Abstract TP321: Testing a Neural Activity Triggered Device for Stroke Rehabilitation

Stroke ◽  
2013 ◽  
Vol 44 (suppl_1) ◽  
Author(s):  
Jie Song ◽  
Leo Walton ◽  
Ricardo Pizarro ◽  
Svyatoslav Vergun ◽  
Veena Nair ◽  
...  
Keyword(s):  
Brain Plasticity ◽  
Arm Movement ◽  
Cortical Activation ◽  
Motor Deficits ◽  
Stroke Patients ◽  
Range Of Movement ◽  
Activation Patterns ◽  
Intention To Move ◽  
Increased Strength ◽  
The Right

Background: In this ongoing study we are testing a closed-loop neurological feedback device that can facilitate functional recovery in stroke patients with upper extremity motor deficits. Methods: This device combines Brain Computer Interface (BCI) and functional electrical muscle stimulation (FES), together with tongue stimulation (TS) in order to utilize the subject’s intention-to-move with the stimulated output. FMRI is used to examine the brain plasticity changes secondary to the rehabilitation. Subjects, wearing a 16-channel EEG cap, are first trained to voluntarily modulate beta and mu rhythms as they use motor imagery or execution of left and right hand squeezing task and then trained to use this imagery or execution to control the movement of a cursor, either to the right or the left depending on the presentation of a target rectangle shown on the screen. Once subjects achieve consistent accuracy in doing this task, FES in conjunction with TS is used. The subject is then asked to perform the task with the stimulation of FES and TS linked to their task performance. Results: Two chronic stroke patients (mean age=57, 1 male, more than 1 year postonset) were able to complete the entire 3-week BCI training course and to perform the tasks at a > 70% success rate. Cortical activation recorded by EEG in response to attempted paretic arm movement became concentrated over the contralateral motor areas. Similar changes were confirmed by fMRI measures (Figure 1). Although neither subject showed any improvement on the Action Research Arm Test (ARAT), subjects self-reported increased strength, less spasticity and a greater range of movement in their paretic arm. Conclusion: Our preliminary results indicate that training with the device may lead to brain plasticity changes toward normalization of cortical activation patterns and promote behavioral improvements for stroke patients even in their chronic stage.

Electrophysiological Measures of Language Processing in Bilinguals

2002 ◽  
Vol 14 (7) ◽  
pp. 994-1017 ◽  
Author(s):  
Alice Mado Proverbio ◽  
Barbara Čok ◽  
Alberto Zani
Keyword(s):  
Language Learners ◽  
Left Hemisphere ◽  
Language Processing ◽  
Right Hemisphere ◽  
Functional Organization ◽  
Brain Plasticity ◽  
Brain Activation ◽  
Activation Patterns ◽  
Bilingual Speakers ◽  
The Right

The aim of the present study was to investigate how multiple languages are represented in the human brain. Event-related brain potentials (ERPs) were recorded from right-handed polyglots and monolinguals during a task involving silent reading. The participants in the experiment were nine Italian monolinguals and nine Italian/Slovenian bilinguals of a Slovenian minority in Trieste; the bilinguals, highly fluent in both languages, had spoken both languages since birth. The stimuli were terminal words that would correctly complete a short, meaningful, previously shown sentence, or else were semantically or syntactically incorrect. The task consisted in deciding whether the sentences were well formed or not, giving the response by pressing a button. Both groups read the same set of 200 Italian sentences to compare the linguistic processing, while the bilinguals also received a set of 200 Slovenian sentences, comparable in complexity and length, to compare the processing of the two languages within the group. For the bilinguals, the ERP results revealed a strong, left-sided activation, reflected by the N1 component, of the occipito-temporal regions dedicated to orthographic processing, with a latency of about 150 msec for Slovenian words, but bilateral activation of the same areas for Italian words, which was also displayed by topographical mapping. In monolinguals, semantic error produced a long-lasting negative response (N2 and N4) that was greater over the right hemisphere, whereas syntactic error activated mostly the left hemisphere. Conversely, in the bilinguals, semantic incongruence resulted in greater response over the left hemisphere than over the right. In this group, the P615 syntactical error responses were of equal amplitude on both hemispheres for Italian words and greater on the right side for Slovenian words. The present findings support the view that there are inter- and intrahemispheric brain activation asymmetries when monolingual and bilingual speakers comprehend written language. The fact that the bilingual speakers in the present study were highly fluent and had acquired both languages in early infancy suggests that the brain activation patterns do not depend on the age of acquisition or the fluency level, as in the case of late, not-so-proficient L2 language learners, but on the functional organization of the bilinguals' brain due to polyglotism and based on brain plasticity.

