Showing papers by "Jose L. Contreras-Vidal published in 2016"

Powered exoskeletons for bipedal locomotion after spinal cord injury

Abstract: OBJECTIVE: Powered exoskeletons promise to increase the quality of life of people with lower-body paralysis or weakened legs by assisting or restoring legged mobility while providing health benefits across multiple physiological systems. Here, a systematic review of the literature on powered exoskeletons addressed critical questions: What is the current evidence of clinical efficacy for lower-limb powered exoskeletons? What are the benefits and risks for individuals with spinal cord injury (SCI)? What are the levels of injury considered in such studies? What are their outcome measures? What are the opportunities for the next generation exoskeletons? APPROACH: A systematic search of online databases was performed to identify clinical trials and safety or efficacy studies with lower-limb powered exoskeletons for individuals with SCI. Twenty-two studies with eight powered exoskeletons thus selected, were analyzed based on the protocol design, subject demographics, study duration, and primary/secondary outcome measures for assessing exoskeleton's performance in SCI subjects. MAIN RESULTS: Findings show that the level of injury varies across studies, with T10 injuries being represented in 45.4% of the studies. A categorical breakdown of outcome measures revealed 63% of these measures were gait and ambulation related, followed by energy expenditure (16%), physiological improvements (13%), and usability and comfort (8%). Moreover, outcome measures varied across studies, and none had measures spanning every category, making comparisons difficult. SIGNIFICANCE: This review of the literature shows that a majority of current studies focus on thoracic level injury as well as there is an emphasis on ambulatory-related primary outcome measures. Future research should: 1) develop criteria for optimal selection and training of patients most likely to benefit from this technology, 2) design multimodal gait intention detection systems that engage and empower the user, 3) develop real-time monitoring and diagnostic capabilities, and 4) adopt comprehensive metrics for assessing safety, benefits, and usability. Language: en

Design and Optimization of an EEG-Based Brain Machine Interface (BMI) to an Upper-Limb Exoskeleton for Stroke Survivors

Abstract: This study demonstrates the feasibility of detecting motor intent from brain activity of chronic stroke patients using an asynchronous electroencephalography (EEG)-based brain machine interface (BMI). Intent was inferred from movement related cortical potentials (MRCPs) measured over an optimized set of EEG electrodes. Successful intent detection triggered the motion of an upper-limb exoskeleton (MAHI Exo-II), to guide movement and to encourage active user participation by providing instantaneous sensory feedback. Several BMI design features were optimized to increase system performance in the presence of single-trial variability of MRCPs in the injured brain: (1) an adaptive time window was used for extracting features during BMI calibration; (2) training data from two consecutive days were pooled for BMI calibration to increase robustness to handle the day-to-day variations typical of EEG, and (3) BMI predictions were gated by residual electromyography (EMG) activity from the impaired arm, to reduce the number of false positives. This patient-specific BMI calibration approach can accommodate a broad spectrum of stroke patients with diverse motor capabilities. Following BMI optimization on day 3, testing of the closed-loop BMI-MAHI exoskeleton, on 4th and 5th days of the study, showed consistent BMI performance with overall mean true positive rate (TPR) = 62.7 ± 21.4% on day 4 and 67.1 ± 14.6% on day 5. The overall false positive rate (FPR) across subjects was 27.74 ± 37.46% on day 4 and 27.5 ± 35.64% on day 5; however for two subjects who had residual motor function and could benefit from the EMG-gated BMI, the mean FPR was quite low (< 10%). On average, motor intent was detected -367 ± 328 ms before movement onset during closed-loop operation. These findings provide evidence that closed-loop EEG-based BMI for stroke patients can be designed and optimized to perform well across multiple days without system recalibration.

