Comparing targeted memory reactivation during slow wave sleep and sleep stage 2.

Sleep facilitates declarative memory consolidation, which is assumed to rely on the reactivation of newly encoded memories orchestrated by the temporal interplay of slow oscillations (SO), fast spindles and ripples. SO as well as the number of spindles coupled to SO are more frequent during slow wave sleep (SWS) compared to lighter sleep stage 2 (S2). But, it is unclear whether memory reactivation is more effective during SWS than during S2. To test this question, we applied Targeted Memory Reactivation (TMR) in a declarative memory design by presenting learning-associated sound cues during SWS vs. S2 in a counterbalanced within-subject design. Contrary to our hypothesis, memory performance was not significantly better when cues were presented during SWS. Event-related potential (ERP) amplitudes were significantly higher for cues presented during SWS than S2, and the density of SO and SO-spindle complexes was generally higher during SWS than during S2. Whereas SO density increased during and after the TMR period, SO-spindle complexes decreased. None of the parameters were associated with memory performance. These findings suggest that the efficacy of TMR does not depend on whether it is administered during SWS or S2, despite differential processing of memory cues in these sleep stages.

Challenges of neural interfaces for stroke motor rehabilitation.

More than 85% of stroke survivors suffer from different degrees of disability for the rest of their lives. They will require support that can vary from occasional to full time assistance. These conditions are also associated to an enormous economic impact for their families and health care systems. Current rehabilitation treatments have limited efficacy and their long-term effect is controversial. Here we review different challenges related to the design and development of neural interfaces for rehabilitative purposes. We analyze current bibliographic evidence of the effect of neuro-feedback in functional motor rehabilitation of stroke patients. We highlight the potential of these systems to reconnect brain and muscles. We also describe all aspects that should be taken into account to restore motor control. Our aim with this work is to help researchers designing interfaces that demonstrate and validate neuromodulation strategies to enforce a contingent and functional neural linkage between the central and the peripheral nervous system. We thus give clues to design systems that can improve or/and re-activate neuroplastic mechanisms and open a new recovery window for stroke patients.

On the extraction of purely motor EEG neural correlates during an upper limb visuomotor task.

Deciphering and analyzing the neural correlates of different movements from the same limb using electroencephalography (EEG) would represent a notable breakthrough in the field of sensorimotor neurophysiology. Functional movements involve concurrent posture co-ordination and head and eye movements, which create electrical activity that affects EEG recordings. In this paper, we revisit the identification of brain signatures of different reaching movements using EEG and present, test, and validate a protocol to separate the effect of head and eye movements from a reaching task-related visuomotor brain activity. Ten healthy participants performed reaching movements under two different conditions: avoiding head and eye movements and moving with no constrains. Reaching movements can be identified from EEG with unconstrained eye and head movement, whereas the discriminability of the signals drops to chance level otherwise. These results show that neural patterns associated with different arm movements could only be extracted from EEG if the eye and head movements occurred concurrently with the task, polluting the recordings. Although these findings do not imply that brain correlates of reaching directions cannot be identified from EEG, they show the consequences that ignoring these events can have in any EEG study that includes a visuomotor task.

The effect of zolpidem on targeted memory reactivation during sleep.

According to the active system consolidation theory, memory consolidation during sleep relies on the reactivation of newly encoded memory representations. This reactivation is orchestrated by the interplay of sleep slow oscillations, spindles, and theta, which are in turn modulated by certain neurotransmitters like GABA to enable long-lasting plastic changes in the memory store. Here we asked whether the GABAergic system and associated changes in sleep oscillations are functionally related to memory reactivation during sleep. We administered the GABAA agonist zolpidem (10 mg) in a double-blind placebo-controlled study. To specifically focus on the effects on memory reactivation during sleep, we experimentally induced such reactivations by targeted memory reactivation (TMR) with learning-associated reminder cues presented during post-learning slow-wave sleep (SWS). Zolpidem significantly enhanced memory performance with TMR during sleep compared with placebo. Zolpidem also increased the coupling of fast spindles and theta to slow oscillations, although overall the power of slow spindles and theta was reduced compared with placebo. In an uncorrected exploratory analysis, memory performance was associated with slow spindle responses to TMR in the zolpidem condition, whereas it was associated with fast spindle responses in placebo. These findings provide tentative first evidence that GABAergic activity may be functionally implicated in memory reactivation processes during sleep, possibly via its effects on slow oscillations, spindles and theta as well as their interplay.

Influence of trans-spinal magnetic stimulation in electrophysiological recordings for closed-loop rehabilitative systems.

Recent studies have shown the feasibility of spinal cord stimulation (SCS) for motor rehabilitation. Currently, there is an increasing interest in developing closed-loop systems employing SCS for lower-limb recovery. These closed-loop systems are based on the use of neurophysiological signals to modulate the stimulation. It is known that electromagnetic stimulation can introduce undesirable noise to the electrophysiological recordings. However, there is little evidence about how electroencephalographic (EEG) or electromyographic (EMG) activities are corrupted when a trans-spinal magnetic stimulation is applied. This paper studies the effects of magnetic SCS in EEG and EMG activity. Furthermore, a median filter is proposed to ameliorate the effects of the artifacts, and to preserve the neural activity. Our results show that SCS can affect both EEG and EMG, and that, while the median filter works well to clean the EEG activity, it did not improve the contaminations of the EMG activity. The obtained results underline the need of cleaning EMG and EEG signals contaminated by SCS, which is essential for optimal closed-loop rehabilitation.

Evaluation of filtering techniques to extract movement intention information from low-frequency EEG activity.

