Large scale investigation of the effect of gender on mu rhythm suppression in motor imagery brain-computer interfaces.

The utmost issue in Motor Imagery Brain-Computer Interfaces (MI-BCI) is the BCI poor performance known as 'BCI inefficiency'. Although past research has attempted to find a solution by investigating factors influencing users' MI-BCI performance, the issue persists. One of the factors that has been studied in relation to MI-BCI performance is gender. Research regarding the influence of gender on a user's ability to control MI-BCIs remains inconclusive, mainly due to the small sample size and unbalanced gender distribution in past studies. To address these issues and obtain reliable results, this study combined four MI-BCI datasets into one large dataset with 248 subjects and equal gender distribution. The datasets included EEG signals from healthy subjects from both gender groups who had executed a right- vs. left-hand motor imagery task following the Graz protocol. The analysis consisted of extracting the Mu Suppression Index from C3 and C4 electrodes and comparing the values between female and male participants. Unlike some of the previous findings which reported an advantage for female BCI users in modulating mu rhythm activity, our results did not show any significant difference between the Mu Suppression Index of both groups, indicating that gender may not be a predictive factor for BCI performance.

Impact of the baseline temporal selection on the ERD/ERS analysis for Motor Imagery-based BCI.

Motor Imagery-based Brain-Computer Interfaces (MI-BCIs) are neurotechnologies that exploit the modulation of sensorimotor rhythms over the motor cortices, respectively known as Event-Related Desynchronization (ERD) and Synchronization (ERS). The interpretation of ERD/ERS is directly related to the selection of the baseline used to estimate them, and might result in a misleading ERD/ERS visualization. In fact, in BCI paradigms, if two trials are separated by a few seconds, taking a baseline close to the end of the previous trial could result in an over-estimation of the ERD, while taking a baseline too close to the upcoming trial could result in an under-estimation of the ERD. This phenomenon may cause a functional misinterpretation of the ERD/ERS phenomena in MI-BCI studies. This may also impair BCI performances for MI vs Rest classification, since such baselines are often used as resting states. In this paper, we propose to investigate the effect of several baseline time window selections on ERD/ERS modulations and BCI performances. Our results show that considering the selected temporal baseline effect is essential to analyze the modulations of ERD/ERS during MI-BCI use.

A large EEG database with users' profile information for motor imagery brain-computer interface research.

We present and share a large database containing electroencephalographic signals from 87 human participants, collected during a single day of brain-computer interface (BCI) experiments, organized into 3 datasets (A, B, and C) that were all recorded using the same protocol: right and left hand motor imagery (MI). Each session contains 240 trials (120 per class), which represents more than 20,800 trials, or approximately 70 hours of recording time. It includes the performance of the associated BCI users, detailed information about the demographics, personality profile as well as some cognitive traits and the experimental instructions and codes (executed in the open-source platform OpenViBE). Such database could prove useful for various studies, including but not limited to: (1) studying the relationships between BCI users' profiles and their BCI performances, (2) studying how EEG signals properties varies for different users' profiles and MI tasks, (3) using the large number of participants to design cross-user BCI machine learning algorithms or (4) incorporating users' profile information into the design of EEG signal classification algorithms.

Detection of Motor Cerebral Activity After Median Nerve Stimulation During General Anesthesia (STIM-MOTANA): Protocol for a Prospective Interventional Study.

BACKGROUND: Accidental awareness during general anesthesia (AAGA) is defined as an unexpected awareness of the patient during general anesthesia. This phenomenon occurs in 1%-2% of high-risk practice patients and can cause physical suffering and psychological after-effects, called posttraumatic stress disorder. In fact, no monitoring techniques are satisfactory enough to effectively prevent AAGA; therefore, new alternatives are needed. Because the first reflex for a patient during an AAGA is to move, but cannot do so because of the neuromuscular blockers, we believe that it is possible to design a brain-computer interface (BCI) based on the detection of movement intention to warn the anesthetist. To do this, we propose to describe and detect the changes in terms of motor cortex oscillations during general anesthesia with propofol, while a median nerve stimulation is performed. We believe that our results could enable the design of a BCI based on median nerve stimulation, which could prevent AAGA. OBJECTIVE: To our knowledge, no published studies have investigated the detection of electroencephalographic (EEG) patterns in relation to peripheral nerve stimulation over the sensorimotor cortex during general anesthesia. The main objective of this study is to describe the changes in terms of event-related desynchronization and event-related synchronization modulations, in the EEG signal over the motor cortex during general anesthesia with propofol while a median nerve stimulation is performed. METHODS: STIM-MOTANA is an interventional and prospective study conducted with patients scheduled for surgery under general anesthesia, involving EEG measurements and median nerve stimulation at two different times: (1) when the patient is awake before surgery (2) and under general anesthesia. A total of 30 patients will receive surgery under complete intravenous anesthesia with a target-controlled infusion pump of propofol. RESULTS: The changes in event-related desynchronization and event-related synchronization during median nerve stimulation according to the various propofol concentrations for 30 patients will be analyzed. In addition, we will apply 4 different offline machine learning algorithms to detect the median nerve stimulation at the cerebral level. Recruitment began in December 2022. Data collection is expected to conclude in June 2024. CONCLUSIONS: STIM-MOTANA will be the first protocol to investigate median nerve stimulation cerebral motor effect during general anesthesia for the detection of intraoperative awareness. Based on strong practical and theoretical scientific reasoning from our previous studies, our innovative median nerve stimulation-based BCI would provide a way to detect intraoperative awareness during general anesthesia. TRIAL REGISTRATION: Clinicaltrials.gov NCT05272202; https://clinicaltrials.gov/ct2/show/NCT05272202. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/43870.

