Single-Trial Classification of Error-Related Potentials in People with Motor Disabilities: A Study in Cerebral Palsy, Stroke, and Amputees.

Brain-computer interface performance may be reduced over time, but adapting the classifier could reduce this problem. Error-related potentials (ErrPs) could label data for continuous adaptation. However, this has scarcely been investigated in populations with severe motor impairments. The aim of this study was to detect ErrPs from single-trial EEG in offline analysis in participants with cerebral palsy, an amputation, or stroke, and determine how much discriminative information different brain regions hold. Ten participants with cerebral palsy, eight with an amputation, and 25 with a stroke attempted to perform 300-400 wrist and ankle movements while a sham BCI provided feedback on their performance for eliciting ErrPs. Pre-processed EEG epochs were inputted in a multi-layer perceptron artificial neural network. Each brain region was used as input individually (Frontal, Central, Temporal Right, Temporal Left, Parietal, and Occipital), the combination of the Central region with each of the adjacent regions, and all regions combined. The Frontal and Central regions were most important, and adding additional regions only improved performance slightly. The average classification accuracies were 84 ± 4%, 87± 4%, and 85 ± 3% for cerebral palsy, amputation, and stroke participants. In conclusion, ErrPs can be detected in participants with motor impairments; this may have implications for developing adaptive BCIs or automatic error correction.

Detection of Error-Related Potentials in Stroke Patients from EEG Using an Artificial Neural Network.

Error-related potentials (ErrPs) have been proposed as a means for improving brain-computer interface (BCI) performance by either correcting an incorrect action performed by the BCI or label data for continuous adaptation of the BCI to improve the performance. The latter approach could be relevant within stroke rehabilitation where BCI calibration time could be minimized by using a generalized classifier that is continuously being individualized throughout the rehabilitation session. This may be achieved if data are correctly labelled. Therefore, the aims of this study were: (1) classify single-trial ErrPs produced by individuals with stroke, (2) investigate test-retest reliability, and (3) compare different classifier calibration schemes with different classification methods (artificial neural network, ANN, and linear discriminant analysis, LDA) with waveform features as input for meaningful physiological interpretability. Twenty-five individuals with stroke operated a sham BCI on two separate days where they attempted to perform a movement after which they received feedback (error/correct) while continuous EEG was recorded. The EEG was divided into epochs: ErrPs and NonErrPs. The epochs were classified with a multi-layer perceptron ANN based on temporal features or the entire epoch. Additionally, the features were classified with shrinkage LDA. The features were waveforms of the ErrPs and NonErrPs from the sensorimotor cortex to improve the explainability and interpretation of the output of the classifiers. Three calibration schemes were tested: within-day, between-day, and across-participant. Using within-day calibration, 90% of the data were correctly classified with the entire epoch as input to the ANN; it decreased to 86% and 69% when using temporal features as input to ANN and LDA, respectively. There was poor test-retest reliability between the two days, and the other calibration schemes led to accuracies in the range of 63-72% with LDA performing the best. There was no association between the individuals' impairment level and classification accuracies. The results show that ErrPs can be classified in individuals with stroke, but that user- and session-specific calibration is needed for optimal ErrP decoding with this approach. The use of ErrP/NonErrP waveform features makes it possible to have a physiological meaningful interpretation of the output of the classifiers. The results may have implications for labelling data continuously in BCIs for stroke rehabilitation and thus potentially improve the BCI performance.

Patient-Reported Outcomes From Patients With Heart Failure Participating in the Future Patient Telerehabilitation Program: Data From the Intervention Arm of a Randomized Controlled Trial.