Low-frequency electroencephalographic (EEG) activity provides relevant information for decoding movement commands in healthy subjects and paralyzed patients. Brainmachine interfaces (BMI) exploiting these signals have been developed to provide closed-loop feedback and induce neuroplasticity. Several offline and online studies have already demonstrated that discriminable information related to movement can be decoded from low-frequency EEG activity. However, there is still not a well-established procedure to guarantee that this activity is optimally filtered from the background noise. This work compares different configurations of non-causal (i.e., offline) and causal (i.e., online) filters to classify movement-related cortical potentials (MRCP) with six healthy subjects during reaching movements. Our results reveal important differences in MRCP decoding accuracy dependent on the selected frequency band for both offline and online approaches. In summary, this paper underlines the importance of optimally choosing filter parameters, since their variable response has an impact on the classification of low EEG frequencies for BMI.

Stroke lesion location influences the decoding of movement intention from EEG.

Recent studies have demonstrated the efficacy of brain-machine interfaces (BMI) for motor rehabilitation after stroke, especially for those patients with severe paralysis. However, a cerebro-vascular accident can affect the brain in many different manners, and lesions in diverse areas, even from significantly different volumes, can lead to similar or equal motor deficits. The location of the insult influences the way the brain activates when moving or attempting to move a paralyzed limb. Since the essence of a rehabilitative BMI is to precisely decode motor commands from the brain, it is crucial to characterize how lesion location affects the measured signals and if and how it influences BMI performance. This paper compares the performances of an electroencephalography (EEG)-based movement intention decoder in two groups of severely paralyzed chronic stroke patients: 14 with subcortical lesions and 14 with mixed (i.e., cortical and subcortical) lesions. We show that the lesion location influences the performance of the BMI when decoding the movement attempts of the paretic arm. The obtained results underline the need for further developments for a better individualization of BMI-based rehabilitative therapies for stroke patients.

Design of continuous EMG classification approaches towards the control of a robotic exoskeleton in reaching movements.

Myoelectric control of rehabilitation devices engages active recruitment of muscles for motor task accomplishment, which has been proven to be essential in motor rehabilitation. Unfortunately, most electromyographic (EMG) activity-based controls are limited to one single degree-of-freedom (DoF), not permitting multi-joint functional tasks. On the other hand, discrete EMG-triggered approaches fail to provide continuous feedback about muscle recruitment during movement. For such purposes, myoelectric interfaces for continuous recognition of functional movements are necessary. Here we recorded EMG activity using 5 bipolar electrodes placed on the upper-arm in 8 healthy participants while they performed reaching movements in 8 different directions. A pseudo on-line system was developed to continuously predict movement intention and attempted arm direction. We evaluated two hierarchical classification approaches. Movement intention detection triggered different movement direction classifiers (4 or 8 classes) that were trained and tested over a 5-fold cross validation. We also investigated the effect of 3 different window lengths to extract EMG features on classification. We obtained classification accuracies above 70% for both hierarchical approaches. These results highlight the viability of classifying online 8 upper-arm different directions using surface EMG activity of 5 muscles and represent a first step towards an online EMG-based control for rehabilitation devices.

A hybrid brain-machine interface based on EEG and EMG activity for the motor rehabilitation of stroke patients.

Including supplementary information from the brain or other body parts in the control of brain-machine interfaces (BMIs) has been recently proposed and investigated. Such enriched interfaces are referred to as hybrid BMIs (hBMIs) and have been proven to be more robust and accurate than regular BMIs for assistive and rehabilitative applications. Electromyographic (EMG) activity is one of the most widely utilized biosignals in hBMIs, as it provides a quite direct measurement of the motion intention of the user. Whereas most of the existing non-invasive EEG-EMG-hBMIs have only been subjected to offline testings or are limited to one degree of freedom (DoF), we present an EEG-EMG-hBMI that allows the simultaneous control of 7-DoFs of the upper limb with a robotic exoskeleton. Moreover, it establishes a biologically-inspired hierarchical control flow, requiring the active participation of central and peripheral structures of the nervous system. Contingent visual and proprioceptive feedback about the user's EEG and EMG activity is provided in the form of velocity modulation during functional task training. We believe that training with this closed-loop system may facilitate functional neuroplastic processes and eventually elicit a joint brain and muscle motor rehabilitation. Its usability is validated during a real-time operation session in a healthy participant and a chronic stroke patient, showing encouraging results for its application to a clinical rehabilitation scenario.

Influence of artifacts on movement intention decoding from EEG activity in severely paralyzed stroke patients.

Brain-machine interfaces (BMI) can be used to control robotic and prosthetic devices for rehabilitation of motor disorders, such as stroke. The calibration of these BMI systems is of paramount importance in order to establish a precise contingent link between the brain activity related to movement intention and the peripheral feedback. However, electroencephalographic (EEG) activity, commonly used to build non-invasive BMIs, can be easily contaminated by artifacts of electrical or physiological origin. The way these interferences can affect the performance of movement intention decoders has not been deeply studied, especially when dealing with severely paralyzed patients, which often generate more artifacts by compensatory movements. This paper evaluates the effects of removing artifacts from the data used to train a BMI decoder on a dataset of 28 severely paralyzed stroke patients. We show that cleaning the training datasets reduces the global BMI performance for decoding attempts of movement. Further, we demonstrate that this performance drop especially affects the test trials contaminated by artifacts (i.e., trials that might not reflect cortical activity but noise), but not the clean test trials (i.e., trials representing correct cortical activity). This paper underlines the importance of cleaning the datasets used to train BMI systems to improve their efficacy for decoding movement intention and maximize their neurorehabilitative potential.