Functional Electrical Stimulation Therapy: Mechanisms for Recovery of Function Following Spinal Cord Injury and Stroke

Popović, Miloš R.; Masani, Kei; Milosevic, Matija

doi:10.1007/978-3-031-08995-4_19

Cited by 5 publications

(6 citation statements)

References 131 publications

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“…Our M1 intervention findings are in agreement with the proposed mechanism that BCI-FES usage involves Hebbian-like learning [9,[16][17][18]. In short, the repeated presynaptic cortical activation detected by the BCI system, which is closely followed by postsynaptic sensory nerve activation and movement-related reafference elicited using FES, could strengthen corticospinal projections after the intervention, as previously proposed [3,9,16,18].…”

Section: Effectiveness Of Motor Cortical Activity For Bci-fes-induced...supporting

confidence: 91%

“…The optimal frequency range for each participant was determined during offline analysis by inspecting the event-related spectral perturbation (ERSP) maps (see section 2.6.3) across all extension and flexion motor imagery trials. The frequency range exhibiting the strongest event-related desynchronization (ERD) during the 'Go' epoch was selected by the experimenter either as the alpha (8-13 Hz) [26,27] or lower beta (13)(14)(15)(16)(17)(18)(19)(20) [27,28] frequency range (figure 2). The ERSP map inspection was focused on the C3 and F3 EEG locations, as these cortical areas were later used as the BCI input sources during the M1 and PFC BCI-FES interventions, respectively.…”

Section: Calibration and Interventions 241 Bci System Calibrationmentioning

confidence: 99%

“…Both M1 [5,8] and PFC [4] based BCI-FES were successfully implemented in therapeutic applications for neuromotor recovery. The involvement of M1 and PFC in movement control effectively facilitates presynaptic cortical engagement of descending circuits through the BCI system, which is simultaneously associated with postsynaptic sensorimotor activation through FES to enable Hebbian-like plasticity that elicits improved neuromotor function [9,[16][17][18].…”

Section: Introductionmentioning

confidence: 99%

“…We aimed to investigate the effectiveness of shortduration BCI-FES interventions based on the motor (M1) and prefrontal (PFC) cortical activities and examine corticospinal and cortical after-effects to help elucidate the underlying mechanisms of the neuromodulation. We hypothesized that both M1 and PFC interventions would be effective for BCI-FES neuromodulation, as both cortical areas are involved in movement control [12,14,15] and thus could enable Hebbian-like plasticity [9,[16][17][18]. Moreover, we also hypothesized that M1 and PFC BCI-FES interventions would induce spatial localization, as demonstrated after several short-duration BCI-based training paradigms [11,13].…”

Section: Introductionmentioning

confidence: 99%

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Effectiveness of motor and prefrontal cortical areas for brain-controlled functional electrical stimulation neuromodulation

Fadli,

Yamanouchi,

Jovanovic

et al. 2023

J. Neural Eng.

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Objective: Brain-computer interface (BCI)-controlled functional electrical stimulation (FES) could excite the central nervous system to enhance upper limb motor recovery. Our current study assessed the effectiveness of motor and prefrontal cortical activity-based BCI-FES to help elucidate the underlying neuromodulation mechanisms of this neurorehabilitation approach.Approach: The primary motor cortex (M1) and prefrontal cortex (PFC) BCI-FES interventions were performed for 25 min on separate days with twelve non-disabled participants. During the interventions, a single electrode from the contralateral M1 or PFC was used to detect event-related desynchronization (ERD) in the calibrated frequency range. If the BCI system detected ERD within 15 s of motor imagery, FES activated wrist extensor muscles. Otherwise, if the BCI system did not detect ERD within 15 s, a subsequent trial was initiated without FES. To evaluate neuromodulation effects, corticospinal excitability was assessed using single-pulse transcranial magnetic stimulation, and cortical excitability was assessed by motor imagery ERD and resting-state functional connectivity before, immediately, 30 min, and 60 min after each intervention.Main results: M1 and PFC BCI-FES interventions had similar success rates of approximately 80%, while the M1 intervention was faster in detecting ERD activity. Consequently, only the M1 intervention effectively elicited corticospinal excitability changes for at least 60 min around the targeted cortical area in the M1, suggesting a degree of spatial localization. However, cortical excitability measures did not indicate changes after either M1 or PFC BCI-FES.Significance: Neural mechanisms underlying the effectiveness of BCI-FES neuromodulation may be attributed to the M1 direct corticospinal projections and/or the closer timing between ERD detection and FES, which likely enhanced Hebbian-like plasticity by synchronizing cortical activation detected by the BCI system with the sensory nerve activation and movement related reafference elicited by FES.