BACKGROUND: More than 37 million people worldwide have been diagnosed with heart failure, which is a growing burden on the health sector. Cardiac rehabilitation aims to improve patients' recovery, functional capacity, psychosocial well-being, and health-related quality of life. However, cardiac rehabilitation programs have poor compliance and adherence. Telerehabilitation may be a solution to overcome some of these challenges to cardiac rehabilitation by making it more individualized. As part of the Future Patient Telerehabilitation program, a digital toolbox aimed at enabling patients with heart failure to monitor and evaluate their own current status has been developed and tested using data from a patient-reported outcome questionnaire that the patient filled in every alternate week for 1 year. OBJECTIVE: The aim of this study is to evaluate the changes in quality of life and well-being among patients with heart failure, who are participants in the Future Patient Telerehabilitation program over the course of 1 year. METHODS: In total, 140 patients were enrolled in the Future Patient Telerehabilitation program and randomized into either the telerehabilitation group (n=70) or the control group (n=70). Of the 70 patients in the telerehabilitation group, 56 (80.0%) answered the patient-reported outcome questionnaire and completed the program, and these 56 patients comprised the study population. The patient-reported outcomes consisted of three components: (1) questions regarding the patients' sleep patterns assessed using the Spiegel Sleep Questionnaire; (2) measurements of physical limitations, symptoms, self-efficacy, social interaction, and quality of life assessed using the Kansas City Cardiomyopathy Questionnaire in 10 dimensions; and (3) 5 additional questions regarding psychological well-being that were developed by the research group. RESULTS: The changes in scores during 1 year of the study were examined using 1-sample Wilcoxon signed-rank tests. There were significant differences in the scores for most of the slopes of the scores from the dimensions of the Kansas City Cardiomyopathy Questionnaire (P<.05). CONCLUSIONS: There was a significant increase in clinical and social well-being and quality of life during the 1-year period of participating in a telerehabilitation program. These results suggest that patient-reported outcome questionnaires may be used as a tool for patients in a telerehabilitation program that can both monitor and guide patients in mastering their own symptoms. TRIAL REGISTRATION: ClinicalTrials.gov NCT03388918; https://clinicaltrials.gov/ct2/show/NCT03388918.

Classification of error-related potentials from single-trial EEG in association with executed and imagined movements: a feature and classifier investigation.

Error-related potentials (ErrPs) have been proposed for designing adaptive brain-computer interfaces (BCIs). Therefore, ErrPs must be decoded. The aim of this study was to evaluate ErrP decoding using combinations of different feature types and classifiers in BCI paradigms involving motor execution (ME) and imagination (MI). Fifteen healthy subjects performed 510 (ME) and 390 (MI) trials of right/left wrist extensions and foot dorsiflexions. Sham BCI feedback was delivered with an accuracy of 80% (ME) and 70% (MI). Continuous EEG was recorded and divided into ErrP and NonErrP epochs. Temporal, spectral, and discrete wavelet transform (DWT) marginals and template matching features were extracted, and all combinations of feature types were classified using linear discriminant analysis, support vector machine, and random forest classifiers. ErrPs were elicited for both ME and MI paradigms, and the average classification accuracies were significantly higher than the chance level. The highest average classification accuracy was obtained using temporal features and a combination of temporal + DWT features classified with random forest; 89 ± 9% and 83 ± 9% for ME and MI, respectively. These results generally indicate that temporal features should be used when detecting ErrPs, but there is great inter-subject variability, which means that user-specific features should be derived to maximize the performance. Graphical abstract.

Continuous 2D control via state-machine triggered by endogenous sensory discrimination and a fast brain switch.

OBJECTIVE: Brain computer interfacing (BCI) is a promising method to control assistive systems for patients with severe disabilities. Recently, we have presented a novel BCI approach that combines an electrotactile menu and a brain switch, which allows the user to trigger many commands robustly and efficiently. However, the commands are timed to periodic tactile cues and this may challenge online control. In the present study, therefore, we implemented and evaluated a novel approach for online closed-loop control using the proposed BCI. APPROACH: Eleven healthy subjects used the novel method to move a cursor in a 2D space. To assure robust control with properly timed commands, the BCI was integrated within a state machine allowing the subject to start the cursor movement in the selected direction and asynchronously stop the cursor. The brain switch was controlled using motor execution (ME) or imagery (MI) and the menu implemented four (straight movements) or eight commands (straight and diagonal movements). MAIN RESULTS: The results showed a high completion rate of a target hitting task (~97% and ~92% for ME and MI, respectively), with a small number of collisions, when four-channel control was used. There was no significant difference in outcome measures between MI and ME, and performance was similar for four and eight commands. SIGNIFICANCE: These results demonstrate that the novel state-based scheme driven by a robust BCI can be successfully utilized for online control. Therefore, it can be an attractive solution for providing the user an online-control interface with many commands, which is difficult to achieve using classic BCI solutions.

