Sho Nakagome

Powered exoskeletons for bipedal locomotion after spinal cord injury

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 exoskeletons 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.

A closed-loop brain computer interface to a virtual reality avatar: Gait adaptation to visual kinematic perturbations

The control of human bipedal locomotion is of great interest to the field of lower-body brain computer interfaces (BCIs) for rehabilitation of gait. While the feasibility of a closed-loop BCI system for the control of a lower body exoskeleton has been recently shown, multi-day closed-loop neural decoding of human gait in a virtual reality (BCI-VR) environment has yet to be demonstrated. In this study, we propose a real-time closed-loop BCI that decodes lower limb joint angles from scalp electroencephalography (EEC) during treadmill walking to control the walking movements of a virtual avatar. Moreover, 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. 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. These findings have implications for the development of BCI-VR systems for gait rehabilitation after stroke and for understanding cortical plasticity induced by a closed-loop BCI system.

Your Brain on Art: Emergent Cortical Dynamics During Aesthetic Experiences

The brain response to conceptual art was studied with mobile electroencephalography (EEG) to examine the neural basis of aesthetic experiences. In contrast to most studies of perceptual phenomena, participants were moving and thinking freely as they viewed the exhibit The Boundary of Life is Quietly Crossed by Dario Robleto at the Menil Collection-Houston. The brain activity of over 400 subjects was recorded using dry-electrode and one reference gel-based EEG systems over a period of 3 months. Here, we report initial findings based on the reference system. EEG segments corresponding to each art piece were grouped into one of three classes (complex, moderate, and baseline) based on analysis of a digital image of each piece. Time, frequency, and wavelet features extracted from EEG were used to classify patterns associated with viewing art, and ranked based on their relevance for classification. The maximum classification accuracy was 55% (chance = 33%) with delta and gamma features the most relevant for classification. Functional analysis revealed a significant increase in connection strength in localized brain networks while subjects viewed the most aesthetically pleasing art compared to viewing a blank wall. The direction of signal flow showed early recruitment of broad posterior areas followed by focal anterior activation. Significant differences in the strength of connections were also observed across age and gender. This work provides evidence that EEG, deployed on freely behaving subjects, can detect selective signal flow in neural networks, identify significant differences between subject groups, and report with greater-than-chance accuracy the complexity of a subjects visual percept of aesthetically pleasing art. Our approach, which allows acquisition of neural activity “in action and context,” could lead to understanding of how the brain integrates sensory input and its ongoing internal state to produce the phenomenon which we term aesthetic experience.

Real-time EEG-based brain-computer interface to a virtual avatar enhances cortical involvement in human treadmill walking

Recent advances in non-invasive brain-computer interface (BCI) technologies have shown the feasibility of neural decoding for both users’ gait intent and continuous kinematics. However, the dynamics of cortical involvement in human upright walking with a closed-loop BCI has not been investigated. This study aims to investigate the changes of cortical involvement in human treadmill walking with and without BCI control of a walking avatar. Source localization revealed significant differences in cortical network activity between walking with and without closed-loop BCI control. Our results showed sustained α/µ suppression in the Posterior Parietal Cortex and Inferior Parietal Lobe, indicating increases of cortical involvement during walking with BCI control. We also observed significant increased activity of the Anterior Cingulate Cortex (ACC) in the low frequency band suggesting the presence of a cortical network involved in error monitoring and motor learning. Additionally, the presence of low γ modulations in the ACC and Superior Temporal Gyrus may associate with increases of voluntary control of human gait. This work is a further step toward the development of a novel training paradigm for improving the efficacy of rehabilitation in a top-down approach.

Data Descriptor: A mobile brainbody imaging dataset recorded during treadmill walking with a brain-computer interface

We present a mobile brain-body imaging (MoBI) dataset acquired during treadmill walking in a brain-computer interface (BCI) task. The data were collected from eight healthy subjects, each having three identical trials. Each trial consisted of three conditions: standing, treadmill walking, and treadmill walking with a closed-loop BCI. During the BCI condition, subjects used their brain activity to control a virtual avatar on a screen to walk in real-time. Robust procedures were designed to record lower limb joint angles (bilateral hip, knee, and ankle) using goniometers synchronized with 60-channel scalp electroencephalography (EEG). Additionally, electrooculogram (EOG), EEG electrodes impedance, and digitized EEG channel locations were acquired to aid artifact removal and EEG dipole-source localization. This dataset is unique in that it is the first published MoBI dataset recorded during walking. It is useful in addressing several important open research questions, such as how EEG is coupled with gait cycle during closed-loop BCI, how BCI influences neural activity during walking, and how a BCI decoder may be optimized.

Electrocortical correlates of human level-ground, slope, and stair walking

This study investigated electrocortical dynamics of human walking across different unconstrained walking conditions (i.e., level ground (LW), ramp ascent (RA), and stair ascent (SA)). Non-invasive active-electrode scalp electroencephalography (EEG) signals were recorded and a systematic EEG processing method was implemented to reduce artifacts. Source localization combined with independent component analysis and k-means clustering revealed the involvement of four clusters in the brain during the walking tasks: Left and Right Occipital Lobe (LOL, ROL), Posterior Parietal Cortex (PPC), and Central Sensorimotor Cortex (SMC). Results showed that the changes of spectral power in the PPC and SMC clusters were associated with the level of motor task demands. Specifically, we observed α and β suppression at the beginning of the gait cycle in both SA and RA walking (relative to LW) in the SMC. Additionally, we observed significant β rebound (synchronization) at the initial swing phase of the gait cycle, which may be indicative of active cortical signaling involved in maintaining the current locomotor state. An increase of low γ band power in this cluster was also found in SA walking. In the PPC, the low γ band power increased with the level of task demands (from LW to RA and SA). Additionally, our results provide evidence that electrocortical amplitude modulations (relative to average gait cycle) are correlated with the level of difficulty in locomotion tasks. Specifically, the modulations in the PPC shifted to higher frequency bands when the subjects walked in RA and SA conditions. Moreover, low γ modulations in the central sensorimotor area were observed in the LW walking and shifted to lower frequency bands in RA and SA walking. These findings extend our understanding of cortical dynamics of human walking at different level of locomotion task demands and reinforces the growing body of literature supporting a shared-control paradigm between spinal and cortical networks during locomotion.

