Gait Training Based-Motor Imagery and EEG Neurofeedback in Lokomat: A Clinical Intervention with Complete Spinal Cord Injury Individuals.

Robotic systems, such as Lokomat® have shown promising results in people with severe motor impairments, who suffered a stroke or other neurological damage. Robotic devices have also been used by people with more challenging damages, such as Spinal Cord Injury (SCI), using feedback strategies that provide information about the brain activity in real-time. This study proposes a novel Motor Imagery (MI)-based Electroencephalogram (EEG) Visual Neurofeedback (VNFB) system for Lokomat® to teach individuals how to modulate their own µ (8-12 Hz) and ß (15-20 Hz) rhythms during passive walking. Two individuals with complete SCI tested our VNFB system completing a total of 12 sessions, each on different days. For evaluation, clinical outcomes before and after the intervention and brain connectivity were analyzed. As findings, the sensitivity related to light touch and painful discrimination increased for both individuals. Furthermore, an improvement in neurogenic bladder and bowel functions was observed according to the American Spinal Injury Association Impairment Scale, Neurogenic Bladder Symptom Score, and Gastrointestinal Symptom Rating Scale. Moreover, brain connectivity between different EEG locations significantly (p <0.05) increased, mainly in the motor cortex. As other highlight, both SCI individuals enhanced their µ rhythm, suggesting motor learning. These results indicate that our gait training approach may have substantial clinical benefits in complete SCI individuals.

EEG motor imagery classification using deep learning approaches in naïve BCI users.

Motor Imagery (MI)-Brain Computer-Interfaces (BCI) illiteracy defines that not all subjects can achieve a good performance in MI-BCI systems due to different factors related to the fatigue, substance consumption, concentration, and experience in the use. To reduce the effects of lack of experience in the use of BCI systems (naïve users), this paper presents the implementation of three Deep Learning (DL) methods with the hypothesis that the performance of BCI systems could be improved compared with baseline methods in the evaluation of naïve BCI users. The methods proposed here are based on Convolutional Neural Network (CNN), Long Short-Term Memory (LSTM)/Bidirectional Long Short-Term Memory (BiLSTM), and a combination of CNN and LSTM used for upper limb MI signal discrimination on a dataset of 25 naïve BCI users. The results were compared with three widely used baseline methods based on the Common Spatial Pattern (CSP), Filter Bank Common Spatial Pattern (FBCSP), and Filter Bank Common Spatial-Spectral Pattern (FBCSSP), in different temporal window configurations. As results, the LSTM-BiLSTM-based approach presented the best performance, according to the evaluation metrics of Accuracy, F-score, Recall, Specificity, Precision, and ITR, with a mean performance of 80% (maximum 95%) and ITR of 10 bits/min using a temporal window of 1.5 s. The DL Methods represent a significant increase of 32% compared with the baseline methods (p< 0.05). Thus, with the outcomes of this study, it is expected to increase the controllability, usability, and reliability of the use of robotic devices in naïve BCI users.