Classification of Hand Grasp Kinetics and Types Using Movement-Related Cortical Potentials and EEG Rhythms.

Detection of single-trial movement intentions from EEG is paramount for brain-computer interfacing in neurorehabilitation. These movement intentions contain task-related information and if this is decoded, the neurorehabilitation could potentially be optimized. The aim of this study was to classify single-trial movement intentions associated with two levels of force and speed and three different grasp types using EEG rhythms and components of the movement-related cortical potential (MRCP) as features. The feature importance was used to estimate encoding of discriminative information. Two data sets were used. 29 healthy subjects executed and imagined different hand movements, while EEG was recorded over the contralateral sensorimotor cortex. The following features were extracted: delta, theta, mu/alpha, beta, and gamma rhythms, readiness potential, negative slope, and motor potential of the MRCP. Sequential forward selection was performed, and classification was performed using linear discriminant analysis and support vector machines. Limited classification accuracies were obtained from the EEG rhythms and MRCP-components: 0.48 ± 0.05 (grasp types), 0.41 ± 0.07 (kinetic profiles, motor execution), and 0.39 ± 0.08 (kinetic profiles, motor imagination). Delta activity contributed the most but all features provided discriminative information. These findings suggest that information from the entire EEG spectrum is needed to discriminate between task-related parameters from single-trial movement intentions.

Influence of attention alternation on movement-related cortical potentials in healthy individuals and stroke patients.

OBJECTIVE: In this study, we analyzed the influence of artificially imposed attention variations using the auditory oddball paradigm on the cortical activity associated to motor preparation/execution. METHODS: EEG signals from Cz and its surrounding channels were recorded during three sets of ankle dorsiflexion movements. Each set was interspersed with either a complex or a simple auditory oddball task for healthy participants and a complex auditory oddball task for stroke patients. RESULTS: The amplitude of the movement-related cortical potentials (MRCPs) decreased with the complex oddball paradigm, while MRCP variability increased. Both oddball paradigms increased the detection latency significantly (p<0.05) and the complex paradigm decreased the true positive rate (TPR) (p=0.04). In patients, the negativity of the MRCP decreased while pre-phase variability increased, and the detection latency and accuracy deteriorated with attention diversion. CONCLUSION: Attention diversion has a significant influence on MRCP features and detection parameters, although these changes were counteracted by the application of the laplacian method. SIGNIFICANCE: Brain-computer interfaces for neuromodulation that use the MRCP as the control signal are robust to changes in attention. However, attention must be monitored since it plays a key role in plasticity induction. Here we demonstrate that this can be achieved using the single channel Cz.

Manipulation of Dysfunctional Spinal Joints Affects Sensorimotor Integration in the Prefrontal Cortex: A Brain Source Localization Study.

Objectives. Studies have shown decreases in N30 somatosensory evoked potential (SEP) peak amplitudes following spinal manipulation (SM) of dysfunctional segments in subclinical pain (SCP) populations. This study sought to verify these findings and to investigate underlying brain sources that may be responsible for such changes. Methods. Nineteen SCP volunteers attended two experimental sessions, SM and control in random order. SEPs from 62-channel EEG cap were recorded following median nerve stimulation (1000 stimuli at 2.3 Hz) before and after either intervention. Peak-to-peak amplitude and latency analysis was completed for different SEPs peak. Dipolar models of underlying brain sources were built by using the brain electrical source analysis. Two-way repeated measures ANOVA was used to assessed differences in N30 amplitudes, dipole locations, and dipole strengths. Results. SM decreased the N30 amplitude by 16.9 ± 31.3% (P = 0.02), while no differences were seen following the control intervention (P = 0.4). Brain source modeling revealed a 4-source model but only the prefrontal source showed reduced activity by 20.2 ± 12.2% (P = 0.03) following SM. Conclusion. A single session of spinal manipulation of dysfunctional segments in subclinical pain patients alters somatosensory processing at the cortical level, particularly within the prefrontal cortex.