scholarly journals Affected Arm Use and Cortical Change in Stroke Patients Exhibiting Minimal Hand Movement

2010 ◽  
Vol 24 (2) ◽  
pp. 195-203 ◽  
Author(s):  
Stephen J. Page ◽  
Stacy M. Harnish ◽  
Martine Lamy ◽  
James C. Eliassen ◽  
Jerzy P. Szaflarski
Keyword(s):  
Electrical Stimulation ◽  
Hand Movement ◽  
Cortical Activation ◽  
Motor Deficits ◽  
Stroke Patients ◽  
Wrist Movement ◽  
Use Patterns ◽  
Stimulation Parameters ◽  
Home Based ◽  
Therapy Sessions

Background and Purpose . Conventional electrical stimulation modalities are limited by their lack of opportunities for motor learning and, consequently, their impact on function. Other rehabilitative regimens necessitate affected hand and wrist movement for patients to be included, making them implausible for most patients. In light of these challenges, the current study examined the efficacy of a repetitive task-specific training (RTP) regimen using an electrical stimulation neuroprosthesis in stroke patients exhibiting no affected wrist or hand movement. Method. Eight chronic stroke patients (mean = 46.5 months) with moderately affected arm motor deficits participated in 30-minute therapy sessions occurring every weekday for 8 weeks. During the sessions, they wore the neuroprosthesis to enable performance of valued activities identified largely by the patients. To ensure transfer to their real-world environments, most sessions were home based, with the patients coming to the clinic for “tune-up” sessions (eg, adjusting the stimulation parameters, exercises, and/or fit of the device) twice every other week (a total of 8 clinical visits). Outcomes were evaluated using the Action Research Arm Test (ARAT) and the upper extremity section of the Fugl-Meyer Assessment (FM), the amount of use scale of the Motor Activity Log (MAL), and high-field functional magnetic resonance imaging (fMRI). Results. Before the intervention, patients exhibited stable motor deficits. After the intervention, they exhibited ARAT and FM score increases (+2.85 and +2.2, respectively). Postintervention fMRI revealed significant increases in cortical activation, possibly brought about by markedly increased affected arm use patterns on the MAL (+0.97). Conclusions. An affected arm RTP program incorporating NEURSTIM appears to increase affected arm use and elicit neural changes in more impaired patients. These factors may conspire to produce motor changes, although motor changes are smaller in this population than with less impaired patients. The program may act as a “bridge” to other promising regimens.

scholarly journals The effect of anxiety on brain activation patterns in response to inspiratory occlusions: an fMRI study

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Pei-Ying S. Chan ◽  
Yu-Ting Wu ◽  
Ai-Ling Hsu ◽  
Chia-Wei Li ◽  
Changwei W. Wu ◽  
...  
Keyword(s):  
Brain Activation ◽  
Face Mask ◽  
Cortical Activation ◽  
Self Report ◽  
Normal Lung ◽  
Anxiety State ◽  
Cingulate Gyrus ◽  
Brain Areas ◽  
Activation Patterns ◽  
The Right

