Feasibility of a new application of noninvasive Brain Computer Interface (BCI): a case study of training for recovery of volitional motor control after stroke.

BACKGROUND/PURPOSE: A large proportion of individuals with stroke have persistent deficits for which current interventions have not restored normal motor behavior. Noninvasive brain computer interfaces (BCIs) have potential advantages for restoration of function. There are also potential advantages for combining BCI with functional electrical stimulation (FES). We tested the feasibility of combined BCI + FES for motor learning after stroke. CASE DESCRIPTION: The participant was a 43-year-old woman who was 10 months post-stroke. She was unable to produce isolated movement of any of the digits of her involved hand. With effort she exhibited simultaneous mass hyperextension of metacarpal phalangeal joints of all four fingers and thumb with simultaneous flexion of proximal interphalangeal and distal interphalangeal joints of all fingers. INTERVENTION: Brain signals from the lesioned hemisphere were used to trigger FES for movement practice. The BCI + FES intervention consisted of trials of either attempted finger movement and relax conditions or imagined finger movement and relax conditions. The training was performed three times per week for three weeks (nine sessions total). OUTCOME: : The participant exhibited highly accurate control of brain signal in the first session for attempted movement (97%), imagined movement (83%), and some difficulties with attempted relaxation (65%). By session 6, control of relaxation (deactivation of brain signal) improved to >80%. After nine sessions (three per week) of BCI + FES intervention, the participant demonstrated recovery of volitional isolated index finger extension. DISCUSSION: BCI + FES training for motor learning after stroke was feasible. A highly accurate brain signal control was achieved, and this signal could be reliably used to trigger the FES device for isolated index finger extension. With training, volitional control of isolated finger extension was attained in a small number of sessions. The source of motor recovery could be attributable to BCI, FES, combined BCI + FES, or whole arm or hand motor task practice.

fMRI methods for proximal upper limb joint motor testing and identification of undesired mirror movement after stroke.

fMRI has been used to characterize the abnormal brain activity after stroke during attempted motor tasks, the change in brain activity accompanying spontaneous motor recovery, and response to interventions. However, many patients after stroke exhibit abnormally high effort during attempted movements, including undesired movements of the supposed quiescent, uninvolved limb, which could confound fMRI measures. We developed a method of identifying the potentially confounded scans, using EMG measures of muscle activity in the supposed quiescent limb. We found that there was no interference in the MRI signal from the EMG data acquisition system, during simultaneous use of both MRI and EMG. For EMG signal acquisition, as expected, we were able to identify EMG signal free of MRI noise contamination during the inter-scan interval between any given scan and its subsequent scan. We tested movement of the involved limb. We determined that when undesired muscle activation was present in the uninvolved, supposed quiescent limb, there was an over-estimation of the number of active voxels ranging from 10 to 11, depending upon the ROI.

Abnormal cognitive planning and movement smoothness control for a complex shoulder/elbow motor task in stroke survivors.

PURPOSE: Cortical function is not well understood in stroke survivors with persistent dyscoordination. The study purpose was two-fold: 1) characterize cognitive planning time and cognitive effort level for a circle-drawing motor task in stroke survivors using shoulder/elbow muscles and 2) identify the relationship between cognitive effort level and movement smoothness. METHODS: Twelve stroke survivors with shoulder/elbow coordination deficits (>12 mo) and eight controls were enrolled. The motor task was to draw a circle on a horizontal surface using only shoulder/elbow muscles. Outcome measures were: EEG-derived cognitive planning time, cognitive effort level, and movement smoothness. Comparisons between stroke and controls were made using t-tests. The Pearson's correlation model was analyzed to determine the relationship between movement smoothness and cognitive effort level. RESULTS: Stroke subjects showed a statistically significant prolonged motor planning time versus controls for both lesion and non-lesion sides (p=0.013 and 0.049, respectively). They also showed a statistically significant elevated effort level versus controls for both sides (p=0.016 and 0.013). The patients exhibited statistically significant poor movement smoothness in the medial/lateral and forward/backward movement directions versus controls (p=0.035 and 0.037, respectively). For stroke, there was a significant correlation between cognitive effort level on the non-lesion side and smoothness of movement in the medial/lateral and forward/backward directions (r=0.54, p=0.036 and r=0.76, p=0.002, respectively). On the lesion side, results were mixed (r=0.268, p=0.2 r=0.59, p=0.023, respectively). CONCLUSIONS: Stroke survivors with upper limb motor deficits exhibit a longer cognitive planning time and elevated cognitive effort for performance of a complex shoulder/elbow motor coordination task. The elevated cognitive effort level was associated with poor (jerky) motor performance, suggesting a potential role of the CNS in controlling movement smoothness of the arm.