A robust adaptive denoising framework for real-time artifact removal in scalp EEG measurements

Abstract: Objective. Non-invasive measurement of human neural activity based on the scalp electroencephalogram (EEG) allows for the development of biomedical devices that interface with the nervous system for scientific, diagnostic, therapeutic, or restorative purposes. However, EEG recordings are often considered as prone to physiological and non-physiological artifacts of different types and frequency characteristics. Among them, ocular artifacts and signal drifts represent major sources of EEG contamination, particularly in real-time closed-loop brain–machine interface (BMI) applications, which require effective handling of these artifacts across sessions and in natural settings. Approach. We extend the usage of a robust adaptive noise cancelling (ANC) scheme ( filtering) for removal of eye blinks, eye motions, amplitude drifts and recording biases simultaneously. We also characterize the volume conduction, by estimating the signal propagation levels across all EEG scalp recording areas due to ocular artifact generators. We find that the amplitude and spatial distribution of ocular artifacts vary greatly depending on the electrode location. Therefore, fixed filtering parameters for all recording areas would naturally hinder the true overall performance of an ANC scheme for artifact removal. We treat each electrode as a separate sub-system to be filtered, and without the loss of generality, they are assumed to be uncorrelated and uncoupled. Main results. Our results show over 95–99.9% correlation between the raw and processed signals at non-ocular artifact regions, and depending on the contamination profile, 40–70% correlation when ocular artifacts are dominant. We also compare our results with the offline independent component analysis and artifact subspace reconstruction methods, and show that some local quantities are handled better by our sample-adaptive real-time framework. Decoding performance is also compared with multi-day experimental data from 2 subjects, totaling 19 sessions, with and without filtering of the raw data. Significance. The proposed method allows real-time adaptive artifact removal for EEG-based closed-loop BMI applications and mobile EEG studies in general, thereby increasing the range of tasks that can be studied in action and context while reducing the need for discarding data due to artifacts. Significant increase in decoding performances also justify the effectiveness of the method to be used in real-time closed-loop BMI applications.

Negligible Motion Artifacts in Scalp Electroencephalography (EEG) During Treadmill Walking.

Abstract: Recent Mobile Brain/Body Imaging (MoBI) techniques based on active electrode scalp electroencephalogram (EEG) allow the acquisition and real-time analysis of brain dynamics during active unrestrained motor behavior involving whole body movements such as treadmill walking, over-ground walking and other locomotive and non-locomotive tasks. Unfortunately, MoBI protocols are prone to physiological and non-physiological artifacts, including motion artifacts that may contaminate the EEG recordings. A few attempts have been made to quantify these artifacts during locomotion tasks but with inconclusive results due in part to methodological pitfalls. In this paper, we investigate the potential contributions of motion artifacts in scalp EEG during treadmill walking at three different speeds (1.5, 3.0, and 4.5 km/h) using a wireless 64 channel active EEG system and a wireless inertial sensor attached to the subject’s head. The experimental setup was designed according to good measurement practices using state-of-the-art commercially-available instruments, and the measurements were analyzed using Fourier analysis and wavelet coherence approaches. Contrary to prior claims, the subjects’ motion did not significantly affect their EEG during treadmill walking although precaution should be taken when gait speeds approach 4.5 km/h. Overall, these findings suggest how MoBI methods may be safely deployed in neural, cognitive, and rehabilitation engineering applications.

Gait adaptation to visual kinematic perturbations using a real-time closed-loop brain-computer interface to a virtual reality avatar.

