ABSTRACT
Brain-computer interface (BCI) based rehabilitation has been proven a promising method facilitating motor recovery. Recognizing motor intention is crucial for realizing BCI rehabilitation training. Event-related desynchronization (ERD) is a kind of electroencephalogram (EEG) inherent characteristics associated with motor intention. However, due to brain deficits poststroke, some patients are not able to generate ERD, which discourages them to be involved in BCI rehabilitation training. To boost ERD during motor imagery (MI), this paper investigates the effects of high-frequency repetitive transcranial magnetic stimulation (rTMS) on BCI classification performance. Eleven subjects participated in this study. The experiment consisted of two conditions: rTMS + MI versus sham rTMS + MI, which were arranged on different days. MI tests with 64-channel EEG recording were arranged immediately before and after rTMS and sham rTMS. Time-frequency analysis were utilized to measure ERD changes. Common spatial pattern was used to extract features and linear discriminant analysis was used to calculate offline classification accuracies. Paired-sample t-test and Wilcoxon signed rank tests with post-hoc analysis were used to compare performance before and after stimulation. Statistically stronger ERD (-13.93±12.99%) was found after real rTMS compared with ERD (-5.71±21.25%) before real rTMS (p<0.05). Classification accuracy after real rTMS (70.71±10.32%) tended to be higher than that before real rTMS (66.50±8.48%) (p<0.1). However, no statistical differences were found after sham stimulation. This research provides an effective method in improving BCI performance by utilizing neural modulation.Clinical Relevance- This study offers a promising treatment for patients who cannot be recruited in BCI rehabilitation training due to poor BCI classification performance.
Subject(s)
Brain-Computer Interfaces , Transcranial Magnetic Stimulation , Electroencephalography , Humans , Imagery, Psychotherapy , ImaginationABSTRACT
INTRODUCTION: Constipation is a common nonmotor symptom of Parkinson disease (PD). Constipation can also impact patient's quality of life. Chinese herbal medicines have been used for the treatment of constipation in PD. This trial will evaluate the efficacy and safety of a Chinese herbal formula Bushen Yisui and Ziyin Jiangzhuo (BYZJ) for the treatment of constipation in PD. METHODS AND ANALYSIS: This randomized, double-blind, placebo-controlled, multicenter clinical trial will involve 4 hospitals in Beijing, China. The study will aim to recruit 90 PD patients with constipation between 30 and 80 years-of age with a score of 1 - 4 on the Hoehn and Yahr scale. Once recruited, Patients will be randomized into a BYZJ group or a placebo group in a 2:1 ratio. The trial will include a 1-week run-in period, a 4-week double-blind treatment period, a 4-week and a 12-week follow-up period. All patients will be educated about PD-related constipation during the run-in period. BYZJ granules and simulated granules will be administered twice daily for 4 weeks to the BYZJ group and the placebo group respectively. Assessments will be performed during run-in period, before the start of treatment (baseline, week 0), and at 4, 8, and 16 weeks. The primary outcome will be measured with the Constipation Severity Instrument, and secondary outcomes will be evaluated with the Patient Assessment of Constipation Quality of Life questionnaire, Bristol Stool Form Scale, Movement Disorders-Unified Parkinson Disease Rating Scale, Nonmotor Symptoms Scale, PD Sleep Scale, Parkinson Fatigue Scale-16. Laxative use (dose and frequency) will also be recorded. Intention-to-treat and per-protocol set analyses will be used to compare symptom improvement between the 2 groups. Any adverse events will be recorded. DISCUSSION: If found effective and safe, BYZJ formula will be one of Chinese herb to treat constipation and even other nonmotor or motor symptoms in PD patients. The results will sustain the broader use of BYZJ formula in PD.