motor-imagery-performance-through-embodied-digital-twins-virtual

Motor Imagery Performance Through Embodied Digital Twins in a Virtual Reality-Enabled Brain-Computer Interface Environment

This study introduces an innovative framework for neurological rehabilitation by integrating brain-computer interfaces (BCI) and virtual reality (VR) ...

Shanghai Jiao Tong University

The purpose of this study was to investigate the relationship between the three dimensional (3D) femoral head displacement in patients with developmental dysplasia of the hip (DDH) and Crowe classification.

Relations between the Crowe classification and the 3D femoral head displacement in patients with developmental dysplasia of the hip.

Benign paroxysmal positional vertigo (BPPV) is one of the most common peripheral vestibular disorders leading to balance difficulties and increased fall risks. This study aims to investigate the walking stability of BPPV patients in clinical settings and propose a machine-learning-based classification method for determining the severity of gait disturbances of BPPV.

Walking stability in patients with benign paroxysmal positional vertigo: an objective assessment using wearable accelerometers and machine learning.

Carpal tunnel syndrome is an entrapment neuropathy at the wrist characterized by compromised median nerve mobility. The purpose of this study was to investigate the effect of wrist position on median nerve longitudinal mobility in healthy subjects and the effect of radioulnar wrist compression on the median nerve mobility under non-neutral wrist positions.

The effects of wrist position and radioulnar wrist compression on median nerve longitudinal mobility.

Carpal tunnel syndrome (CTS) is the most common peripheral entrapment neuropathy, and endoscopic carpal tunnel release (ECTR) is one of the minimally invasive procedures for the treatment of CTS. Based on the shortcomings of ECTR, we designed the "Modified Soft Tissue Release Kit" to assist the endoscopic operation. This study aimed to evaluate the effectiveness and safety of endoscopic treatment of CTS using this kit.

A Retrospective Clinical Study of Endoscopic Treatment of Carpal Tunnel Syndrome using the Modified Soft Tissue Release kit.

There is a tremendous unmet medical need for osteoarthritis (OA) treatment around the world, and pharmacological management is the most common option but presents a limited and short efficacy. Insufficient drug delivery to articular cartilage is the key cause. It is widely accepted that the complex structure of articular cartilage and the rapid clearance of joint liquids largely hinder drug penetration and retention in the cartilage. To address these obstacles, we designed and prepared a positively charged micellar system that can effectively deliver a model drug to the deep zone of the cartilage and prolong the drug retention time. In this work, a triblock copolymer composed of cationic poly(,-dimethylaminoethyl methacrylate) (PDMAEMA) and poly(ε-caprolactone) (PCL), denoted as PDMAEMA-PCL-PDMAEMA, was synthesized. A triblock copolymer composed of brush poly[poly(ethylene glycol) methacrylate] (pPEGMA) and PCL, denoted as pPEGMA-PCL-pPEGMA, was prepared for comparison. The two types of triblock copolymers were self-assembled in an aqueous environment to form cationic and neutral micelles, respectively. A hydrophobic fluorescent dye as a model drug was loaded into micelle cores, and the dye-loaded micelles were evaluated for intra-cartilage penetration and retention using porcine knee cartilage explants. The PDMAEMA-PCL-PDMAEMA cationic micelles were found to significantly enhance the intra-cartilage penetration and retention capability due to the electrostatic interaction between the micelles and the negatively charged cartilage extracellular matrix. The confocal microscopy study showed that the cationic micelles could penetrate the full-thickness porcine cartilage explants (around 1.5 mm) within 24 hours. Up to 87% of the cationic micelles were taken up by porcine cartilage explants, and 71% of the absorbed micelles were retained in the tissue for at least 4 days. Although the pPEGMA-PCL-pPEGMA neutral micelles were able to penetrate the full-thickness cartilage, this type of micelle showed lower uptake (44%) and retention (44%) rates. This observation implied that the surface charge of micelles could play an important role in efficient intra-cartilage drug delivery. This study verified the feasibility and effectiveness of the PDMAEMA-PCL-PDMAEM cationic micelles in intra-cartilage drug delivery, showing that cationic micelles could be promising carriers for OA treatment.

Cationic micelles as nanocarriers for enhancing intra-cartilage drug penetration and retention.

Previous studies have demonstrated that both visual and proprioceptive feedback play vital roles in mental practice of movements. Tactile sensation has been shown to improve with peripheral sensory stimulation via imperceptible vibratory noise by stimulating the sensorimotor cortex. With both proprioception and tactile sensation sharing the same population of posterior parietal neurons encoding within high-level spatial representations, the effect of imperceptible vibratory noise on motor imagery-based brain-computer interface is unknown. The objective of this study was to investigate the effects of this sensory stimulation via imperceptible vibratory noise applied to the index fingertip in improving motor imagery-based brain-computer interface performance. Fifteen healthy adults (nine males and six females) were studied. Each subject performed three motor imagery tasks, namely drinking, grabbing, and flexion-extension of the wrist, with and without sensory stimulation while being presented a rich immersive visual scenario through a virtual reality headset. Results showed that vibratory noise increased event-related desynchronization during motor imagery compared with no vibration. Furthermore, the task classification percentage was higher with vibration when the tasks were discriminated using a machine learning algorithm. In conclusion, subthreshold random frequency vibration affected motor imagery-related event-related desynchronization and improved task classification performance.