Abstract Respiratory sensations such as breathlessness are prevalent in many diseases and are amplified by increased levels of anxiety. Cortical activation in response to inspiratory occlusions in high- and low-anxious individuals was found different in previous studies using the respiratory-related evoked potential method. However, specific brain areas showed different activation patterns remained unknown in these studies. Therefore, the purpose of this study was to compare cortical and subcortical neural substrates of respiratory sensation in response to inspiratory mechanical occlusion stimuli between high- and low-anxious individuals using functional magnetic resonance imaging (fMRI). In addition, associations between brain activation patterns and levels of anxiety, and breathlessness were examined. Thirty-four (17 high- and 17 low-anxious) healthy non-smoking adults with normal lung function completed questionnaires on anxiety (State Trait Anxiety Inventory - State), and participated in a transient inspiratory occlusion fMRI experiment. The participants breathed with a customized face-mask while respiration was repeatedly interrupted by a transient inspiratory occlusion of 150-msec, delivered every 2 to 4 breaths. Breathlessness was assessed by self-report. At least 32 occluded breaths were collected for data analysis. The results showed that compared to the low-anxious group, the high-anxious individuals demonstrated significantly greater neural activations in the hippocampus, insula, and middle cingulate gyrus in response to inspiratory occlusions. Moreover, a significant relationship was found between anxiety levels and activations of the right inferior parietal gyrus, and the right precuneus. Additionally, breathlessness levels were significantly associated with activations of the bilateral thalamus, bilateral insula and bilateral cingulate gyrus. The above evidences support stronger recruitment of emotion-related cortical and subcortical brain areas in higher anxious individuals, and thus these areas play an important role in respiratory mechanosensation mediated by anxiety.

Influence of Gravity Compensation on Muscle Activation Patterns During Different Temporal Phases of Arm Movements of Stroke Patients

2009 ◽  
Vol 23 (5) ◽  
pp. 478-485 ◽  
Author(s):  
G.B. Prange ◽  
M.J.A. Jannink ◽  
A.H.A. Stienen ◽  
H. van der Kooij ◽  
M.J. IJzerman ◽  
...  
Keyword(s):  
Motor Control ◽  
Muscle Activation ◽  
Arm Movement ◽  
Quantitative Information ◽  
Gravity Compensation ◽  
Stroke Patients ◽  
Activation Patterns ◽  
Muscle Activation Patterns ◽  
Arm Support ◽  
Control Objective

Background. Arm support to help compensate for the effects of gravity may improve functional use of the shoulder and elbow during therapy after stroke, but gravity compensation may alter motor control. Objective. To obtain quantitative information on how gravity compensation influences muscle activation patterns during functional, 3-dimensional reaching movements. Methods. Eight patients with mild hemiparesis performed 2 sets of repeated reach and retrieval movements, with and without unloading the arm, using a device that acted at the elbow and forearm to compensate for gravity. Electromyographic (EMG) patterns of 6 upper extremity muscles were compared during elbow and shoulder joint excursions with and without gravity compensation. Results. Movement performance was similar with and without gravity compensation. Smooth rectified EMG (SRE) values were decreased from 25% to 50% during movements with gravity compensation in 5 out of 6 muscles. The variation of SRE values across movement phases did not differ across conditions. Conclusions. Gravity compensation did not affect general patterns of muscle activation in this sample of stroke patients, probably since they had adequate function to complete the task without arm support. Gravity compensation did facilitate active arm movement excursions without impairing motor control. Gravity compensation may be a valuable modality in conventional or robot-aided therapy to increase the intensity of training for mildly impaired patients.

scholarly journals Language Representation Following Left MCA Stroke in Children and Adults: An fMRI Study

2017 ◽  
Vol 44 (5) ◽  
pp. 483-497 ◽  
Author(s):  
Robyn Westmacott ◽  
Mary Pat McAndrews ◽  
Gabrielle deVeber
Keyword(s):  
Brain Injuries ◽  
Case Series ◽  
Cortical Activation ◽  
Left Middle Cerebral Artery ◽  
Language Function ◽  
Childhood Stroke ◽  
Stroke Patients ◽  
Significant Group ◽  
Activation Patterns ◽  
Verb Generation

AbstractBackground: In this case series, functional magnetic resonance imaging was used to examine brain networks that mediate different aspects of language function in 4 young adults (17-22 years) with a history of left middle cerebral artery (MCA) stroke in childhood (<7 years of age but after the neonatal period), and five older individuals (42-57 years) with left MCA stroke as adults (>40 years of age). Although it is widely believed that altered lateralization patterns are more likely to occur following early brain injuries compared with later brain injuries, the presumed plasticity of the young brain has been challenged in recent years, particularly in the domain of language. Methods: We explored this issue by contrasting the brain activation patterns of individuals with childhood left MCA stroke and adult left MCA stroke while performing two language tasks: verb generation and picture-word matching. Importantly, both groups showed significant recovery of language function, based on standard clinical indicators. Results: Controls showed left lateralized activation for both tasks, although much more pronounced for verb generation. Adult stroke patients also showed left lateralization for both tasks, though somewhat weaker than controls. Childhood stroke patients exhibited significantly weaker lateralization than the adult group for verb generation, but there was no significant group difference for picture-word matching. Conclusions: These preliminary findings suggest that successful reorganization of language function is more likely to involve bilateral recruitment following left MCA stroke in childhood than in adulthood. Of importance, although childhood stroke patients had primarily subcortical lesions, there were substantial alterations in cortical activation patterns.

