Prediction of Single Trial Somatosensory Evoked Potentials From Mechanical Stimulation Intensity.

Somatosensory evoked potentials (SSEPs) are important for both scientific research and the evaluation of treatment efficacy in neurorehabilitation. SSEPs measure the response in the sensorimotor cortex to a peripheral stimulation. Individual responses are often noisy, so SSEPs have typically required hundreds of stimulation-response trials to produce a single measurement. This work presents a method to estimate single trial SSEPs from tendon hammer accelerations. While predictions from the input side can not completely replace actual measurements of SSEPs, the results produced may help to provide clinicians insight where full scale SSEP measurement is not practical.

Towards Image Guided Magnetic Resonance Elastography via Active Driver Positioning Robot.

Magnetic Resonance Elastography (MRE) is a developing imaging technique that enables non-invasive estimation of tissue mechanical properties through the combination of induced mechanical displacements in the tissue and Magnetic Resonance Imaging (MRI). The mechanical drivers necessary to produce shear waves in the tissue have been a focus of engineering effort in the development and refinement of MRE. The potential targeting of smaller and stiffer tissues calls for increases in actuation frequency and refinement of mechanical driver positioning. Furthermore, the anisotropic nature of soft tissues results in driver position related changes in observed displacement wave patterns. These challenges motivate the investigation and development of the concept of active MRE driver positioning through visual servoing under MR imaging. OBJECTIVE: This work demonstrates the initial prototype of an MRE driver positioning system, allowing capture of displacement wave patterns from various mechanical vibration loading angles under different vibration frequencies through MR imaging. METHODS: Three different configurations of the MRE driver positioning robot are tested with an intervertebral disc (IVD) shaped gel phantom. RESULTS: Both the octahedral shear stress signal to noise ratio (OSS-SNR) and estimated stiffness show statistically significant dependence on driver configuration in each of the three phantom IVD regions. CONCLUSION: This dependence demonstrates that driver configuration is a critical factor in MRE, and that the developed robot is capable of producing a range of configurations. SIGNIFICANCE: This work presents the first demonstration of an active, imaging guided MRE driver positioning system, with significance for the future application of MRE to a wider range of human tissues.

A Smart Tendon Hammer System for Remote Neurological Examination.

The deep tendon reflex exam is an important part of neurological assessment of patients consisting of two components, reflex elicitation and reflex grading. While this exam has traditionally been performed in person, with trained clinicians both eliciting and grading the reflex, this work seeks to enable the exam by novices. The COVID-19 pandemic has motivated greater utilization of telemedicine and other remote healthcare delivery tools. A smart tendon hammer capable of streaming acceleration measurements wirelessly allows differentiation of correct and incorrect tapping locations with 91.5% accuracy to provide feedback to users about the appropriateness of stimulation, enabling reflex elicitation by laypeople, while survey results demonstrate that novices are reasonably able to grade reflex responses. Novice reflex grading demonstrates adequate performance with a mean error of 0.2 points on a five point scale. This work shows that by assisting in the reflex elicitation component of the reflex exam via a smart hammer and feedback application, novices should be able to complete the reflex exam remotely, filling a critical gap in neurological care during the COVID-19 pandemic.

A Direct Drive Parallel Plane Piezoelectric Needle Positioning Robot for MRI Guided Intraspinal Injection.

Recent developments in the field of cellular therapeutics have indicated the potential of stem cell injections directly to the spinal cord. Injections require either open surgery or a Magnetic Resonance Imaging (MRI) guided injection. Needle positioning during MRI imaging is a significant hurdle to direct spinal injection, as the small target region and interlaminar space require high positioning accuracy. OBJECTIVE: To improve both the procedure time and positioning accuracy, an MRI guided robotic needle positioning system is developed. METHODS: The robot uses linear piezoelectric motors to directly drive a parallel plane positioning mechanism. Feedback is provided through MRI during the orientation procedure. Both accuracy and repeatability of the robot are characterized. RESULTS: This system is found to be capable of repeatability below 51 µm. Needle endpoint error is limited by imaging modality, but is validated to 156 µm. CONCLUSION: The reported robot and MRI image feedback system is capable of repeatable and accurate needle guide positioning. SIGNIFICANCE: This high accuracy will result in a significant improvement to the workflow of spinal injection procedures.

Statistical Inter-stimulus Interval Window Estimation for Transient Neuromodulation via Paired Mechanical and Brain Stimulation.

For achieving motor recovery in individuals with sensorimotor deficits, augmented activation of the appropriate sensorimotor system, and facilitated induction of neural plasticity are essential. An emerging procedure that combines peripheral nerve stimulation and its associative stimulation with central brain stimulation is known to enhance the excitability of the motor cortex. In order to effectively apply this paired stimulation technique, timing between central and peripheral stimuli must be individually adjusted. There is a small range of effective timings between two stimuli, or the inter-stimulus interval window (ISI-W). Properties of ISI-W from neuromodulation in response to mechanical stimulation (Mstim) of muscles have been understudied because of the absence of a versatile and reliable mechanical stimulator. This paper adopted a combination of transcranial magnetic stimulation (TMS) and Mstim by using a high-precision robotic mechanical stimulator. A pneumatically operated robotic tendon tapping device was applied. A low-friction linear cylinder achieved high stimulation precision in time and low electromagnetic artifacts in physiological measurements. This paper describes a procedure to effectively estimate an individual ISI-W from the transiently enhanced motor evoked potential (MEP) with a reduced number of paired Mstim and sub-threshold TMS trials by applying statistical sampling and regression technique. This paper applied a total of four parametric and non-parametric statistical regression methods for ISI-W estimation. The developed procedure helps to reduce time for individually adjusting effective ISI, reducing physical burden on the subject.