Endogenous Sensory Discrimination and Selection by a Fast Brain Switch for a High Transfer Rate Brain-Computer Interface.

In this study, we present a novel multi-class brain-computer interface (BCI) for communication and control. In this system, the information processing is shared by the algorithm (computer) and the user (human). Specifically, an electro-tactile cycle was presented to the user, providing the choice (class) by delivering timely sensory input. The user discriminated these choices by his/her endogenous sensory ability and selected the desired choice with an intuitive motor task. This selection was detected by a fast brain switch based on real-time detection of movement-related cortical potentials from scalp EEG. We demonstrated the feasibility of such a system with a four-class BCI, yielding a true positive rate of  âˆ¼ 80% and  âˆ¼ 70%, and an information transfer rate of  âˆ¼ 7 bits/min and  âˆ¼ 5 bits/min, for the movement and imagination selection command, respectively. Furthermore, when the system was extended to eight classes, the throughput of the system was improved, demonstrating the capability of accommodating a large number of classes. Combining the endogenous sensory discrimination with the fast brain switch, the proposed system could be an effective, multi-class, gaze-independent BCI system for communication and control applications.

Efficient neuroplasticity induction in chronic stroke patients by an associative brain-computer interface.

Brain-computer interfaces (BCIs) have the potential to improve functionality in chronic stoke patients when applied over a large number of sessions. Here we evaluated the effect and the underlying mechanisms of three BCI training sessions in a double-blind sham-controlled design. The applied BCI is based on Hebbian principles of associativity that hypothesize that neural assemblies activated in a correlated manner will strengthen synaptic connections. Twenty-two chronic stroke patients were divided into two training groups. Movement-related cortical potentials (MRCPs) were detected by electroencephalography during repetitions of foot dorsiflexion. Detection triggered a single electrical stimulation of the common peroneal nerve timed so that the resulting afferent volley arrived at the peak negative phase of the MRCP (BCIassociative group) or randomly (BCInonassociative group). Fugl-Meyer motor assessment (FM), 10-m walking speed, foot and hand tapping frequency, diffusion tensor imaging (DTI) data, and the excitability of the corticospinal tract to the target muscle [tibialis anterior (TA)] were quantified. The TA motor evoked potential (MEP) increased significantly after the BCIassociative intervention, but not for the BCInonassociative group. FM scores (0.8 ± 0.46 point difference, P = 0.01), foot (but not finger) tapping frequency, and 10-m walking speed improved significantly for the BCIassociative group, indicating clinically relevant improvements. Corticospinal tract integrity on DTI did not correlate with clinical or physiological changes. For the BCI as applied here, the precise coupling between the brain command and the afferent signal was imperative for the behavioral, clinical, and neurophysiological changes reported. This association may become the driving principle for the design of BCI rehabilitation in the future. Indeed, no available BCIs can match this degree of functional improvement with such a short intervention.

EMD-Based Temporal and Spectral Features for the Classification of EEG Signals Using Supervised Learning.

This paper presents a novel method for feature extraction from electroencephalogram (EEG) signals using empirical mode decomposition (EMD). Its use is motivated by the fact that the EMD gives an effective time-frequency analysis of nonstationary signals. The intrinsic mode functions (IMF) obtained as a result of EMD give the decomposition of a signal according to its frequency components. We present the usage of upto third order temporal moments, and spectral features including spectral centroid, coefficient of variation and the spectral skew of the IMFs for feature extraction from EEG signals. These features are physiologically relevant given that the normal EEG signals have different temporal and spectral centroids, dispersions and symmetries when compared with the pathological EEG signals. The calculated features are fed into the standard support vector machine (SVM) for classification purposes. The performance of the proposed method is studied on a publicly available dataset which is designed to handle various classification problems including the identification of epilepsy patients and detection of seizures. Experiments show that good classification results are obtained using the proposed methodology for the classification of EEG signals. Our proposed method also compares favorably to other state-of-the-art feature extraction methods.