Abstract: Objective The control of human bipedal locomotion is of great interest to the field of lower-body brain-computer interfaces (BCIs) for gait rehabilitation. While the feasibility of closed-loop BCI systems for the control of a lower body exoskeleton has been recently shown, multi-day closed-loop neural decoding of human gait in a BCI virtual reality (BCI-VR) environment has yet to be demonstrated. BCI-VR systems provide valuable alternatives for movement rehabilitation when wearable robots are not desirable due to medical conditions, cost, accessibility, usability, or patient preferences. Approach In this study, we propose a real-time closed-loop BCI that decodes lower limb joint angles from scalp electroencephalography (EEG) during treadmill walking to control a walking avatar in a virtual environment. Fluctuations in the amplitude of slow cortical potentials of EEG in the delta band (0.1-3 Hz) were used for prediction; thus, the EEG features correspond to time-domain amplitude modulated potentials in the delta band. Virtual kinematic perturbations resulting in asymmetric walking gait patterns of the avatar were also introduced to investigate gait adaptation using the closed-loop BCI-VR system over a period of eight days. Main results Our results demonstrate the feasibility of using a closed-loop BCI to learn to control a walking avatar under normal and altered visuomotor perturbations, which involved cortical adaptations. The average decoding accuracies (Pearson's r values) in real-time BCI across all subjects increased from (Hip: 0.18 ± 0.31; Knee: 0.23 ± 0.33; Ankle: 0.14 ± 0.22) on Day 1 to (Hip: 0.40 ± 0.24; Knee: 0.55 ± 0.20; Ankle: 0.29 ± 0.22) on Day 8. Significance These findings have implications for the development of a real-time closed-loop EEG-based BCI-VR system for gait rehabilitation after stroke and for understanding cortical plasticity induced by a closed-loop BCI-VR system.

Brain-computer interface devices for patients with paralysis and amputation: A meeting report

Abstract: Objective. The Food and Drug Administration's (FDA) Center for Devices and Radiological Health (CDRH) believes it is important to help stakeholders (e.g., manufacturers, health-care professionals, patients, patient advocates, academia, and other government agencies) navigate the regulatory landscape for medical devices. For innovative devices involving brain–computer interfaces, this is particularly important. Approach. Towards this goal, on 21 November, 2014, CDRH held an open public workshop on its White Oak, MD campus with the aim of fostering an open discussion on the scientific and clinical considerations associated with the development of brain–computer interface (BCI) devices, defined for the purposes of this workshop as neuroprostheses that interface with the central or peripheral nervous system to restore lost motor or sensory capabilities. Main results. This paper summarizes the presentations and discussions from that workshop. Significance. CDRH plans to use this information to develop regulatory considerations that will promote innovation while maintaining appropriate patient protections. FDA plans to build on advances in regulatory science and input provided in this workshop to develop guidance that provides recommendations for premarket submissions for BCI devices. These proceedings will be a resource for the BCI community during the development of medical devices for consumers.

Cortical activity modulations underlying age-related performance differences during posture–cognition dual tasking

Abstract: To date, no systematic research investigating cortical correlates of performance changes in dual tasking has been reported in the elderly population. Thus, we monitored whole-scalp cortical activations (EEG) during both single task and posture-cognition dual tasking with the main goal of understanding cortical activity modulations underlying age-related differences on posture-cognition dual tasking conditions. Postural and cognitive data analyses showed that elderly people had decreased cognitive performance even during challenging single cognitive tasks. Working memory impairments in the elderly group can be observed when a challenging cognitive task is performed in any postural condition, while postural control performance differences only became significant during challenging dual task conditions. Behavioral performance results, in general, indicate that elderly subjects may adopt a non-automated conscious control strategy and prioritize postural performance over cognitive performance to maintain upright stance only when the cognitive load is low. EEG analyses showed increased delta, theta and gamma oscillations, primarily over frontal, central-frontal, central and central-parietal cortices during dual tasking conditions. We found that delta oscillations were more responsive to challenging postural conditions presumably related to cortical representations of changing sensory conditions in postural tasks. Theta rhythms, on the other hand, were more responsive to cognitive task difficulty in both groups, with more pronounced increases in younger subjects which may underlie neural correlates of high-level cognitive computations including encoding and retrieval. Gamma oscillations also increased in the elderly primarily over central and central-parietal cortices during challenging postural tasks, indicating increased allocation of attentional sources to postural tasks.