ERD modulations during motor imageries relate to users' traits and BCI performances.

Improving user performances is one of the major issues for Motor Imagery (MI) - based BCI control. MI-BCIs exploit the modulation of sensorimotor rhythms (SMR) over the motor and sensorimotor cortices to discriminate several mental states and enable user interaction. Such modulations are known as Event-Related Desynchronization (ERD) and Synchronization (ERS), coming from the mu (7-13 Hz) and beta (15-30 Hz) frequency bands. This kind of BCI opens up promising fields, particularly to control assistive technologies, for sport training or even for post-stroke motor rehabilitation. However, MI - BCIs remain barely used outside laboratories, notably due to their lack of robustness and usability (15 to 30% of users seem unable to gain control of an MI-BCI). One way to increase user performance would be to better understand the relationships between user traits and ERD/ERS modulations underlying BCI performance. Therefore, in this article we analyzed how cerebral motor patterns underlying MI tasks (i.e., ERDs and ERSs) are modulated depending (i) on nature of the task (i.e., right-hand MI and left-hand MI), (ii) the session during which the task was performed (i.e., calibration or user training) and (iii) on the characteristics of the user (e.g., age, gender, manual activity, personality traits) on a large MI-BCI data base of N=75 participants. One of the originality of this study is to combine the investigation of human factors related to the user's traits and the neurophysiological ERD modulations during the MI task. Our study revealed for the first time an association between ERD and self-control from the 16PF5 questionnaire.

Optimizing Motor Intention Detection With Deep Learning: Towards Management of Intraoperative Awareness.

OBJECTIVE: This article shows the interest in deep learning techniques to detect motor imagery (MI) from raw electroencephalographic (EEG) signals when a functional electrical stimulation is added or not. Impacts of electrode montages and bandwidth are also reported. The perspective of this work is to improve the detection of intraoperative awareness during general anesthesia. METHODS: Various architectures of EEGNet were investigated to optimize MI detection. They have been compared to the state-of-the-art classifiers in Brain-Computer Interfaces (based on Riemannian geometry, linear discriminant analysis), and other deep learning architectures (deep convolution network, shallow convolutional network). EEG data were measured from 22 participants performing motor imagery with and without median nerve stimulation. RESULTS: The proposed architecture of EEGNet reaches the best classification accuracy (83.2%) and false-positive rate (FPR 19.0%) for a setup with only six electrodes over the motor cortex and frontal lobe and for an extended 4-38 Hz EEG frequency range while the subject is being stimulated via a median nerve. Configurations with a larger number of electrodes result in higher accuracy (94.5%) and FPR (6.1%) for 128 electrodes (and respectively 88.0% and 12.9% for 13 electrodes). CONCLUSION: The present work demonstrates that using an extended EEG frequency band and a modified EEGNet deep neural network increases the accuracy of MI detection when used with as few as 6 electrodes which include frontal channels. SIGNIFICANCE: The proposed method contributes to the development of Brain-Computer Interface systems based on MI detection from EEG.

Multiclass Classification Based on Combined Motor Imageries.

