zero position. Tremor was identified by the acceleration in the frequency range 7–12 Hz. Two different conditions were compared: with and without superimposed noise at optimal amplitude (determined at the beginning of the experiment). The application of optimum noise reduced tremor (accelerometric amplitude and EMG activity) and improved the motor performance (reduced mean absolute deviation from zero). These data provide the first evidence of a significant reduction of enhanced physiological tremor in the human sensorimotor system due to application of external stochastic noise.

Enhanced corticomuscular coherence by external stochastic noise

Noise can have beneficial effects as shown by the stochastic resonance (SR) phenomenon which is characterized by performance improvement when an optimal noise is added. Modern attempts to improve human performance utilize this phenomenon. The purpose of the present study was to investigate whether performance improvement by addition of optimum noise (ON) is related to increased cortical motor spectral power (SP) and increased corticomuscular coherence. Eight subjects performed a visuomotor task requiring to compensate with the right index finger a static force (SF) generated by a manipulandum on which Gaussian noise was applied. The finger position was displayed on-line on a monitor as a small white dot which the subjects had to maintain in the center of a green bigger circle. Electroencephalogram from the contralateral motor area, electromyogram from active muscles and finger position were recorded. The performance was measured by the mean absolute deviation (MAD) of the white dot from the zero position. ON compared to the zero noise condition induced an improvement in motor accuracy together with an enhancement of cortical motor SP and corticomuscular coherence in beta-range. These data suggest that the improved sensorimotor performance via SR is consistent with an increase in the cortical motor SP and in the corticomuscular coherence.