Multisession, noninvasive closed-loop neuroprosthetic control of grasping by upper limb amputees

Abstract: Upper limb amputation results in a severe reduction in the quality of life of affected individuals due to their inability to easily perform activities of daily living. Brain-machine interfaces (BMIs) that translate grasping intent from the brain's neural activity into prosthetic control may increase the level of natural control currently available in myoelectric prostheses. Current BMI techniques demonstrate accurate arm position and single degree-of-freedom grasp control but are invasive and require daily recalibration. In this study we tested if transradial amputees (A1 and A2) could control grasp preshaping in a prosthetic device using a noninvasive electroencephalography (EEG)-based closed-loop BMI system. Participants attempted to grasp presented objects by controlling two grasping synergies, in 12 sessions performed over 5 weeks. Prior to closed-loop control, the first six sessions included a decoder calibration phase using action observation by the participants; thereafter, the decoder was fixed to examine neuroprosthetic performance in the absence of decoder recalibration. Ability of participants to control the prosthetic was measured by the success rate of grasping; ie, the percentage of trials within a session in which presented objects were successfully grasped. Participant A1 maintained a steady success rate (63±3%) across sessions (significantly above chance [41±5%] for 11 sessions). Participant A2, who was under the influence of pharmacological treatment for depression, hormone imbalance, pain management (for phantom pain as well as shoulder joint inflammation), and drug dependence, achieved a success rate of 32±2% across sessions (significantly above chance [27±5%] in only two sessions). EEG signal quality was stable across sessions, but the decoders created during the first six sessions showed variation, indicating EEG features relevant to decoding at a smaller timescale (100ms) may not be stable. Overall, our results show that (a) an EEG-based BMI for grasping is a feasible strategy for further investigation of prosthetic control by amputees, and (b) factors that may affect brain activity such as medication need further examination to improve accuracy and stability of BMI performance.

Noninvasive EEG correlates of overground and stair walking

Abstract: Automated walking intention detection remains a challenge in lower-limb neuroprosthetic systems. Here, we assess the feasibility of extracting motor intent from scalp electroencephalography (EEG). First, we evaluated the corticomuscular coherence between central EEG electrodes (C1, Cz, C2) and muscles of the shank and thigh during walking on level ground and stairs. Second, we trained decoders to predict the linear envelope of the surface electromyogram (EMG). We observed significant EEG-led corticomuscular coupling between electrodes and sEMG (tibialis anterior) in the high delta (3–4 Hz) and low theta (4–5 Hz) frequency bands during level walking, indicating efferent signaling from the cortex to peripheral motor neurons. The coherence was increased between EEG and vastus lateralis and tibialis anterior in the delta band (< 2 Hz) during stair ascent, indicating a task specific modulation in corticomuscular coupling. However, EMG was the leading signal for biceps femoris and gastrocnemius coherence during stair ascent, possibly representing afferent feedback loops from periphery to the motor cortex. Decoder validation showed that EEG signals contained information about the sEMG patterns during over ground walking, however, the accuracy of the predicted sEMG patterns decreased during the stair condition. Overall, these initial findings support the feasibility of integrating sEMG and EEG into a hybrid decoder for volitional control of lower limb neuroprostheses.

Unscented Kalman filter for neural decoding of human treadmill walking from non-invasive electroencephalography

Abstract: The feasibility of decoding lower limb kinematics in human treadmill walking from noninvasive electroencephalography (EEG) has been demonstrated with linear Wiener filter. However, nonlinear relationship between neural activities and limb movements may challenge the linear decoders in real-time brain computer interface (BCI) applications. In this study, we propose a nonlinear neural decoder using an Unscented Kalman Filter (UKF) to infer lower limb joint angles from noninvasive scalp EEG signals during human treadmill walking. Our results demonstrate that lower limb joint angles during treadmill walking can be decoded from the fluctuations in the amplitude of slow cortical potentials in the delta band (0.1–3Hz). Overall, the average decoding accuracy were 0.43 ± 0.18 for Pearson's r value and 1.82 ± 3.07 for signal to noise ratio (SNR), and robust to ocular, muscle, or movement artifacts. Moreover, the signal preprocessing scheme and the design of UKF allow the implementation of the proposed EEG-based BCI for real-time applications. This has implications for the development of closed-loop EEG-based BCI systems for gait rehabilitation after stroke.

Robotic assistance of human motion using active-backdrivability on a geared electromagnetic motor

Abstract: In this research, we describe an actuation and control system designed for geared electromagnetic motors, which is characterized by its simple implementation, fast response to external input loads,...