Detecting and classifying three different hand movement types through electroencephalography recordings for neurorehabilitation.

Brain-computer interfaces can be used for motor substitution and recovery; therefore, detection and classification of movement intention are crucial for optimal control. In this study, palmar, lateral and pinch grasps were differentiated from the idle state and classified from single-trial EEG using only information prior to the movement onset. Fourteen healthy subjects performed the three grasps 100 times, while EEG was recorded from 25 electrodes. Temporal and spectral features were extracted from each electrode, and feature reduction was performed using sequential forward selection (SFS) and principal component analysis (PCA). The detection problem was investigated as the ability to discriminate between movement preparation and the idle state. Furthermore, all task pairs and the three movements together were classified. The best detection performance across movements (79 ± 8 %) was obtained by combining temporal and spectral features. The best movement-movement discrimination was obtained using spectral features: 76 ± 9 % (2-class) and 63 ± 10 % (3-class). For movement detection and discrimination, the performance was similar across grasp types and task pairs; SFS outperformed PCA. The results show it is feasible to detect different grasps and classify the distinct movements using only information prior to the movement onset, which may enable brain-computer interface-based neurorehabilitation of upper limb function through Hebbian learning mechanisms.

Detecting and classifying movement-related cortical potentials associated with hand movements in healthy subjects and stroke patients from single-electrode, single-trial EEG.

OBJECTIVE: To detect movement intention from executed and imaginary palmar grasps in healthy subjects and attempted executions in stroke patients using one EEG channel. Moreover, movement force and speed were also decoded. APPROACH: Fifteen healthy subjects performed motor execution and imagination of four types of palmar grasps. In addition, five stroke patients attempted to perform the same movements. The movements were detected from the continuous EEG using a single electrode/channel overlying the cortical representation of the hand. Four features were extracted from the EEG signal and classified with a support vector machine (SVM) to decode the level of force and speed associated with the movement. The system performance was evaluated based on both detection and classification. MAIN RESULTS: ∼ 75% of all movements (executed, imaginary and attempted) were detected 100 ms before the onset of the movement. ∼ 60% of the movements were correctly classified according to the intended level of force and speed. When detection and classification were combined, ∼ 45% of the movements were correctly detected and classified in both the healthy and stroke subjects, although the performance was slightly better in healthy subjects. SIGNIFICANCE: The results indicate that it is possible to use a single EEG channel for detecting movement intentions that may be combined with assistive technologies. The simple setup may lead to a smoother transition from laboratory tests to the clinic.

Comparison of spatial filters and features for the detection and classification of movement-related cortical potentials in healthy individuals and stroke patients.

OBJECTIVE: The possibility of detecting movement-related cortical potentials (MRCPs) at the single trial level has been explored for closing the motor control loop with brain-computer interfaces (BCIs) for neurorehabilitation. A distinct feature of MRCPs is that the movement kinetic information is encoded in the brain potential prior to the onset of the movement, which makes it possible to timely drive external devices to provide sensory feedback according to the efferent activity from the brain. The aim of this study was to compare methods for the detection (different spatial filters) and classification (features extracted from various domains) of MRCPs from continuous electroencephalography recordings from executed and imagined movements from healthy subjects (n = 24) and attempted movements from stroke patients (n = 6) to optimize the performance of MRCP-based BCIs for neurorehabilitation. APPROACH: The MRCPs from four cue-based tasks were detected with a template matching approach and a set of spatial filters, and classified with a linear support vector machine using the combination of temporal, spectral, time-scale, or entropy-based features. MAIN RESULTS: The best spatial filter (large Laplacian spatial filter (LLSF)) resulted in a true positive rate of 82 ± 9%, 78 ± 12% and 72 ± 9% (with detections occurring ∼ 200 ms before the onset of the movement) for executed, imagined and attempted movements (stroke patients). The best feature combination (temporal and spectral) led to pairwise classification of 73 ± 9%, 64 ± 10% and 80 ± 12%. When the detection was combined with classification, 60 ± 10%, 49 ± 10% and 58 ± 10% of the movements were both correctly detected and classified for executed, imagined and attempted movements. A similar performance for detection and classification was obtained with optimized spatial filtering. SIGNIFICANCE: A simple setup with an LLSF is useful for detecting cued movements while the combination of features from the time and frequency domain can optimize the decoding of kinetic information from MRCPs; this may be used in neuromodulatory BCIs.

