Cancellous and cortical bone mineral density around an elastic press-fit socket in total hip arthroplasty.

Background and purpose - The acetabular component has remained the weakest link in hip arthroplasty for achievement of long-term survival. One of the possible explanatory factors for acetabular failure has been acetabular stress shielding. For this, we investigated the effects of a cementless elastic socket on acetabular bone mineral density (BMD). Patients and methods - During 2008-2009, we performed a single-center prospective cohort trial on 25 patients (mean age 64 (SD 4), 18 females) in whom we implanted a cementless elastic press-fit socket. Using quantitative BMD measurements on CT, we determined the change in BMD surrounding the acetabular component over a 2-year follow-up period. Results - We found a statistically significant decrease in cancellous BMD (-14% to -35%) and a stable level of cortical BMD (5% to -5%) surrounding the elastic press-fit cup during the follow-up period. The main decrease was seen during the first 6 months after implantation. During the second year, cancellous BMD showed a further decrease in the medial and lower acetabular regions. Interpretation - We found no evidence that an elastic press-fit socket would prevent acetabular stress shielding during a 2-year follow-up.

Decoding Sensorimotor Rhythms during Robotic-Assisted Treadmill Walking for Brain Computer Interface (BCI) Applications.

Locomotor malfunction represents a major problem in some neurological disorders like stroke and spinal cord injury. Robot-assisted walking devices have been used during rehabilitation of patients with these ailments for regaining and improving walking ability. Previous studies showed the advantage of brain-computer interface (BCI) based robot-assisted training combined with physical therapy in the rehabilitation of the upper limb after stroke. Therefore, stroke patients with walking disorders might also benefit from using BCI robot-assisted training protocols. In order to develop such BCI, it is necessary to evaluate the feasibility to decode walking intention from cortical patterns during robot-assisted gait training. Spectral patterns in the electroencephalogram (EEG) related to robot-assisted active and passive walking were investigated in 10 healthy volunteers (mean age 32.3±10.8, six female) and in three acute stroke patients (all male, mean age 46.7±16.9, Berg Balance Scale 20±12.8). A logistic regression classifier was used to distinguish walking from baseline in these spectral EEG patterns. Mean classification accuracies of 94.0±5.4% and 93.1±7.9%, respectively, were reached when active and passive walking were compared against baseline. The classification performance between passive and active walking was 83.4±7.4%. A classification accuracy of 89.9±5.7% was achieved in the stroke patients when comparing walking and baseline. Furthermore, in the healthy volunteers modulation of low gamma activity in central midline areas was found to be associated with the gait cycle phases, but not in the stroke patients. Our results demonstrate the feasibility of BCI-based robotic-assisted training devices for gait rehabilitation.

Using Actual and Imagined Walking Related Desynchronization Features in a BCI.

Recently, brain-computer interface (BCI) research has extended to investigate its possible use in motor rehabilitation. Most of these investigations have focused on the upper body. Only few studies consider gait because of the difficulty of recording EEG during gross movements. However, for stroke patients the rehabilitation of gait is of crucial importance. Therefore, this study investigates if a BCI can be based on walking related desynchronization features. Furthermore, the influence of complexity of the walking movements on the classification performance is investigated. Two BCI experiments were conducted in which healthy subjects performed a cued walking task, a more complex walking task (backward or adaptive walking), and imagination of the same tasks. EEG data during these tasks was classified into walking and no-walking. The results from both experiments show that despite the automaticity of walking and recording difficulties, brain signals related to walking could be classified rapidly and reliably. Classification performance was higher for actual walking movements than for imagined walking movements. There was no significant increase in classification performance for both the backward and adaptive walking tasks compared with the cued walking tasks. These results are promising for developing a BCI for the rehabilitation of gait.

A multi-signature brain-computer interface: use of transient and steady-state responses.

OBJECTIVE: The aim of this paper was to increase the information transfer in brain-computer interfaces (BCI). Therefore, a multi-signature BCI was developed and investigated. Stimuli were designed to simultaneously evoke transient somatosensory event-related potentials (ERPs) and steady-state somatosensory potentials (SSSEPs) and the ERPs and SSSEPs in isolation. APPROACH: Twelve subjects participated in two sessions. In the first session, the single and combined stimulation conditions were compared on these somatosensory responses and on the classification performance. In the second session the on-line performance with the combined stimulation was evaluated while subjects received feedback. Furthermore, in both sessions, the performance based on ERP and SSSEP features was compared. MAIN RESULTS: No difference was found in the ERPs and SSSEPs between stimulation conditions. The combination of ERP and SSSEP features did not perform better than with ERP features only. In both sessions, the classification performances based on ERP and combined features were higher than the classification based on SSSEP features. SIGNIFICANCE: Although the multi-signature BCI did not increase performance, it also did not negatively impact it. Therefore, such stimuli could be used and the best performing feature set could then be chosen individually.

Introducing the tactile speller: an ERP-based brain-computer interface for communication.

In this study, a tactile speller was developed and compared with existing visual speller paradigms in terms of classification performance and elicited event-related potentials (ERPs). The fingertips of healthy participants were stimulated with short mechanical taps while electroencephalographic activity was measured. The letters of the alphabet were allocated to different fingers and subjects could select one of the fingers by silently counting the number of taps on that finger. The offline and online performance of the tactile speller was compared to the overt and covert attention visual matrix speller and the covert attention Hex-o-Spell speller. For the tactile speller, binary target versus non-target classification accuracy was 67% on average. Classification and decoding accuracies of the tactile speller were lower than the overt matrix speller, but higher than the covert matrix speller, and similar to Hex-o-Spell. The average maximum information transfer rate of the tactile speller was 7.8 bits min(-1) (1.51 char min(-1)), with the best subject reaching a bit-rate of 27 bits min(-1) (5.22 char min(-1)). An increased amplitude of the P300 ERP component was found in response to attended stimuli versus unattended stimuli in all speller types. In addition, the tactile and overt matrix spellers also used the N2 component for discriminating between targets and non-targets. Overall, this study shows that it is possible to use a tactile speller for communication. The tactile speller provides a useful alternative to the visual speller, especially for people whose eye gaze is impaired.

Response preparation with adjacent versus overlapped hands: a pupillometric study.

Preparatory cues facilitate performance in speeded choice tasks. It is debated, however, whether the lateralized neuro-anatomical organization of the human motor system contributes to this facilitation. To investigate this issue, we examined response preparation in a finger-cuing task using two conditions. In the hands adjacent condition, the hands were placed adjacently to each other with index and middle fingers placed on four linearly arrayed response keys. In the overlapped hand placement condition, the fingers of different hands alternated, thus dissociating hand and spatial position factors. Preparatory cues specified a subset of two fingers. Left-right cues specified the two leftmost or two rightmost fingers. Inner-outer cues specified the two inner or outer fingers. Alternate cues specified the first and third, or the second and fourth finger in the response set. In addition to reaction time and response errors, we measured the pupillary response to assess the cognitive processing load associated with response preparation. Results showed stronger pupil dilations (and also longer RTs and more errors) for the overlapped than for the adjacent hand placement condition, reflecting an overall increase in cognitive processing load. Furthermore, the negative impact of overlapping the hands on pupil dilation interacted with cue type, indicating that left-right cues (associated with two fingers on one hand) suffered most from overlapping the hands. With the hands overlapped, alternate cues (now associated with two fingers on the same hand) produced the shortest RTs. These findings demonstrate the importance of motoric factors in response preparation.