Controlling pre-movement sensorimotor rhythm can improve finger extension after stroke.

OBJECTIVE: Brain-computer interface (BCI) technology is attracting increasing interest as a tool for enhancing recovery of motor function after stroke, yet the optimal way to apply this technology is unknown. Here, we studied the immediate and therapeutic effects of BCI-based training to control pre-movement sensorimotor rhythm (SMR) amplitude on robot-assisted finger extension in people with stroke. APPROACH: Eight people with moderate to severe hand impairment due to chronic stroke completed a four-week three-phase protocol during which they practiced finger extension with assistance from the FINGER robotic exoskeleton. In Phase 1, we identified spatiospectral SMR features for each person that correlated with the intent to extend the index and/or middle finger(s). In Phase 2, the participants learned to increase or decrease SMR features given visual feedback, without movement. In Phase 3, the participants were cued to increase or decrease their SMR features, and when successful, were then cued to immediately attempt to extend the finger(s) with robot assistance. MAIN RESULTS: Of the four participants that achieved SMR control in Phase 2, three initiated finger extensions with a reduced reaction time after decreasing (versus increasing) pre-movement SMR amplitude during Phase 3. Two also extended at least one of their fingers more forcefully after decreasing pre-movement SMR amplitude. Hand function, measured by the box and block test (BBT), improved by 7.3 ± 7.5 blocks versus 3.5 ± 3.1 blocks in those with and without SMR control, respectively. Higher BBT scores at baseline correlated with a larger change in BBT score. SIGNIFICANCE: These results suggest that learning to control person-specific pre-movement SMR features associated with finger extension can improve finger extension ability after stroke for some individuals. These results merit further investigation in a rehabilitation context.

EEG-Based Brain-Computer Interfaces.

Brain-Computer Interfaces (BCIs) are real-time computer-based systems that translate brain signals into useful commands. To date most applications have been demonstrations of proof-of-principle; widespread use by people who could benefit from this technology requires further development. Improvements in current EEG recording technology are needed. Better sensors would be easier to apply, more confortable for the user, and produce higher quality and more stable signals. Although considerable effort has been devoted to evaluating classifiers using public datasets, more attention to real-time signal processing issues and to optimizing the mutually adaptive interaction between the brain and the BCI are essential for improving BCI performance. Further development of applications is also needed, particularly applications of BCI technology to rehabilitation. The design of rehabilitation applications hinges on the nature of BCI control and how it might be used to induce and guide beneficial plasticity in the brain.

BCI in practice.

Brain-computer interfaces are systems that use signals recorded from the brain to enable communication and control applications for individuals who have impaired function. This technology has developed to the point that it is now being used by individuals who can actually benefit from it. However, there are several outstanding issues that prevent widespread use. These include the ease of obtaining high-quality recordings by home users, the speed, and accuracy of current devices and adapting applications to the needs of the user. In this chapter, we discuss some of these unsolved issues.

Trained modulation of sensorimotor rhythms can affect reaction time.

OBJECTIVE: Brain-computer interface (BCI) technology might be useful for rehabilitation of motor function. This speculation is based on the premise that modifying the EEG will modify behavior, a proposition for which there is limited empirical data. The present study examined the possibility that voluntary modulation of sensorimotor rhythm (SMR) can affect motor behavior in normal human subjects. METHODS: Six individuals performed a cued-reaction task with variable warning periods. A typical variable foreperiod effect was associated with SMR desynchronization. SMR features that correlated with reaction times were then used to control a two-target cursor movement BCI task. Following successful BCI training, an uncued reaction time task was embedded within the cursor movement task. RESULTS: Voluntarily increasing SMR beta rhythms was associated with longer reaction times than decreasing SMR beta rhythms. CONCLUSIONS: Voluntary modulation of EEG SMR can affect motor behavior. SIGNIFICANCE: These results encourage studies that integrate BCI training into rehabilitation protocols and examine its capacity to augment restoration of useful motor function.

Toward enhanced P300 speller performance.

This study examines the effects of expanding the classical P300 feature space on the classification performance of data collected from a P300 speller paradigm [Farwell LA, Donchin E. Talking off the top of your head: toward a mental prosthesis utilizing event-related brain potentials. Electroenceph Clin Neurophysiol 1988;70:510-23]. Using stepwise linear discriminant analysis (SWLDA) to construct a classifier, the effects of spatial channel selection, channel referencing, data decimation, and maximum number of model features are compared with the intent of establishing a baseline not only for the SWLDA classifier, but for related P300 speller classification methods in general. By supplementing the classical P300 recording locations with posterior locations, online classification performance of P300 speller responses can be significantly improved using SWLDA and the favorable parameters derived from the offline comparative analysis.