Initial characterization of the microgravity environment of the international space station: increments 2 through 4.

The primary objective of the International Space Station (ISS) is to provide a long-term quiescent environment for the conduct of scientific research for a variety of microgravity science disciplines. This paper reports to the microgravity scientific community the results of an initial characterization of the microgravity environment on the International Space Station for increments 2 through 4. During that period almost 70,000 hours of station operations and scientific experiments were conducted. 720 hours of crew research time were logged aboard the orbiting laboratory and over half a terabyte of acceleration data were recorded and much of that was analyzed. The results discussed in this paper cover both the quasi-steady and vibratory acceleration environment of the station during its first year of scientific operation. For the quasi-steady environment, results are presented and discussed for the following: the space station attitudes Torque Equilibrium Attitude and the X-Axis Perpendicular to the Orbital Plane; station docking attitude maneuvers; Space Shuttle joint operation with the station; cabin de-pressurizations and the station water dumps. For the vibratory environment, results are presented for the following: crew exercise, docking events, and the activation/de-activation of both station life support system hardware and experiment hardware. Finally, a grand summary of all the data collected aboard the station during the 1-year period is presented showing where the overall quasi-steady and vibratory acceleration magnitude levels fall over that period of time using a 95th percentile benchmark.

A status report on the characterization of the microgravity environment of the International Space Station.

A primary objective of the International Space Station is to provide a long-term quiescent environment for the conduct of scientific research for a variety of microgravity science disciplines. Since continuous human presence on the space station began in November 2000 through the end of Increment-6, over 1260 hours of crew time have been allocated to research. However, far more research time has been accumulated by experiments controlled on the ground. By the end of the time period covered by this paper (end of Increment-6), the total experiment hours performed on the station are well over 100,000 hours (Expedition 6 Press Kit: Station Begins Third Year of Human Occupation, Boeing/USA/NASA, October 25, 2002). This paper presents the results of the on-going effort by the Principal Investigator Microgravity Services project, at NASA Glenn Research Center, in Cleveland, Ohio, to characterize the microgravity environment of the International Space Station in order to keep the microgravity scientific community apprised of the reduced gravity environment provided by the station for the performance of space experiments. This paper focuses on the station microgravity environment for Increments 5 and 6. During that period over 580 Gbytes of acceleration data were collected, out of which over 34,790 hours were analyzed. The results presented in this paper are divided into two sections: quasi-steady and vibratory. For the quasi-steady analysis, over 7794 hours of acceleration data were analyzed, while over 27,000 hours were analyzed for the vibratory analysis. The results of the data analysis are presented in this paper in the form of a grand summary for the period under consideration. For the quasi-steady acceleration response, results are presented in the form of a 95% confidence interval for the station during "normal microgravity mode operations" for the following three attitudes: local vertical local horizontal, X-axis perpendicular to the orbit plane and the Russian torque equilibrium attitude. The same analysis was performed for the station during "non-microgravity mode operations" to assess the station quasi-steady acceleration environment over a long period of time. The same type of analysis was performed for the vibratory, but a 95th percentile benchmark was used, which shows the overall acceleration magnitude during Increments 5 and 6. The results, for both quasi-steady and vibratory acceleration response, show that the station is not yet meeting the microgravity requirements during the microgravity mode operations. However, it should be stressed that the requirements apply only at assembly complete, whereas the results presented below apply up to the station's configuration at the end of Increment-6.