Motor imagery (MI) allows the design of self-paced brain-computer interfaces (BCIs), which can potentially afford an intuitive and continuous interaction. However, the implementation of non-invasive MI-based BCIs with more than three commands is still a difficult task. First, the number of MIs for decoding different actions is limited by the constraint of maintaining an adequate spacing among the corresponding sources, since the electroencephalography (EEG) activity from near regions may add up. Second, EEG generates a rather noisy image of brain activity, which results in a poor classification performance. Here, we propose a solution to address the limitation of identifiable motor activities by using combined MIs (i.e., MIs involving 2 or more body parts at the same time). And we propose two new multilabel uses of the Common Spatial Pattern (CSP) algorithm to optimize the signal-to-noise ratio, namely MC2CMI and MC2SMI approaches. We recorded EEG signals from seven healthy subjects during an 8-class EEG experiment including the rest condition and all possible combinations using the left hand, right hand, and feet. The proposed multilabel approaches convert the original 8-class problem into a set of three binary problems to facilitate the use of the CSP algorithm. In the case of the MC2CMI method, each binary problem groups together in one class all the MIs engaging one of the three selected body parts, while the rest of MIs that do not engage the same body part are grouped together in the second class. In this way, for each binary problem, the CSP algorithm produces features to determine if the specific body part is engaged in the task or not. Finally, three sets of features are merged together to predict the user intention by applying an 8-class linear discriminant analysis. The MC2SMI method is quite similar, the only difference is that any of the combined MIs is considered during the training phase, which drastically accelerates the calibration time. For all subjects, both the MC2CMI and the MC2SMI approaches reached a higher accuracy than the classic pair-wise (PW) and one-vs.-all (OVA) methods. Our results show that, when brain activity is properly modulated, multilabel approaches represent a very interesting solution to increase the number of commands, and thus to provide a better interaction.

Deep Learning Techniques to Improve Intraoperative Awareness Detection from Electroencephalographic Signals.

Every year, millions of patients regain conscious- ness during surgery and can potentially suffer from post-traumatic disorders. We recently showed that the detection of motor activity during a median nerve stimulation from electroencephalographic (EEG) signals could be used to alert the medical staff that a patient is waking up and trying to move under general anesthesia [1], [2]. In this work, we measure the accuracy and false positive rate in detecting motor imagery of several deep learning models (EEGNet, deep convolutional network and shallow convolutional network) directly trained on filtered EEG data. We compare them with efficient non-deep approaches, namely, a linear discriminant analysis based on common spatial patterns, the minimum distance to Riemannian mean algorithm applied to covariance matrices, a logistic regression based on a tangent space projection of covariance matrices (TS+LR). The EEGNet improves significantly the classification performance comparing to other classifiers (p- value <; 0.01); moreover it outperforms the best non-deep classifier (TS+LR) for 7.2% of accuracy. This approach promises to improve intraoperative awareness detection during general anesthesia.

Median Nerve Stimulation Based BCI: A New Approach to Detect Intraoperative Awareness During General Anesthesia.

Hundreds of millions of general anesthesia are performed each year on patients all over the world. Among these patients, 0.1-0.2% are victims of Accidental Awareness during General Anesthesia (AAGA), i.e., an unexpected awakening during a surgical procedure under general anesthesia. Although anesthesiologists try to closely monitor patients using various techniques to prevent this terrifying phenomenon, there is currently no efficient solution to accurately detect its occurrence. We propose the conception of an innovative passive brain-computer interface (BCI) based on an intention of movement to prevent AAGA. Indeed, patients typically try to move to alert the medical staff during an AAGA, only to discover that they are unable to. First, we examine the challenges of such a BCI, i.e., the lack of a trigger to facilitate when to look for an intention to move, as well as the necessity for a high classification accuracy. Then, we present a solution that incorporates Median Nerve Stimulation (MNS). We investigate the specific modulations that MNS causes in the motor cortex and confirm that they can be altered by an intention of movement. Finally, we perform experiments on 16 healthy participants to assess whether an MI-based BCI using MNS is able to generate high classification accuracies. Our results show that MNS may provide a foundation for an innovative BCI that would allow the detection of AAGA.

Hypnotic State Modulates Sensorimotor Beta Rhythms During Real Movement and Motor Imagery.

Hypnosis techniques are currently used in the medical field and directly influences the patient's state of relaxation, perception of the body, and its visual imagination. There is evidence to suggest that a hypnotic state may help patients to better achieve tasks of motor imagination, which is central in the rehabilitation protocols after a stroke. However, the hypnosis techniques could also alter activity in the motor cortex. To the best of our knowledge, the impact of hypnosis on the EEG signal during a movement or an imagined movement is poorly investigated. In particular, how event-related desynchronization (ERD) and event-related synchronization (ERS) patterns would be modulated for different motor tasks may provide a better understanding of the potential benefits of hypnosis for stroke rehabilitation. To investigate this purpose, we recorded EEG signals from 23 healthy volunteers who performed real movements and motor imageries in a closed eye condition. Our results suggest that the state of hypnosis changes the sensorimotor beta rhythm during the ERD phase but maintains the ERS phase in the mu and beta frequency band, suggesting a different activation of the motor cortex in a hypnotized state.