An evaluation of autoregressive spectral estimation model order for brain-computer interface applications.

Autoregressive (AR) spectral estimation is a popular method for modeling the electroencephalogram (EEG), and therefore the frequency domain EEG phenomena that are used for control of a brain-computer interface (BCI). Several studies have been conducted to evaluate the optimal AR model order for EEG, but the criteria used in these studies does not necessarily equate to the optimal AR model order for sensorimotor rhythm (SMR)-based BCI control applications. The present study confirms this by evaluating the EEG spectra of data obtained during control of SMR-BCI using different AR model orders and model evaluation criteria. The results indicate that the AR model order that optimizes SMR-BCI control performance is generally higher than the model orders that are frequently used in SMR-BCI studies.

Patients with ALS can use sensorimotor rhythms to operate a brain-computer interface.

People with severe motor disabilities can maintain an acceptable quality of life if they can communicate. Brain-computer interfaces (BCIs), which do not depend on muscle control, can provide communication. Four people severely disabled by ALS learned to operate a BCI with EEG rhythms recorded over sensorimotor cortex. These results suggest that a sensorimotor rhythm-based BCI could help maintain quality of life for people with ALS.

EMG contamination of EEG: spectral and topographical characteristics.

OBJECTIVE: Electromyogram (EMG) contamination is often a problem in electroencephalogram (EEG) recording, particularly, for those applications such as EEG-based brain-computer interfaces that rely on automated measurements of EEG features. As an essential prelude to developing methods for recognizing and eliminating EMG contamination of EEG, this study defines the spectral and topographical characteristics of frontalis and temporalis muscle EMG over the entire scalp. It describes both average data and the range of individual differences. METHODS: In 25 healthy adults, signals from 64 scalp and 4 facial locations were recorded during relaxation and during defined (15, 30, or 70% of maximum) contractions of frontalis or temporalis muscles. RESULTS: In the average data, EMG had a broad frequency distribution from 0 to >200 Hz. Amplitude was greatest at 20-30 Hz frontally and 40-80 Hz temporally. Temporalis spectra also showed a smaller peak around 20 Hz. These spectral components attenuated and broadened centrally. Even with weak (15%) contraction, EMG was detectable (P<0.001) near the vertex at frequencies >12 Hz in the average data and >8 Hz in some individuals. CONCLUSIONS: Frontalis or temporalis muscle EMG recorded from the scalp has spectral and topographical features that vary substantially across individuals. EMG spectra often have peaks in the beta frequency range that resemble EEG beta peaks. SIGNIFICANCE: While EMG contamination is greatest at the periphery of the scalp near the active muscles, even weak contractions can produce EMG that obscures or mimics EEG alpha, mu, or beta rhythms over the entire scalp. Recognition and elimination of this contamination is likely to require recording from an appropriate set of peripheral scalp locations.

EEG-based communication: presence of an error potential.

BACKGROUND: EEG-based communication could be a valuable new augmentative communication technology for those with severe motor disabilities. Like all communication methods, it faces the problem of errors in transmission. In the Wadsworth EEG-based brain-computer interface (BCI) system, subjects learn to use mu or beta rhythm amplitude to move a cursor to targets on a computer screen. While cursor movement is highly accurate in trained subjects, it is not perfect. METHODS: In an effort to develop a method for detecting errors, this study compared the EEG immediately after correct target selection to that after incorrect selection. RESULTS: The data showed that a mistake is followed by a positive potential centered at the vertex that peaks about 180 ms after the incorrect selection. CONCLUSION: The results suggest that this error potential might provide a method for detecting and voiding errors that requires no additional time and could thereby improve the speed and accuracy of EEG-based communication.

Brain-computer interface technology: a review of the first international meeting.

