Catharina Zich

Real-time EEG feedback during simultaneous EEG-fMRI identifies the cortical signature of motor imagery.

Motor imagery (MI) combined with real-time electroencephalogram (EEG) feedback is a popular approach for steering brain-computer interfaces (BCI). MI BCI has been considered promising as add-on therapy to support motor recovery after stroke. Yet whether EEG neurofeedback indeed targets specific sensorimotor activation patterns cannot be unambiguously inferred from EEG alone. We combined MI EEG neurofeedback with concurrent and continuous functional magnetic resonance imaging (fMRI) to characterize the relationship between MI EEG neurofeedback and activation in cortical sensorimotor areas. EEG signals were corrected online from interfering MRI gradient and ballistocardiogram artifacts, enabling the delivery of real-time EEG feedback. Significantly enhanced task-specific brain activity during feedback compared to no feedback blocks was present in EEG and fMRI. Moreover, the contralateral MI related decrease in EEG sensorimotor rhythm amplitude correlated inversely with fMRI activation in the contralateral sensorimotor areas, whereas a lateralized fMRI pattern did not necessarily go along with a lateralized EEG pattern. Together, the findings indicate a complex relationship between MI EEG signals and sensorimotor cortical activity, whereby both are similarly modulated by EEG neurofeedback. This finding supports the potential of MI EEG neurofeedback for motor rehabilitation and helps to better understand individual differences in MI BCI performance.

Mobile EEG and its potential to promote the theory and application of imagery-based motor rehabilitation

Studying the brain in its natural state remains a major challenge for neuroscience. Solving this challenge would not only enable the refinement of cognitive theory, but also provide a better understanding of cognitive function in the type of complex and unpredictable situations that constitute daily life, and which are often disturbed in clinical populations. With mobile EEG, researchers now have access to a tool that can help address these issues. In this paper we present an overview of technical advancements in mobile EEG systems and associated analysis tools, and explore the benefits of this new technology. Using the example of motor imagery (MI) we will examine the translational potential of MI-based neurofeedback training for neurological rehabilitation and applied research.

Wireless EEG with individualized channel layout enables efficient motor imagery training

OBJECTIVE The study compared two channel-reduction approaches in order to investigate the effects of systematic motor imagery (MI) neurofeedback practice in an everyday environment using a very user-friendly EEG system consisting of individualized caps and highly portable hardware. METHODS Sixteen BCI novices were trained over four consecutive days to imagine left and right hand movements while receiving feedback. The most informative bipolar channels for use on the subsequent days were identified on the first day for each individual based on a high-density online MI recording. RESULTS Online classification accuracy on the first day was 85.1% on average (range: 64.7-97.7%). Offline an individually-selected bipolar channel pair based on common spatial patterns significantly outperformed a pair informed by independent component analysis and a standard 10-20 pair. From day 2 to day 4 online MI accuracy increased significantly (day 2: 69.1%; day 4: 73.3%), which was mostly caused by a reduction in ipsilateral event-related desynchronization of sensorimotor rhythms. CONCLUSION The present study demonstrates that systematic MI practice in an everyday environment with a user-friendly EEG system results in MI learning effects. SIGNIFICANCE These findings help to bridge the gap between elaborate laboratory studies with healthy participants and efficient home or hospital based MI neurofeedback protocols.

Lateralization patterns of covert but not overt movements change with age: An EEG neurofeedback study.

The mental practice of movements has been suggested as a promising add-on therapy to facilitate motor recovery after stroke. In the case of mentally practised movements, electroencephalogram (EEG) can be utilized to provide feedback about an otherwise covert act. The main target group for such an intervention are elderly patients, though research so far is largely focused on young populations (<30 years). The present study therefore aimed to examine the influence of age on the neural correlates of covert movements (CMs) in a real-time EEG neurofeedback framework. CM-induced event-related desynchronization (ERD) was studied in young (mean age: 23.6 years) and elderly (mean age: 62.7 years) healthy adults. Participants performed covert and overt hand movements. CMs were based on kinesthetic motor imagery (MI) or quasi-movements (QM). Based on previous studies investigating QM in the mu frequency range (8-13Hz) QM were expected to result in more lateralized ERD% patterns and accordingly higher classification accuracies. Independent of CM strategy the elderly were characterized by a significantly reduced lateralization of ERD%, due to stronger ipsilateral ERD%, and in consequence, reduced classification accuracies. QM were generally perceived as more vivid, but no differences were evident between MI and QM in ERD% or classification accuracies. EEG feedback enhanced task-related activity independently of strategy and age. ERD% measures of overt and covert movements were strongly related in young adults, whereas in the elderly ERD% lateralization is dissociated. In summary, we did not find evidence in support of more pronounced ERD% lateralization patterns in QM. Our finding of a less lateralized activation pattern in the elderly is in accordance to previous research and with the idea that compensatory processes help to overcome neurodegenerative changes related to normal ageing. Importantly, it indicates that EEG neurofeedback studies should place more emphasis on the age of the potential end-users.

