Aging-induced alterations in EEG spectral power associated with graded force motor tasks.

BACKGROUND: It has been demonstrated that in young and healthy individuals, there is a strong association between the amplitude of EEG-derived motor activity-related cortical potential or EEG spectral power (ESP) and voluntary muscle force. This association suggests that the motor-related ESP may serve as an index of central nervous system function in controlling voluntary muscle activation Therefore, it may potentially be used as an objective marker to track changes in functional neuroplasticity due to neurological disorders, aging, and following rehabilitation therapies. To this end, the relationship between the band-specific ESP-combined spectral power of EEG oscillatory and aperiodic (noise) components-and voluntary elbow flexion (EF) force has been analyzed in elder and young individuals. METHODS: 20 young (22.6 ± 0.87 year) and 28 elderly (74.79 ± 1.37 year) participants performed EF contractions at 20%, 50%, and 80% of maximum voluntary contraction (MVC) while high-density EEG signals were recorded. Both the absolute and relative ESPs were computed for the EEG frequency bands of interest. RESULTS: The MVC force generated by the elderly was foreseeably lower than that of the young participants. Compared to young, the elderly cohort's (1) total ESP was significantly lower for the high (80% MVC) force task; (2) relative ESP in beta band was significantly elevated for the low and moderate (20% MVC and 50% MVC) force tasks; (3) absolute ESP failed to have a positive trend with force for EEG frequency bands of interest; and (4) beta-band relative ESP did not exhibit a significant decrease with increasing force levels. CONCLUSIONS: As opposed to young subjects, the beta-band relative ESP in elderly did not significantly decrease with increasing EF force values. This observation suggests the use of beta-band relative ESP as a potential biomarker for age-related motor control degeneration.

Evaluation of the optimum positioning for a multi-use and wearable pressure ulcer sensor.

Pressure ulcers, also called bedsores, occur when the skin is under constant pressure for a long time and is more common in hospitalized patients. To prevent a diminish in quality of daily lives and the additional cost of clinical care, a "patient rotate system" is the standard procedure. Although there are commercial clinical platforms that suggest when and how to rotate a patient lying in bed, some of these platforms are 1) using a wearable system that has one-use accessories which increase the total cost of operation 2) rely on a system-on-a-chip that should be placed on a predetermined location which might not be the most comfortable based on the posture. This study evaluates an alternative by using a simple inertial measurement unit (IMU) hardware inside a self-designed and re-usable (disinfectable) 3d printed case placed on different anatomical regions (sternum, left and right acromion, above talus, below patella) for performance. It is suggested that, based on the regions selected, a "patient rotate system" automation is feasible with more comfortable sensor placements (e.g., on the lower limbs) without statistically significant differences (p<0.05). Clinical Relevance- The outcome of this study promises a pressure ulcer prevention system, with placing a wearable and multi-use sensor system on more comfortable and various locations on the body for a "patient rotate system".

High-Frequency rTMS Combined with Task-Specific Hand Motor Training Modulates Corticospinal Plasticity in Motor Complete Spinal Cord Injury: A case report.

Since its first use in spinal cord injury (SCI) in the early 2000s [1], high-frequency repetitive transcranial magnetic stimulation (HF-rTMS) demonstrated a capacity to modulate corticospinal excitability (CSE) and motor performance. Studies focused on individuals with incomplete SCI. Here, we examined the feasibility of a 15-day therapeutic stimulation protocol combining HF-rTMS with task-specific motor training targeting the weaker hand in an individual with early chronic complete SCI. In this case report, we present evidence of progressive increase of CSE at rest and during muscle activation, and decreased cortical inhibition, associated with a trend toward improvement in pinch function of the weaker hand. These promising findings need to be confirmed in a larger population. Clinical Relevance- These preliminary results are promising and demonstrate the importance of a large number of training session repetitions to induce consistent changes relevant to the recovery after a complete SCI.

