Detection of movement intention from neural signals combined with assistive technologies may be used for effective neurofeedback in rehabilitation. In order to promote plasticity, a causal relation between intended actions (detected for example from the EEG) and the corresponding feedback should be established. This requires reliable detection of motor intentions. In this study, we propose a method to detect movements from EEG with limited latency. In a self-paced asynchronous BCI paradigm, the initial negative phase of the movement-related cortical potentials (MRCPs), extracted from multi-channel scalp EEG was used to detect motor execution/imagination in healthy subjects and stroke patients. For MRCP detection, it was demonstrated that a new optimized spatial filtering technique led to better accuracy than a large Laplacian spatial filter and common spatial pattern. With the optimized spatial filter, the true positive rate (TPR) for detection of movement execution in healthy subjects (n = 15) was 82.5 ± 7.8%, with latency of -66.6 ± 121 ms. Although TPR decreased with motor imagination in healthy subject (n = 10, 64.5 ± 5.33%) and with attempted movements in stroke patients (n = 5, 55.01 ± 12.01%), the results are promising for the application of this approach to provide patient-driven real-time neurofeedback.

clinicaltrials.gov Identifier: NCT01689077.

Gizzi L, Nielsen JF, Felici F, Ivanenko YP, Farina D. Impulses of activation but not motor modules are preserved in the locomotion of subacute stroke patients. J Neurophysiol 106: 202-210, 2011. First published April 20, 2011 doi:10.1152/jn.00727.2010.-It has been hypothesized that the coordinated activation of muscles is controlled by the central nervous system by means of a small alphabet of control signals (also referred to as activation signals) and motor modules (synergies). We analyzed the locomotion of 10 patients recently affected by stroke (maximum of 20 wk) and compared it with that of healthy controls. The aim was to assess whether the walking of subacute stroke patients is based on the same motor modules and/or activation signals as healthy subjects. The activity of muscles of the lower and upper limb and the trunk was measured and used for extracting motor modules. Four modules were sufficient to explain the majority of variance in muscle activation in both controls and patients. Modules from the affected side of stroke patients were different from those of healthy controls and from the unaffected side of stroke patients. However, the activation signals were similar between groups and between the affected and unaffected side of stroke patients, and were characterized by impulses at specific time instants within the gait cycle, underlying an impulsive controller of gait. In conclusion, motor modules observed in healthy subjects during locomotion are different from those used by subacute stroke patients, despite similar impulsive activation signals. We suggest that this pattern is consistent with a neuronal network in which the timing of activity generated by central pattern generators is directed to the motoneurons via a premotor network that distributes the activity in a task-dependent manner determined by sensory and descending control information. stroke; gait; motor control THE PLANNING AND EXECUTION of movements implies a considerable computational load by the central nervous system (CNS). This complexity may be reduced by the activation of motor modules (also referred to as loadings or muscle synergies) in the spinal cord by means of a small number of activation signals (also referred to as factors or primitives or activation coefficients). This hypothesis has been confirmed in animal and human studies during a variety of tasks (Bizzi et al.

Chronic pain and spasticity are common problems after SCI, and in particular, high pain interference is associated with lower quality of life.

The effect of repetitive magnetic stimulation on spasticity was evaluated in 38 patients with multiple sclerosis in a double-blind placebo-controlled study. One group was treated with repetitive magnetic stimulation (n = 21) and the other group with sham stimulation (n = 17). Both groups were treated twice daily for 7 consecutive days. Primary end-points of the study were changes in the patients self-score, in clinical spasticity score, and in the stretch reflex threshold. The self-score of ease of daily day activities improved by 22% (P = 0.007) after treatment and by 29% (P = 0.004) after sham stimulation. The clinical spasticity score improved -3.3 +/- 4.7 arbitrary unit (AU) in treated patients and 0.7 +/- 2.5 AU in sham stimulation (P = 0.003). The stretch reflex threshold increased 4.3 +/- 7.5 deg/s in treated patients and -3.8 +/- 9.7 deg/s in sham stimulation (P = 0.001). The data presented in this study supports the idea that repetitive magnetic stimulation has an antispastic effect in multiple sclerosis. Future studies should clarify the optimal treatment regimen.