Frontal  activation  patterns  during  Tetris game  play  and  differences  between  high  and  low performers:  a preliminary functional  near-infrared  spectroscopy study

2019 ◽  
Author(s):  
Takayuki Nakahachi ◽  
Ryouhei Ishii ◽  
Leonides Canuet ◽  
Iori Sato ◽  
Kiyoko Kamibeppu ◽  
...  
Keyword(s):  
Prefrontal Cortex ◽  
Infrared Spectroscopy ◽  
Frontal Cortex ◽  
Near Infrared Spectroscopy ◽  
Near Infrared ◽  
Cortical Activation ◽  
The Other ◽  
Functional Near Infrared Spectroscopy ◽  
Activation Patterns ◽  
The Right

Abstract Background: Tetris has recently expanded its place of activity not only to the original entertainment but also to clinical applications such as prevention of trauma flashback. However, to our knowledge, no studies focused on the cortical activation patterns themselves when playing Tetris in a natural form. This study aimed to investigate the activation patterns in the frontal cortex during naturally-performed Tetris for 90 seconds in 24 healthy subjects using functional near-infrared spectroscopy robust to artifacts by motion and electric devices. We also calculated the correlations of behavioral data with cortical activations, and compared the differences in activations between the high and low performers of Tetris. Results: The results demonstrated that significant activations in the frontal cortex during Tetris play had two factors, each showing a similar activation pattern. One of the factors was distributed over the lateral prefrontal cortex bilaterally, and the other was localized to the right prefrontal cortex. Moreover, in the high performers, the activations of the areas centered on the right dorsolateral prefrontal cortex (DLPFC) were estimated to increase and correlations of the activations between those areas and the other areas decrease compared with the low performers. Conclusions: It is suggested that high Tetris performers might reduce functional connectivity between activations of the areas centered on the right DLPFC and the other areas, and increase the local activations compared with low performers. It would be necessary to consider whether its visuospatial cognitive loads stimulate the appropriate areas of the subject’s brain to effectively utilize Tetris play for clinical interventions.

scholarly journals Is Lateropulsion Really Related with a Specific Lesion of the Brain?

2021 ◽  
Vol 11 (3) ◽  
pp. 354
Author(s):  
Kyoung Lee ◽  
Sang Yoo ◽  
Eun Ji ◽  
Woo Hwang ◽  
Yeun Yoo ◽  
...  
Keyword(s):  
Right Hemisphere ◽  
Parietal Lobe ◽  
Inferior Frontal Gyrus ◽  
Brain Lesions ◽  
Vertical Posture ◽  
Lesion Volume ◽  
Precentral Gyrus ◽  
Stroke Patients ◽  
The Right ◽  
Right Hemisphere Stroke

Lateropulsion (pusher syndrome) is an important barrier to standing and gait after stroke. Although several studies have attempted to elucidate the relationship between brain lesions and lateropulsion, the effects of specific brain lesions on the development of lateropulsion remain unclear. Thus, the present study investigated the effects of stroke lesion location and size on lateropulsion in right hemisphere stroke patients. The present retrospective cross-sectional observational study assessed 50 right hemisphere stroke patients. Lateropulsion was diagnosed and evaluated using the Scale for Contraversive Pushing (SCP). Voxel-based lesion symptom mapping (VLSM) analysis with 3T-MRI was used to identify the culprit lesion for SCP. We also performed VLSM controlling for lesion volume as a nuisance covariate, in a multivariate model that also controlled for other factors contributing to pusher behavior. VLSM, combined with statistical non-parametric mapping (SnPM), identified the specific region with SCP. Lesion size was associated with lateropulsion. The precentral gyrus, postcentral gyrus, inferior frontal gyrus, insula and subgyral parietal lobe of the right hemisphere seemed to be associated with the lateropulsion; however, after adjusting for lesion volume as a nuisance covariate, no lesion areas were associated with the SCP scores. The size of the right hemisphere lesion was the only factor most strongly associated with lateropulsion in patients with stroke. These results may be useful for planning rehabilitation strategies of restoring vertical posture and understanding the pathophysiology of lateropulsion in stroke patients.