Application of Empirical Mode Decomposition Combined With Notch Filtering for Interpretation of Surface Electromyograms During Functional Electrical Stimulation.

The goal of this paper is to demonstrate a novel approach that combines Empirical Mode Decomposition (EMD) with Notch filtering to remove the electrical stimulation (ES) artifact from surface electromyogram (EMG) data for interpretation of muscle responses during functional electrical stimulation (FES) experiments. FES was applied to the rectus femoris (RF) muscle unilaterally of six able bodied (AB) and one individual with spinal cord injury (SCI). Each trial consisted of three repetitions of ES. We hypothesized that the EMD algorithm provides a suitable platform for decomposing the EMG signal into physically meaningful intrinsic mode functions (IMFs) which can be further used to isolate electrical stimulation (ES) artifact. A basic EMD algorithm was used to decompose the EMG signals collected during FES into IMFs for each repetition separately. IMFs most contaminated by ES were identified based on the standard deviation (SD) of each IMF. Each artifact IMF was Notch filtered to filter ES harmonics and added to remaining IMFs containing pure EMG data to get a version of a filtered EMG signal. Of all such versions of filtered signals generated from each artifact IMF, the one with maximum signal to noise ratio (SNR) was chosen as the final output. The validity of the filtered signal was assessed by quantitative metrics, 1) root mean squared error (RMSE) and signal to noise (SNR) ratio values obtained by comparing a clean EMG and EMD-Notch filtered signal from the combination of simulated ES and clean EMG and, 2) using EMG-force correlation analysis on the data collected from AB individuals. Finally, the potential applicability of this algorithm on a neurologically impaired population was shown by applying the algorithm on EMG data collected from an individual with SCI. EMD combined with Notch filtering successfully extracted the EMG signal buried under ES artifact. Filtering performance was validated by smaller RMSE values and greater SNR post filtering. The amplitude values of the filtered EMG signal were seen to be consistent for three repetitions of ES and there was no significant difference among the repetition for all subjects. For the individual with a SCI the algorithm was shown to successfully isolate the underlying bursts of muscle activations during FES. The data driven nature of EMD algorithm and its ability to act as a filter bank at different bandwidths make this method extremely suitable for dissecting ES induced EMG into IMFs. Such IMFs clearly show the presence of ES artifact at different intensities as well as pure artifact free EMG. This allows the application of Notch filters to IMFs containing ES artifact to further isolate the EMG. As a result of such stepwise approach, the extraction of EMG is achieved with minimal data loss. This study provides a unique approach to dissect and interpret the EMG signal during FES applications.

Weakening of Corticomuscular Signal Coupling During Voluntary Motor Action in Aging.

BACKGROUND: Aging is associated with muscle weakness and impairment in performing skilled motor tasks. Still, little is known about whether the link or functional coupling or connection between the central and peripheral systems during voluntary motor performance is compromised in the elderly subjects. The purposes of this study were to estimate functional corticomuscular connection (CMC) strength in the elderly subjects by calculating EEG-EMG coherence during voluntary motor performance, determine the relationship between the CMC and voluntary muscle force, and compare these between the old and the young subjects. METHODS: Maximal voluntary contraction (MVC) of elbow flexion (EF) and EFs at three submaximal (20%, 50%, and 80% MVC) levels were performed in 28 healthy older (74.96±1.32 years) and 20 young (22.60±0.90 years) individuals, while EEG and EMG from biceps brachii, brachioradialis, and triceps brachii muscles were recorded simultaneously. RESULTS: Compared with the young, older individuals exhibited significantly weakened CMC at all force levels tested. There was a proportional relationship between the CMC and EF force and high-positive correlation between the CMC and EF strength in both groups. CONCLUSIONS: Weakened CMC in aging may be a major factor contributing to age-related muscle weakness, and the linear relationship between the CMC and voluntary muscle force suggests dependence of force output on translation of the descending command to muscle electrical signal.