Over the past decade, many laboratories have begun to explore brain-computer interface (BCI) technology as a radically new communication option for those with neuromuscular impairments that prevent them from using conventional augmentative communication methods. BCI's provide these users with communication channels that do not depend on peripheral nerves and muscles. This article summarizes the first international meeting devoted to BCI research and development. Current BCI's use electroencephalographic (EEG) activity recorded at the scalp or single-unit activity recorded from within cortex to control cursor movement, select letters or icons, or operate a neuroprosthesis. The central element in each BCI is a translation algorithm that converts electrophysiological input from the user into output that controls external devices. BCI operation depends on effective interaction between two adaptive controllers, the user who encodes his or her commands in the electrophysiological input provided to the BCI, and the BCI which recognizes the commands contained in the input and expresses them in device control. Current BCI's have maximum information transfer rates of 5-25 b/min. Achievement of greater speed and accuracy depends on improvements in signal processing, translation algorithms, and user training. These improvements depend on increased interdisciplinary cooperation between neuroscientists, engineers, computer programmers, psychologists, and rehabilitation specialists, and on adoption and widespread application of objective methods for evaluating alternative methods. The practical use of BCI technology depends on the development of appropriate applications, identification of appropriate user groups, and careful attention to the needs and desires of individual users. BCI research and development will also benefit from greater emphasis on peer-reviewed publications, and from adoption of standard venues for presentations and discussion.

Brain-computer interface research at the Wadsworth Center.

Studies at the Wadsworth Center over the past 14 years have shown that people with or without motor disabilities can learn to control the amplitude of mu or beta rhythms in electroencephalographic (EEG) activity recorded from the scalp over sensorimotor cortex and can use that control to move a cursor on a computer screen in one or two dimensions. This EEG-based brain-computer interface (BCI) could provide a new augmentative communication technology for those who are totally paralyzed or have other severe motor impairments. Present research focuses on improving the speed and accuracy of BCI communication.

Mu and beta rhythm topographies during motor imagery and actual movements.

People can learn to control the 8-12 Hz mu rhythm and/or the 18-25 Hz beta rhythm in the EEG recorded over sensorimotor cortex and use it to control a cursor on a video screen. Subjects often report using motor imagery to control cursor movement, particularly early in training. We compared in untrained subjects the EEG topographies associated with actual hand movement to those associated with imagined hand movement. Sixty-four EEG channels were recorded while each of 33 adults moved left- or right-hand or imagined doing so. Frequency-specific differences between movement or imagery and rest, and between right- and left-hand movement or imagery, were evaluated by scalp topographies of voltage and r spectra, and principal component analysis. Both movement and imagery were associated with mu and beta rhythm desynchronization. The mu topographies showed bilateral foci of desynchronization over sensorimotor cortices, while the beta topographies showed peak desynchronization over the vertex. Both mu and beta rhythm left/right differences showed bilateral central foci that were stronger on the right side. The independence of mu and beta rhythms was demonstrated by differences for movement and imagery for the subjects as a group and by principal components analysis. The results indicated that the effects of imagery were not simply an attenuated version of the effects of movement. They supply evidence that motor imagery could play an important role in EEG-based communication, and suggest that mu and beta rhythms might provide independent control signals.

Temporal processing deficits in remediation-resistant reading-impaired children.

There is considerable interest in whether a deficit in temporal processing underlies specific learning and language disabilities in school-aged children. This view is particularly controversial in the area of developmental reading problems. The temporal-processing hypothesis was tested in a sample of normal children, 9-11 years of age, and in a sample of age-matched children with reading impairments, by assessing temporal-order discrimination. Five different binary temporal-order tasks were evaluated in the auditory and visual sensory modalities. Other basic discrimination abilities for single auditory stimuli were also assessed, including just noticeable differences (JNDs) for frequency and intensity and a simple threshold detection task. In these tasks, the temporal dimension was the duration of the individual stimuli (20 and 200 ms). All data were obtained using forced- choice psychophysical methods, either in a single-track adaptive format or using psychometric functions. The results from these experiments showed that children with reading impairments had deficits in temporal-order discrimination, but these effects were not modality specific. These same children also had significantly elevated frequency and intensity JNDs and their performance on these tasks were not dependent on stimulus duration. No group differences were observed on the threshold detection task, and the derived measurements of temporal integration (i.e. the threshold difference between the 20- and 200-ms stimuli) were considered normal, averaging 11.7 dB. As a whole, discrimination deficits observed in the reading-impaired group only occurred with suprathreshold stimuli. The deficits were neither modality specific nor temporal (duration) specific.