scholarly journals Are visual working memory and episodic memory distinct processes? Insight from stroke patients by lesion-symptom mapping

2021 ◽  
Author(s):  
Selma Lugtmeijer ◽  
◽  
Linda Geerligs ◽  
Frank Erik de Leeuw ◽  
Edward H. F. de Haan ◽  
...  
Keyword(s):  
Working Memory ◽  
Episodic Memory ◽  
Visual Working Memory ◽  
Visual Memory ◽  
Right Hemisphere ◽  
Memory Task ◽  
Stroke Patients ◽  
Lesion Symptom Mapping ◽  
Criterion Setting ◽  
The Right

AbstractWorking memory and episodic memory are two different processes, although the nature of their interrelationship is debated. As these processes are predominantly studied in isolation, it is unclear whether they crucially rely on different neural substrates. To obtain more insight in this, 81 adults with sub-acute ischemic stroke and 29 elderly controls were assessed on a visual working memory task, followed by a surprise subsequent memory test for the same stimuli. Multivariate, atlas- and track-based lesion-symptom mapping (LSM) analyses were performed to identify anatomical correlates of visual memory. Behavioral results gave moderate evidence for independence between discriminability in working memory and subsequent memory, and strong evidence for a correlation in response bias on the two tasks in stroke patients. LSM analyses suggested there might be independent regions associated with working memory and episodic memory. Lesions in the right arcuate fasciculus were more strongly associated with discriminability in working memory than in subsequent memory, while lesions in the frontal operculum in the right hemisphere were more strongly associated with criterion setting in subsequent memory. These findings support the view that some processes involved in working memory and episodic memory rely on separate mechanisms, while acknowledging that there might also be shared processes.

scholarly journals Actigraphic Measurement of the Upper Limbs for the Prediction of Ischemic Stroke Prognosis: An Observational Study

Sensors ◽  
2021 ◽  
Vol 21 (7) ◽  
pp. 2479
Author(s):  
Giuseppe Reale ◽  
Silvia Giovannini ◽  
Chiara Iacovelli ◽  
Stefano Filippo Castiglia ◽  
Pietro Picerno ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Observational Study ◽  
Acute Ischemic Stroke ◽  
Acute Phase ◽  
Stroke Unit ◽  
Prognostic Model ◽  
Recovery Process ◽  
Motor Deficits ◽  
Stroke Patients ◽  
Movement Asymmetry

Background: It is often challenging to formulate a reliable prognosis for patients with acute ischemic stroke. The most accepted prognostic factors may not be sufficient to predict the recovery process. In this view, describing the evolution of motor deficits over time via sensors might be useful for strengthening the prognostic model. Our aim was to assess whether an actigraphic-based parameter (Asymmetry Rate Index for the 24 h period (AR2_24 h)) obtained in the acute stroke phase could be a predictor of a 90 d prognosis. Methods: In this observational study, we recorded and analyzed the 24 h upper limb movement asymmetry of 20 consecutive patients with acute ischemic stroke during their stay in a stroke unit. We recorded the motor activity of both arms using two programmable actigraphic systems positioned on patients’ wrists. We clinically evaluated the stroke patients by NIHSS in the acute phase and then assessed them across 90 days using the modified Rankin Scale (mRS). Results: We found that the AR2_24 h parameter positively correlates with the 90 d mRS (r = 0.69, p < 0.001). Moreover, we found that an AR2_24 h > 32% predicts a poorer outcome (90 d mRS > 2), with sensitivity = 100% and specificity = 89%. Conclusions: Sensor-based parameters might provide useful information for predicting ischemic stroke prognosis in the acute phase.

Sign in / Sign up

Export Citation Format

Share Document