Motor Imagery Impairment in Postacute Stroke Patients

Not much is known about how well stroke patients are able to perform motor imagery (MI) and which MI abilities are preserved after stroke. We therefore applied three different MI tasks (one mental chronometry task, one mental rotation task, and one EEG-based neurofeedback task) to a sample of postacute stroke patients (n = 20) and age-matched healthy controls (n = 20) for addressing the following questions: First, which of the MI tasks indicate impairment in stroke patients and are impairments restricted to the paretic side? Second, is there a relationship between MI impairment and sensory loss or paresis severity? And third, do the results of the different MI tasks converge? Significant differences between the stroke and control groups were found in all three MI tasks. However, only the mental chronometry task and EEG analysis revealed paresis side-specific effects. Moreover, sensitivity loss contributed to a performance drop in the mental rotation task. The findings indicate that although MI abilities may be impaired after stroke, most patients retain their ability for MI EEG-based neurofeedback. Interestingly, performance in the different MI measures did not strongly correlate, neither in stroke patients nor in healthy controls. We conclude that one MI measure is not sufficient to fully assess an individuals MI abilities.

High-Intensity Chronic Stroke Motor Imagery Neurofeedback Training at Home: Three Case Reports:

Motor imagery (MI) with neurofeedback has been suggested as promising for motor recovery after stroke. Evidence suggests that regular training facilitates compensatory plasticity, but frequent training is difficult to integrate into everyday life. Using a wireless electroencephalogram (EEG) system, we implemented a frequent and efficient neurofeedback training at the patients’ home. Aiming to overcome maladaptive changes in cortical lateralization patterns we presented a visual feedback, representing the degree of contralateral sensorimotor cortical activity and the degree of sensorimotor cortex lateralization. Three stroke patients practiced every other day, over a period of 4 weeks. Training-related changes were evaluated on behavioral, functional, and structural levels. All 3 patients indicated that they enjoyed the training and were highly motivated throughout the entire training regime. EEG activity induced by MI of the affected hand became more lateralized over the course of training in all three patients. The patient with a significant functional change also showed increased white matter integrity as revealed by diffusion tensor imaging, and a substantial clinical improvement of upper limb motor functions. Our study provides evidence that regular, home-based practice of MI neurofeedback has the potential to facilitate cortical reorganization and may also increase associated improvements of upper limb motor function in chronic stroke patients.

Modulating hemispheric lateralization by brain stimulation yields gain in mental and physical activity

Imagery plays an important role in our life. Motor imagery is the mental simulation of a motor act without overt motor output. Previous studies have documented the effect of motor imagery practice. However, its translational potential for patients as well as for athletes, musicians and other groups, depends largely on the transfer from mental practice to overt physical performance. We used bilateral transcranial direct current stimulation (tDCS) over sensorimotor areas to modulate neural lateralization patterns induced by unilateral mental motor imagery and the performance of a physical motor task. Twenty-six healthy older adults participated (mean age = 67.1 years) in a double-blind cross-over sham-controlled study. We found stimulation-related changes at the neural and behavioural level, which were polarity-dependent. Specifically, for the hand contralateral to the anode, electroencephalographic activity induced by motor imagery was more lateralized and motor performance improved. In contrast, for the hand contralateral to the cathode, hemispheric lateralization was reduced. The stimulation-related increase and decrease in neural lateralization were negatively related. Further, the degree of stimulation-related change in neural lateralization correlated with the stimulation-related change on behavioural level. These convergent neurophysiological and behavioural effects underline the potential of tDCS to improve mental and physical motor performance.

Modulatory effects of dynamic fMRI-based neurofeedback on emotion regulation networks during adolescence

This study used real-time fMRI-based neurofeedback (NF) to modulate functional connectivity patterns in the emotional regulation networks in a sample of adolescent girls. Adolescence is a developmental period which brings along changes at multiple levels, such as hormonal changes, improvements in socio-emotional processing, as well as ongoing brain maturation and functioning. It has been suggested that these changes increase the risk for the individual. For example, early, difficulties with emotion regulation have been linked to a range of mental health problems, such as anxiety. Here we successfully trained participants to modulate the functional coupling of the prefrontal cortex and the amygdala towards a more negative connectivity pattern, which resembles the connectivity pattern found in the mature brain. These brain-based changes were related to changes at the behavioural level. We also found that the modulation largely depends on the specific neurofeedback implementation, which provides important insights for future NF training approaches.

Motor learning shapes temporal activity in human sensorimotor cortex

Although neuroimaging techniques have provided vital insights into the anatomical regions involved in motor learning, the underlying changes in temporal dynamics are not well understood. Using magnetoencephalography and Hidden Markov Modelling to model the dynamics of neural oscillations on data-adaptive time-scales, we detected specific changes in movement-related sensorimotor β-activity during practice of a self-paced sequential visuo-motor task. The behaviourally-relevant neural signature generalised to another motor task, emphasising the centrality of β-activity in motor plasticity.