Cutaneous-evoked tinnitus. II. Review Of neuroanatomical, physiological and functional imaging studies.

Cutaneous-evoked tinnitus is a clinical entity that has not been reported previously in the neurootological literature. Herein, a neuroscience framework that encompasses several distinct areas of research is used to conceptualize and help understand this phenomenon. We review normal neuroanatomical and physiological interactions between auditory and somatosensory systems in mammals. Also considered are mechanistic accounts of lesion-induced changes in the CNS following deafferentation/deefferentation of peripheral sensory or motor structures that may have a relationship to this phenomenon, as well as the role of functional imaging modalities in studying various phantom perceptions.

Cutaneous-evoked tinnitus. I. Phenomenology, psychophysics and functional imaging.

DC00166e and acute unilateral deafferentation of the auditory periphery (auditory and vestibular afferents) can induce changes in the central nervous system that may result in unique forms of tinnitus. These tinnitus perceptions can be controlled (turned on and off) or modulated (changed in pitch or loudness) by performing certain overt behaviors in other sensory/motor systems. Clinical reports from our laboratory and several other independent sources indicate that static change in eye gaze, from a neutral head-referenced position, is one such behavior that can evoke, modulate and/or suppress these phantom auditory events. This report deals with a new clinical entity and a form of tinnitus that can be evoked directly by cutaneous stimulation of the upper hand and fingertip regions. In 2 adults, cutaneous-evoked tinnitus was reported following neurosurgery for space-occupying lesions at the base of the skull and posterior craniofossa, where hearing and vestibular functions were lost completely and acutely in one ear (unilateral deafferentation) and facial nerve paralysis (unilateral deefferentation) was present either immediately following neurosurgery or had occurred as a delayed-onset event. Herein, we focus on the phenomenology of this discovery, provide perceptual correlates using contemporary psychophysical methods and document in one individual cutaneous-evoked tinnitus-related neural activity using functional magnetic resonance imaging. In a companion paper, neuroanatomical and physiological interactions between auditory and somatosensory systems, possible mechanistic accounts and relevant functional neuroimaging studies are reviewed.

Central deafness in a young child with Moyamoya disease: paternal linkage in a Caucasian family: two case reports and a review of the literature.

A case of 'central deafness' is presented in a 3-year-old male Caucasian child with Moyamoya disease (MMD); a rare, progressive and occlusive cerebrovascular disorder predominantly affecting the carotid artery system. Documentation of normal peripheral auditory function and brainstem pathway integrity is provided by acoustic admittance, otoacoustic emission and brainstem auditory evoked potential measurements. The lack of behavioral response to sound, and absent middle and long latency auditory evoked potentials suggest thalamo-cortical dysfunction. Magnetic resonance imaging showed diffuse ischemic damage in subcortical white matter including areas of the temporal lobes. In addition, there were multiple and focal cortical infarctions in both cerebral hemispheres, focused primarily in the frontal, parietal and temporal areas. Taken together, these structural and functional abnormalities in addition to severely delayed speech and language development are consistent with the diagnosis of central deafness and suggest a disconnection between higher brainstem and cortical auditory areas. The child's father also has MMD, but was diagnosed only recently. The presence of paternal linkage is informative since it rules out x-linked recessive and maternal inheritance. To our knowledge, this represents the first documented case of paternal linkage in MMD with central deafness in a Caucasian child with no apparent Japanese ancestry. Herein, we focus on central auditory dysfunction and consider how lesion-induced changes have contributed to a deficit in basic auditory responsiveness, including a severe disturbance in receptive and expressive auditory-based speech and language skills.

Answering questions with an electroencephalogram-based brain-computer interface.

OBJECTIVE: To demonstrate that humans can learn to control selected electroencephalographic components and use that control to answer simple questions. METHODS: Four adults (one with amyotrophic lateral sclerosis) learned to use electroencephalogram (EEG) mu rhythm (8 to 12Hz) or beta rhythm (18 to 25Hz) activity over sensorimotor cortex to control vertical cursor movement to targets at the top or bottom edge of a video screen. In subsequent sessions, the targets were replaced with the words YES and NO, and individuals used the cursor to answer spoken YES/NO questions from single- or multiple-topic question sets. They confirmed their answers through the response verification (RV) procedure, in which the word positions were switched and the question was answered again. RESULTS: For 5 consecutive sessions after initial question training, individuals were asked an average of 4.0 to 4.6 questions per minute; 64% to 87% of their answers were confirmed by the RV procedure and 93% to 99% of these answers were correct. Performances for single- and multiple-topic question sets did not differ significantly. CONCLUSIONS: The results indicate that (1) EEG-based cursor control can be used to answer simple questions with a high degree of accuracy, (2) attention to auditory queries and formulation of answers does not interfere with EEG-based cursor control, (3) question complexity (at least as represented by single versus multiple-topic question sets) does not noticeably affect performance, and (4) the RV procedure improves accuracy as expected. Several options for increasing the speed of communication appear promising. An EEG-based brain-computer interface could provide a new communication and control modality for people with severe motor disabilities.