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Section: Effectiveness Of Motor Cortical Activity For Bci-fes-induced...supporting

confidence: 91%

Section: Calibration and Interventions 241 Bci System Calibrationmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Effectiveness of motor and prefrontal cortical areas for brain-controlled functional electrical stimulation neuromodulation

Fadli,

Yamanouchi,

Jovanovic

et al. 2023

J. Neural Eng.

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show abstract

“…1 Interventions using NMES could help to restore functional movements and improve neuromotor function after neurological impairments such as spinal cord injury and stroke. 2 Moreover, NMES has been widely used for spasticity management. 3 While NMES has been applied successfully in clinical settings, the underlying mechanisms are still not well understood.…”

Section: Introductionmentioning

confidence: 99%

Inhibition of tibialis anterior spinal reflex circuits using frequency‐specific neuromuscular electrical stimulation

Arai,

Sasaki,

Tsugaya

et al. 2024

Artificial Organs

Self Cite

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BackgroundNeuromuscular electrical stimulation (NMES) can generate muscle contractions and elicit excitability of neural circuits. However, the optimal stimulation frequency for effective neuromodulation remains unclear.MethodsEleven able‐bodied individuals participated in our study to examine the effects of: (1) low‐frequency NMES at 25 Hz, (2) high‐frequency NMES at 100 Hz; and (3) mixed‐frequency NMES at 25 and 100 Hz switched every second. NMES was delivered to the right tibialis anterior (TA) muscle for 1 min in each condition. The order of interventions was pseudorandomized between participants with a washout of at least 15 min between conditions. Spinal reflexes were elicited using single‐pulse transcutaneous spinal cord stimulation applied over the lumbar enlargement to evoke responses in multiple lower‐limb muscles bilaterally and maximum motor responses (Mmax) were elicited in the TA muscle by stimulating the common peroneal nerve to assess fatigue at the baseline and immediately, 5, 10, and 15 min after each intervention.ResultsOur results showed that spinal reflexes were significantly inhibited immediately after the mixed‐frequency NMES, and for at least 15 min in follow‐up. Low‐frequency NMES inhibited spinal reflexes 5 min after the intervention, and also persisted for at least 10 min. These effects were present only in the stimulated TA muscle, while other contralateral and ipsilateral muscles were unaffected. Mmax responses were not affected by any intervention.ConclusionsOur results indicate that even a short‐duration (1 min) NMES intervention using low‐ and mixed‐frequency NMES could inhibit spinal reflex excitability of the TA muscle without inducing fatigue.

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Facilitating limb movement after stroke

Reinkensmeyer

Farrens

Kamper

2023

Nat Med

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Functional Electrical Stimulation Therapy: Mechanisms for Recovery of Function Following Spinal Cord Injury and Stroke

Cited by 5 publications

References 131 publications

Effectiveness of motor and prefrontal cortical areas for brain-controlled functional electrical stimulation neuromodulation

Effectiveness of motor and prefrontal cortical areas for brain-controlled functional electrical stimulation neuromodulation

Inhibition of tibialis anterior spinal reflex circuits using frequency‐specific neuromuscular electrical stimulation

Facilitating limb movement after stroke

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