Full body mobile brain-body imaging data during unconstrained locomotion on stairs, ramps, and level ground

Human locomotion is a complex process that requires the integration of central and peripheral nervous signalling. Understanding the brain’s involvement in locomotion is challenging and is traditionally investigated during locomotor imagination or observation. However, stationary imaging methods lack the ability to infer information about the peripheral and central signalling during actual task execution. In this report, we present a dataset containing simultaneously recorded electroencephalography (EEG), lower-limb electromyography (EMG), and full body motion capture recorded from ten able-bodied individuals. The subjects completed an average of twenty trials on an experimental gait course containing level-ground, ramps, and stairs. We recorded 60-channel EEG from the scalp and 4-channel EOG from the face and temples. Surface EMG was recorded from six muscle sites bilaterally on the thigh and shank. The motion capture system consisted of seventeen wireless IMUs, allowing for unconstrained ambulation in the experimental space. In this report, we present the rationale for collecting these data, a detailed explanation of the experimental setup, and a brief validation of the data quality.

Effects of speed and direction of perturbation on electroencephalographic and balance responses

The modulation of perturbation-evoked potential (PEP) N1 as a function of different biomechanical characteristics of perturbation has been investigated before. However, it remains unknown whether the PEP N1 modulation contributes to the shaping of the functional postural response. To improve this understanding, we examined the modulation of functional postural response in relation to the PEP N1 response in ten healthy young subjects during unpredictable perturbations to their upright stance—translations of the support surface in a forward or backward direction at two different amplitudes of constant speed. Using independent components from the fronto-central region, obtained from subject-specific head models created from the MRI, our results show that the latency of onset of the functional postural response after the PEP N1 response was faster for forward than backward perturbations at a constant speed but was not affected by the speed of perturbation. Further, our results reinforce some of the previous findings that suggested that the N1 peak amplitude and peak latency are both modulated by the speed of perturbation but not by the direction of the perturbation. Our results improve the understanding of the relation between characteristics of perturbation and the neurophysiology of reactive balance control and may have implications for the design of brain–machine interfaces for populations with a higher risk of falls.

Prediction of lower-limb joint kinematics from surface EMG during overground locomotion

Recent advancements in powered lower limb prostheses have led to the development of neural-machine interfaces for natural control during bipedal locomotion. In particular, electromyography (EMG) patterns recorded from the amputated limb can be leveraged to infer the intended gait pattern of the user. However, the optimal control strategy for translating the EMG patterns to kinematic space remains a challenge. In this study, six able bodied subjects were instrumented for mobile brain-body imaging and asked to walk on a multi-terrain gait course. A non-linear extension of the Kalman filter was used to predict knee and ankle joint kinematics from lower limb muscle activation patterns during overground locomotion. Specifically, muscles of the anterior and posterior thigh were used to predict both the knee and ankle joint position. The results revealed that muscles in the thigh can be used to predict the position of the knee and ankle with high accuracy. The highest mean r-value obtained for each of the six subjects was 0.92, 0.77, 0.38, 0.39, 0.63, and 0.77, with corresponding SNR values of 10.8 dB, 6.7 dB, 5.9 dB, 2.8 dB, 9.1 dB, and 9.2 dB, for each subject, respectively. This study is the first to demonstrate that continuous EMG can be used to predict the joint kinematics of the knee and ankle during overground locomotion. This approach may provide improvements during closed-loop control of a powered lower limb prosthesis when compared to other pattern-recognition based methods.

Prediction of EMG envelopes of multiple terrains over-ground walking from EEG signals using an unscented Kalman filter

Advanced powered lower-limb prosthetic devices require an intuitive and flexible user control interface to work in a dynamic environment. This study investigated the feasibility of inferring muscle activation patterns (electromyography, EMG, envelope) from non-invasive electroencephalography (EEG) signals. Six healthy individuals participated in this study; the subjects were instructed to walk at a comfortable speed across various terrains (e.g. level-ground, up/down slope, up/down stair walking). An unscented kalman filter (UKF) was used to predict the EMG envelope from fluctuations in the amplitude of slow cortical potentials of EEG in the delta band (0.1–3 Hz). The highest decoding accuracy obtained was an r-value (Pearsons correlation r-value) of 0.57 in the medial gastrocnemius of a single subject. In the same subject, the mean r-value across all the muscle groups exceeded 0.4. The mean accuracy across all subjects and muscle group corresponded to an r-value of 0.236. As for the Signal to Noise Ratio (SNR), 79.3% of the obtained results were more than 0 dB with mean performance SNR of 0.8 (max: 2.8 to min: −1.7). The highest accuracy was obtained using a lag of 50ms with a window length (tap) of 500ms. In conclusion, this is the first study to show offline continuous decoding of the EMG envelope during over-ground walking on multiple terrains. The results show the feasibility of such neural decoding. This method could be coupled with EMG-based terrain prediction techniques to further improve the neural control interface with powered lower-limb prostheses.