EEG-based communication: improved accuracy by response verification.

Humans can learn to control the amplitude of electroencephalographic (EEG) activity in specific frequency bands over sensorimotor cortex and use it to move a cursor to a target on a computer screen. EEG-based communication could provide a new augmentative communication channel for individuals with motor disabilities. In the present system, each dimension of cursor movement is controlled by a linear equation. While the intercept in the equation is continually updated, it does not perfectly eliminate the impact of spontaneous variations in EEG amplitude. This imperfection reduces the accuracy of cursor movement. We evaluated a response verification (RV) procedure in which each outcome is determined by two opposite trials (e.g., one top-target trial and one bottom-target trial). Success, or failure, on both is required for a definitive outcome. The RV procedure reduces errors due to imperfection in intercept selection. Accuracy for opposite-trial pairs exceeds that predicted from the accuracies of individual trials, and greatly exceeds that for same-trial pairs. The RV procedure should be particularly valuable when the first trial has >2 possible targets, because the second trial need only confirm or deny the outcome of the first, and it should be applicable to nonlinear as well as to linear algorithms.

Temporal-order discrimination for selected auditory and visual stimulus dimensions.

Thresholds for the discrimination of temporal order were determined for selected auditory and visual stimulus dimensions in 10 normal-adult volunteers. Auditory stimuli consisted of binary pure tones varying in frequency or sound pressure level, and visual stimuli consisted of binary geometric forms varying in size, orientation, or color. We determined the effect of psychophysical method and the reliability of performance across stimulus dimensions. Using a single-track adaptive procedure, Experiment 1 showed that temporal-order thresholds (TOTs) varied with stimulus dimension, being lowest for auditory frequency, intermediate for size, orientation, and auditory level, and longest for color. Test performance improved over sessions and the profile of thresholds across stimulus dimensions had a modest reliability. Experiment 2 used a double-interleaved adaptive procedure and TOTs were similarly ordered as in Experiment 1. However, TOTs were significantly lower for initially ascending versus descending tracks. With this method, the reliability of the profile across stimulus dimensions and tracks was relatively low. In Experiment 3, psychometric functions were obtained for each of the stimulus dimensions and thresholds were defined as the interpolated 70.7% correct point. The relative ordering of TOTs was similar to those obtained in the first two experiments. Non-monotonicities were found in some of the psychometric functions, with the most prominent being for the color dimension. A cross-experiment comparison of results demonstrates that TOTs and their reliability are significantly influenced by the psychophysical method. Taken together, these results support the notion that the temporal resolution of ordered stimuli involves perceptual mechanisms specific to a given sensory modality or submodality.

Central auditory processing disorder in school-aged children: a critical review.

The rationale to evaluate for central auditory processing disorder (CAPD) in school-aged children is based on the assumption that an auditory-specific perceptual deficit underlies many learning problems including specific reading and language disabilities. A fundamental issue in this area is whether convincing empirical evidence exists to validate this proposition. Herein, we consider the issue of modality specificity by examining the extent to which reading, language, and attention disorders in school-aged children involve perceptual dysfunctions limited to a single sensory modality. Difficulty in validating CAPD as a diagnostic label is due in large part to use of the unimodal inclusive framework, which has biased the diagnosis to favor sensitivity of test results over documenting the specificity of the deficit. Indeed, empirical research documenting modality-specific auditory-perceptual dysfunction in this population is scarce. Therefore, the existing literature on this topic has not clarified the "true" nature of the problem, and has left many questions about this disorder unanswered. It is argued that demonstrating modality specificity is one way to rule out supramodal disorders as explanations for observed dysfunction. Multimodal perceptual testing is one logical approach to help clarify this area of investigation.