Frontoparietal Dysconnection in Covert Bipedal Activity for Enhancing the Performance of the Motor Preparation-Based Brain-Computer Interface.

Motor-based brain-computer interfaces (BCIs) were developed from the brain signals during motor imagery (MI), motor preparation (MP), and motor execution (ME). Motor-based BCIs provide an active rehabilitation scheme for post-stroke patients. However, BCI based solely on MP was rarely investigated. Since MP is the precedence phase before MI or ME, MP-BCI could potentially detect brain commands at an earlier state. This study proposes a bipedal MP-BCI system, which is actuated by the reduction in frontoparietal connectivity strength. Three substudies, including bipedal classification, neurofeedback, and post-stroke analysis, were performed to validate the performance of our proposed model. In bipedal classification, functional connectivity was extracted by Pearson's correlation model from electroencephalogram (EEG) signals recorded while the subjects were performing MP and MI. The binary classification of MP achieved short-lived peak accuracy of 73.73(±7.99)% around 200-400 ms post-cue. The peak accuracy was found synchronized to the MP-related potential and the decrement in frontoparietal connection strength. The connection strengths of the right frontal and left parietal lobes in the alpha range were found negatively correlated to the classification accuracy. In the subjective neurofeedback study, the majority of subjects reported that motor preparation instead of the motor imagery activated the frontoparietal dysconnection. Post-stroke study also showed that patients exhibit lower frontoparietal connections compared to healthy subjects during both MP and ME phases. These findings suggest that MP reduced alpha band functional frontoparietal connectivity and the EEG signatures of left and right foot MP could be discriminated more effectively during this phase. A neurofeedback paradigm based on the frontoparietal network could also be utilized to evaluate post-stroke rehabilitation training.

Effects of intravascular laser phototherapy on delayed neurological sequelae after carbon monoxide intoxication as evaluated by brain perfusion imaging: A case report and review of the literature.

BACKGROUND: Delayed neurological sequelae (DNS) caused by carbon monoxide (CO) intoxication poses considerable treatment challenges for clinical practitioners. In this report, we used nuclear medicine imaging and the Mini-Mental State Examination (MMSE) to evaluate the effectiveness of intravascular laser irradiation of blood (ILIB) therapy for the management of DNS. CASE SUMMARY: A 51-year-old woman presented to our medical center experiencing progressive bradykinesia, rigidity of limbs, gait disturbance, and cognitive impairment. Based on her neurological deficits, laboratory tests and imaging findings, the patient was diagnosed with delayed neurological sequelae of CO intoxication. She received intensive rehabilitation and ILIB therapy during 30 sessions over 2 mo after diagnosis. Brain single-photon emission computed tomography was performed both prior to and after ILIB therapy. The original hypoperfusion area in bilateral striata, bilateral frontal lobe, right parietal lobe, and bilateral cerebellum showed considerable improvement after completion of therapy. The patient's MMSE score also increased markedly from 6/30 to 25/30. Symptoms of DNS became barely detectable, and the woman was able to carry out her daily living activities independently. CONCLUSION: ILIB therapy could facilitate recovery from delayed neurological sequelae in patients with CO intoxication, as demonstrated by improved cerebral blood flow and functional outcomes in our patient.

Vestibular rehabilitation in a patient with whiplash-associated disorders.

Whiplash-associated disorders are characterized by multiple physical complaints after a flexion-extension trauma to the neck. They are difficult to treat, and they often result in great impact on the patient's quality of life. In this paper, the comprehensive treatment of a patient with whiplash-associated disorders is presented. The purpose is to highlight the importance of accurate diagnosis and appropriate treatment plans to improve patients' quality of life. This 23-year-old woman experienced a traffic accident which caused severely painful neck disability, numbness over bilateral upper limbs, dizziness, double vision and loss of balance. Among these symptoms, dizziness was the problem that bothered the patient most. She received a comprehensive rehabilitation program including physical modalities, trigger point injections for relief of pain, as well as a vestibular rehabilitation program, which included exercises challenging and improving her balance function, head-eye coordination exercise, visual-ocular control exercise and sensory substitution-promoting exercises. She resumed her previous full-time work after 3 weeks of treatment. This successfully treated case illustrates the importance of correct diagnosis and appropriate treatment for patients who suffer from whiplash-associated disorders.