Automated Variable Stimulus Tendon Tapping Modulates Somatosensory Evoked Potentials.

Somatosensory Evoked Potentials (SSEPs) are an important tool for both basic neuroscience research and evaluation of therapeutic techniques. While a large body of work exists in the study of electrically induced SSEPs both as a metric for therapeutic performance and tool for physiological research, comparatively little work has explored stretch response SSEPs evoked via tendon tapping. The measurement of SSEPs necessitates both timing and stimulation intensity consistency. This work presents an evaluation of a simple tapping device for automating this procedure and a comparison to manual tendon tapping demonstrating significantly reduced variability in both timing and intensity. The variable intensity nature of automated tapping is then used to measure SSEPs in a single subject, with apparent modulation of peak-peak amplitude by stimulation intensity.

Fast, High Resolution, and Wide Modulus Range Nanomechanical Mapping with Bimodal Tapping Mode.

Tapping mode atomic force microscopy (AFM), also known as amplitude modulated (AM) or AC mode, is a proven, reliable, and gentle imaging mode with widespread applications. Over the several decades that tapping mode has been in use, quantification of tip-sample mechanical properties such as stiffness has remained elusive. Bimodal tapping mode keeps the advantages of single-frequency tapping mode while extending the technique by driving and measuring an additional resonant mode of the cantilever. The simultaneously measured observables of this additional resonance provide the additional information necessary to extract quantitative nanomechanical information about the tip-sample mechanics. Specifically, driving the higher cantilever resonance in a frequency modulated (FM) mode allows direct measurement of the tip-sample interaction stiffness and, with appropriate modeling, the set point-independent local elastic modulus. Here we discuss the advantages of bimodal tapping, coined AM-FM imaging, for modulus mapping. Results are presented for samples over a wide modulus range, from a compliant gel (∼100 MPa) to stiff materials (∼100 GPa), with the same type of cantilever. We also show high-resolution (subnanometer) stiffness mapping of individual molecules in semicrystalline polymers and of DNA in fluid. Combined with the ability to remain quantitative even at line scan rates of nearly 40 Hz, the results demonstrate the versatility of AM-FM imaging for nanomechanical characterization in a wide range of applications.

Generalized Hertz model for bimodal nanomechanical mapping.

Bimodal atomic force microscopy uses a cantilever that is simultaneously driven at two of its eigenmodes (resonant modes). Parameters associated with both resonances can be measured and used to extract quantitative nanomechanical information about the sample surface. Driving the first eigenmode at a large amplitude and a higher eigenmode at a small amplitude simultaneously provides four independent observables that are sensitive to the tip-sample nanomechanical interaction parameters. To demonstrate this, a generalized theoretical framework for extracting nanomechanical sample properties from bimodal experiments is presented based on Hertzian contact mechanics. Three modes of operation for measuring cantilever parameters are considered: amplitude, phase, and frequency modulation. The experimental equivalence of all three modes is demonstrated on measurements of the second eigenmode parameters. The contact mechanics theory is then extended to power-law tip shape geometries, which is applied to analyze the experimental data and extract a shape and size of the tip interacting with a polystyrene surface.

Calibration of higher eigenmodes of cantilevers.

A method is presented for calibrating the higher eigenmodes (resonant modes) of atomic force microscopy cantilevers that can be performed prior to any tip-sample interaction. The method leverages recent efforts in accurately calibrating the first eigenmode by providing the higher-mode stiffness as a ratio to the first mode stiffness. A one-time calibration routine must be performed for every cantilever type to determine a power-law relationship between stiffness and frequency, which is then stored for future use on similar cantilevers. Then, future calibrations only require a measurement of the ratio of resonant frequencies and the stiffness of the first mode. This method is verified through stiffness measurements using three independent approaches: interferometric measurement, AC approach-curve calibration, and finite element analysis simulation. Power-law values for calibrating higher-mode stiffnesses are reported for several cantilever models. Once the higher-mode stiffnesses are known, the amplitude of each mode can also be calibrated from the thermal spectrum by application of the equipartition theorem.

Initial investigation into the effect of an Active/Passive exoskeleton on hammer curl performance in healthy subjects.

Assistive robotic devices are traditionally constrained by their power source. Entirely passive devices exist, but are limited by their fixed mechanical parameters. This work introduces a new device that can provide active and passive assistance. This device provides assistance in a passive mode, but retains the actively change this passive response. This paper examines the effect different passive parameter settings have on healthy subjects performing hammer curls. Passive parameter settings to either increase or decrease the number of curls a subject could perform were found. An average increase of 84% or a decrease of 33% in curls was produced by varying the passive parameters. These effects were seen across all six subjects. This indicates that there is potential for the Active/Passive framework to provide lightweight, energy efficient assistance.