Techniques and devices to restore cognition

Abstract

Executive planning, the ability to direct and sustain attention, language and several types of memory may be compromised by conditions such as stroke, traumatic brain injury, cancer, autism, cerebral palsy and Alzheimer's disease. No medical devices are currently available to help restore these cognitive functions. Recent findings about the neurophysiology of these conditions in humans coupled with progress in engineering devices to treat refractory neurological conditions imply that the time has arrived to consider the design and evaluation of a new class of devices. Like their neuromotor counterparts, neurocognitive prostheses might sense or modulate neural function in a non-invasive manner or by means of implanted electrodes. In order to paint a vision for future device development, it is essential to first review what can be achieved using behavioral and external modulatory techniques. While non-invasive approaches might strengthen a patient's remaining intact cognitive abilities, neurocognitive prosthetics comprised of direct brain-computer interfaces could in theory physically reconstitute and augment the substrate of cognition itself.

Invasive Neurostimulation in Stroke Rehabilitation

“…Studies are promising at an early clinical stage, but in learning carefully from the strengths and shortcomings of trials in upper limb rehabilitation, groups are already envisioning customized stimulation for individual patient profiles [82,83]. Another new dimension for neurostimulation lies in the field of executive planning and memory, impaired not only in stroke, but also in traumatic brain injury, autism, cerebral palsy, and Alzheimer's disease [84]. The prospect of neurostimulation is still only experimental, but ideas of frequency-contingent learning, where, through a theta rhythm, hippocampal plasticity can be induced, are now showing promise in experimental models [85].…”

Effects of Neurofeedback on Brain Waves and Cognitive Functions of Children with Cerebral Palsy: a Randomized Control Trial

“…Cognitive problem is caused not only by CP but also by various other conditions such as traumatic brain injury (TBI), autistic spectrum disorder, and attention deficit/ hyperactivity disorder (ADHD) 4,5) . Moreover, it may have a negative effect on mental and intellectual capacity development 6) .…”

“…Therefore, treatments that enhance the cognitive domains are of great interest, and diverse approaches are being used. Recently, the neurofeedback (NFB) approach was tested using EEG biofeedback training 4,5) . Electroencephalography (EEG) is a valuable method for assessing the damaged brain parts of CP subjects who tend to have abnormal brain waves and a high incidence of epilepsy 3) .…”

Analysis of the cerebral mechanisms underlying rehabilitation of the patients after stroke

“…В настоящее время господствует гипотеза о том, что временной процессинг (т.е. об-работка) промежутков, измеряемых субсекундным диапазоном, модулируется допаминергической ак-тивностью базальных ганглиев, что очень важно для понимания происхождения нарушений двига-тельной активности и функционального статуса [5,8,11,[13][14][15][16][17][18][19][20][21][22].…”

“…Кроме того, современные методы высоко-и низкочастотной транскраниальной магнитотерапии позволяют неинвазивно воздействовать на микро-структурно-функциональные и нейрохимические «мишени», восстанавливая психомоторные функ-ции больных, перенесших инсульт [18][19][20][21]26 Примечание. Здесь и в табл.…”