MOTANA: study protocol to investigate motor cerebral activity during a propofol sedation.

BACKGROUND: Accidental Accidental awareness during general anesthesia (AAGA) occurs in 1-2% of high-risk practice patients and is a cause of severe psychological trauma, termed post-traumatic stress disorder (PTSD). However, no monitoring techniques can accurately predict or detect AAGA. Since the first reflex for a patient during AAGA is to move, a passive brain-computer interface (BCI) based on the detection of an intention of movement would be conceivable to alert the anesthetist. However, the way in which propofol (i.e., an anesthetic commonly used for the general anesthesia induction) affects motor brain activity within the electroencephalographic (EEG) signal has been poorly investigated and is not clearly understood. For this reason, a detailed study of the motor activity behavior with a step-wise increasing dose of propofol is required and would provide a proof of concept for such an innovative BCI. The main goal of this study is to highlight the occurrence of movement attempt patterns, mainly changes in oscillations called event-related desynchronization (ERD) and event-related synchronization (ERS), in the EEG signal over the motor cortex, in healthy subjects, without and under propofol sedation, during four different motor tasks. METHODS: MOTANA is an interventional, prospective, exploratory, physiological, monocentric, and randomized study conducted in healthy volunteers under light anesthesia, involving EEG measurements before and after target-controlled infusion of propofol at three different effect-site concentrations (0 µg.ml -1, 0.5 µg.ml -1, and 1.0 µg.ml -1). In this exploratory study, 30 healthy volunteers will perform 50 trials for the four motor tasks (real movement, motor imagery, motor imagery with median nerve stimulation, and median nerve stimulation alone) in a randomized sequence. In each conditions and for each trial, we will observe changes in terms of ERD and ERS according to the three propofol concentrations. Pre- and post-injection comparisons of propofol will be performed by paired series tests. DISCUSSION: MOTANA is an exploratory study aimed at designing an innovative BCI based on EEG-motor brain activity that would detect an attempt to move by a patient under anesthesia. This would be of interest in the prevention of AAGA. TRIAL REGISTRATION: Agence Nationale de Sécurité du Médicament (EUDRACT 2017-004198-1), NCT03362775. Registered on 29 August 2018. https://clinicaltrials.gov/ct2/show/NCT03362775?term=03362775&rank=1.

Electroencephalographic modulations during an open- or closed-eyes motor task.

There is fundamental knowledge that during the resting state cerebral activity recorded by electroencephalography (EEG) is strongly modulated by the eyes-closed condition compared to the eyes-open condition, especially in the occipital lobe. However, little research has demonstrated the influence of the eyes-closed condition on the motor cortex, particularly during a self-paced movement. This prompted the question: How does the motor cortex activity change between the eyes-closed and eyes-open conditions? To answer this question, we recorded EEG signals from 15 voluntary healthy subjects who performed a simple motor task (i.e., a voluntary isometric flexion of the right-hand index) under two conditions: eyes-closed and eyes-open. Our results confirmed strong modulation in the mu rhythm (7-13 Hz) with a large event-related desynchronisation. However, no significant differences have been observed in the beta band (15-30 Hz). Furthermore, evidence suggests that the eyes-closed condition influences the behaviour of subjects. This study gives us greater insight into the motor cortex and could also be useful in the brain-computer interface (BCI) domain.

Can a Subjective Questionnaire Be Used as Brain-Computer Interface Performance Predictor?

Predicting a subject's ability to use a Brain Computer Interface (BCI) is one of the major issues in the BCI domain. Relevant applications of forecasting BCI performance include the ability to adapt the BCI to the needs and expectations of the user, assessing the efficiency of BCI use in stroke rehabilitation, and finally, homogenizing a research population. A limited number of recent studies have proposed the use of subjective questionnaires, such as the Motor Imagery Questionnaire Revised-Second Edition (MIQ-RS). However, further research is necessary to confirm the effectiveness of this type of subjective questionnaire as a BCI performance estimation tool. In this study we aim to answer the following questions: can the MIQ-RS be used to estimate the performance of an MI-based BCI? If not, can we identify different markers that could be used as performance estimators? To answer these questions, we recorded EEG signals from 35 healthy volunteers during BCI use. The subjects had previously completed the MIQ-RS questionnaire. We conducted an offline analysis to assess the correlation between the questionnaire scores related to Kinesthetic and Motor imagery tasks and the performances of four classification methods. Our results showed no significant correlation between BCI performance and the MIQ-RS scores. However, we reveal that BCI performance is correlated to habits and frequency of practicing manual activities.