Comparison of Features for Movement Prediction from Single-Trial Movement-Related Cortical Potentials in Healthy Subjects and Stroke Patients.

Detection of movement intention from the movement-related cortical potential (MRCP) derived from the electroencephalogram (EEG) signals has shown to be important in combination with assistive devices for effective neurofeedback in rehabilitation. In this study, we compare time and frequency domain features to detect movement intention from EEG signals prior to movement execution. Data were recoded from 24 able-bodied subjects, 12 performing real movements, and 12 performing imaginary movements. Furthermore, six stroke patients with lower limb paresis were included. Temporal and spectral features were investigated in combination with linear discriminant analysis and compared with template matching. The results showed that spectral features were best suited for differentiating between movement intention and noise across different tasks. The ensemble average across tasks when using spectral features was (error = 3.4 ± 0.8%, sensitivity = 97.2 ± 0.9%, and specificity = 97 ± 1%) significantly better (P < 0.01) than temporal features (error = 15 ± 1.4%, sensitivity: 85 ± 1.3%, and specificity: 84 ± 2%). The proposed approach also (error = 3.4 ± 0.8%) outperformed template matching (error = 26.9 ± 2.3%) significantly (P > 0.001). Results imply that frequency information is important for detecting movement intention, which is promising for the application of this approach to provide patient-driven real-time neurofeedback.

Factors of Influence on the Performance of a Short-Latency Non-Invasive Brain Switch: Evidence in Healthy Individuals and Implication for Motor Function Rehabilitation.

Brain-computer interfacing (BCI) has recently been applied as a rehabilitation approach for patients with motor disorders, such as stroke. In these closed-loop applications, a brain switch detects the motor intention from brain signals, e.g., scalp EEG, and triggers a neuroprosthetic device, either to deliver sensory feedback or to mimic real movements, thus re-establishing the compromised sensory-motor control loop and promoting neural plasticity. In this context, single trial detection of motor intention with short latency is a prerequisite. The performance of the event detection from EEG recordings is mainly determined by three factors: the type of motor imagery (e.g., repetitive, ballistic), the frequency band (or signal modality) used for discrimination (e.g., alpha, beta, gamma, and MRCP, i.e., movement-related cortical potential), and the processing technique (e.g., time-series analysis, sub-band power estimation). In this study, we investigated single trial EEG traces during movement imagination on healthy individuals, and provided a comprehensive analysis of the performance of a short-latency brain switch when varying these three factors. The morphological investigation showed a cross-subject consistency of a prolonged negative phase in MRCP, and a delayed beta rebound in sensory-motor rhythms during repetitive tasks. The detection performance had the greatest accuracy when using ballistic MRCP with time-series analysis. In this case, the true positive rate (TPR) was ~70% for a detection latency of ~200 ms. The results presented here are of practical relevance for designing BCI systems for motor function rehabilitation.

A brain-computer interface for single-trial detection of gait initiation from movement related cortical potentials.

OBJECTIVE: Applications of brain-computer interfacing (BCI) in neurorehabilitation have received increasing attention. The intention to perform a motor task can be detected from scalp EEG and used to control rehabilitation devices, resulting in a patient-driven rehabilitation paradigm. In this study, we present and validate a BCI system for detection of gait initiation using movement related cortical potentials (MRCP). METHODS: The templates of MRCP were extracted from 9-channel scalp EEG during gait initiation in 9 healthy subjects. Independent component analysis (ICA) was used to remove artifacts, and the Laplacian spatial filter was applied to enhance the signal-to-noise ratio of MRCP. Following these pre-processing steps, a matched filter was used to perform single-trial detection of gait initiation. RESULTS: ICA preprocessing was shown to significantly improve the detection performance. With ICA preprocessing, across all subjects, the true positive rate (TPR) of the detection was 76.9±8.97%, and the false positive rate was 2.93±1.09 per minute. CONCLUSION: The results demonstrate the feasibility of detecting the intention of gait initiation from EEG signals, on a single trial basis. SIGNIFICANCE: The results are important for the development of new gait rehabilitation strategies, either for recovery/replacement of function or for neuromodulation.

Movement-related cortical potentials in paraplegic patients: abnormal patterns and considerations for BCI-rehabilitation.

Non-invasive EEG-based Brain-Computer Interfaces (BCI) can be promising for the motor neuro-rehabilitation of paraplegic patients. However, this shall require detailed knowledge of the abnormalities in the EEG signatures of paraplegic patients. The association of abnormalities in different subgroups of patients and their relation to the sensorimotor integration are relevant for the design, implementation and use of BCI systems in patient populations. This study explores the patterns of abnormalities of movement related cortical potentials (MRCP) during motor imagery tasks of feet and right hand in patients with paraplegia (including the subgroups with/without central neuropathic pain (CNP) and complete/incomplete injury patients) and the level of distinctiveness of abnormalities in these groups using pattern classification. The most notable observed abnormalities were the amplified execution negativity and its slower rebound in the patient group. The potential underlying mechanisms behind these changes and other minor dissimilarities in patients' subgroups, as well as the relevance to BCI applications, are discussed. The findings are of interest from a neurological perspective as well as for BCI-assisted neuro-rehabilitation and therapy.

A closed-loop brain-computer interface triggering an active ankle-foot orthosis for inducing cortical neural plasticity.

In this paper, we present a brain-computer interface (BCI) driven motorized ankle-foot orthosis (BCI-MAFO), intended for stroke rehabilitation, and we demonstrate its efficacy in inducing cortical neuroplasticity in healthy subjects with a short intervention procedure (∼15 min). This system detects imaginary dorsiflexion movements within a short latency from scalp EEG through the analysis of movement-related cortical potentials (MRCPs). A manifold-based method, called locality preserving projection, detected the motor imagery online with a true positive rate of 73.0 ± 10.3%. Each detection triggered the MAFO to elicit a passive dorsiflexion. In nine healthy subjects, the size of the motor-evoked potential (MEP) elicited by transcranial magnetic stimulation increased significantly immediately following and 30 min after the cessation of this BCI-MAFO intervention for ∼15 min ( p = 0.009 and , respectively), indicating neural plasticity. In four subjects, the size of the short latency stretch reflex component did not change following the intervention, suggesting that the site of the induced plasticity was cortical. All but one subject also performed two control conditions where they either imagined only or where the MAFO was randomly triggered. Both of these control conditions resulted in no significant changes in MEP size (p = 0.38 and p = 0.15). The proposed system provides a fast and effective approach for inducing cortical plasticity through BCI and has potential in motor function rehabilitation following stroke.

Enhanced low-latency detection of motor intention from EEG for closed-loop brain-computer interface applications.

In recent years, the detection of voluntary motor intentions from electroencephalogram (EEG) has been used for triggering external devices in closed-loop brain-computer interface (BCI) research. Movement-related cortical potentials (MRCP), a type of slow cortical potentials, have been recently used for detection. In order to enhance the efficacy of closed-loop BCI systems based on MRCPs, a manifold method called Locality Preserving Projection, followed by a linear discriminant analysis (LDA) classifier (LPP-LDA) is proposed in this paper to detect MRCPs from scalp EEG in real time. In an online experiment on nine healthy subjects, LPP-LDA statistically outperformed the classic matched filter approach with greater true positive rate (79 ± 11% versus 68 ± 10%; p = 0.007) and less false positives (1.4 ± 0.8/min versus 2.3 ± 1.1/min; p = 0.016 ). Moreover, the proposed system performed detections with significantly shorter latency (315 ± 165 ms versus 460 ± 123 ms; p = 0.013), which is a fundamental characteristics to induce neuroplastic changes in closed-loop BCIs, following the Hebbian principle. In conclusion, the proposed system works as a generic brain switch, with high accuracy, low latency, and easy online implementation. It can thus be used as a fundamental element of BCI systems for neuromodulation and motor function rehabilitation.