The Effects of Subthreshold Vibratory Noise on Cortical Activity During Motor Imagery.

Deep tissue injury is a common form of pressure ulcers in muscle tissues under bony prominences caused by sustained pressure or shear, which has a great impact on patients with restricted mobility such as spinal cord injury. Frequent spasms in spinal cord injury patients featured by muscle stiffening may be one of the factors leading to deep tissue injury. The purpose of this study was to investigate the relationship between the gluteal muscle shear modulus and intramuscular compressive/shear stress/strain.

Stiffening of the gluteal muscle increased the intramuscular stress: An in-silico implication of deep tissue injury.

Moderate reactive oxygen species (ROS) at reperfusion would trigger cardioprotection and various antioxidants for pharmacological preconditioning failed to achieve cardioprotection. The causes for different roles of preischemic ROS during cardiac ischemia/reperfusion (I/R) require reevaluation. We investigated the precise role of ROS and its working model in this study. Different doses of hydrogen peroxide (HO, the most stable form of ROS) were added 5 min before ischemia using isolated perfused rat hearts, only moderate-dose HO preconditioning (HOPC) achieved contractile recovery, whereas the low dose and high dose led to injury. Similar results were observed in isolated rat cardiomyocytes on cytosolic free Ca concentration ([Ca]) overload, ROS production, the recovery of Ca transient, and cell shortening. Based on the data mentioned above, we set up a mathematics model to describe the effects of HOPC with the fitting curve by the percentage of recovery of heart function and Ca transient in I/R. Besides, we used the two models to define the initial thresholds of HOPC achieving cardioprotection. We also detected the expression of redox enzymes and Ca signaling toolkits to explain the mathematics models of HOPC in a biological way. The expression of tyrosine 705 phosphorylation of STAT3, Nuclear factor E2-related factor 2, manganese superoxide dismutase, phospholamban, catalase, ryanodine receptors, and sarcoendoplasmic reticulum calcium ATPase 2 were similar with the control I/R and low-dose HOPC but were increased in the moderate HOPC and decreased in the high-dose HOPC. Thus, we concluded that preischemic ROS are of dual role in cardiac I/R.

Hydrogen peroxide preconditioning is of dual role in cardiac ischemia/reperfusion.

Ankle sprain is a frequent type of sports injury leading to lateral ligament injury. The anterior talofibular ligament (ATFL) is a primary ligamentous stabilizer of the ankle joint and typically the most vulnerable ligament injured in a lateral ankle sprain (LAS). This study aimed to quantitively investigate the effect of the thickness and elastic modulus of ATFL on anterior ankle joint stiffness (AAJS) by developing nine subject-specific finite element (FE) models under acute injury, chronic injury, and control conditions of ATFL. A 120 N forward force was applied at the posterior calcaneus leading to an anterior translation of the calcaneus and talus to simulate the anterior drawer test (ADT). In the results, the ratio of the forward force to the talar displacement was used to assess the AAJS, which increased by 5.85% in the acute group and decreased by 19.78% in the chronic group, compared to those of the control group. An empirical equation described the relationship between AAJS, thickness, and elastic modulus (R-square 0.98). The equation proposed in this study provided an approach to quantify AAJS and revealed the effect of the thickness and the elastic modulus of ATFL on ankle stability, which may shed light on the potential diagnosis of lateral ligament injury.

The effect of thickness and elastic modulus of the anterior talofibular ligament on anterior ankle joint stiffness: A subject-specific finite element study.

: The purpose of this study was to investigate the cortical activity and digit classification performance during tactile imagery (TI) of a vibratory stimulus at the index, middle, and thumb digits within the left hand in healthy individuals. Furthermore, the cortical activities and classification performance of the compound TI were compared with similar compound motor imagery (MI) with the same digits as TI in the same subjects.  Twelve healthy right-handed adults with no history of upper limb injury, musculoskeletal condition, or neurological disorder participated in the study. The study evaluated the event-related desynchronization (ERD) response and brain-computer interface (BCI) classification performance on discriminating between the digits in the left-hand during the imagery of vibrotactile stimuli to either the index, middle, or thumb finger pads for TI and while performing a motor activity with the same digits for MI. A supervised machine learning technique was applied to discriminate between the digits within the same given limb for both imagery conditions.  Both TI and MI exhibited similar patterns of ERD in the alpha and beta bands at the index, middle, and thumb digits within the left hand. While TI had significantly lower ERD for all three digits in both bands, the classification performance of TI-based BCI (77.74 ± 6.98%) was found to be similar to the MI-based BCI (78.36 ± 5.38%).  The results of this study suggest that compound tactile imagery can be a viable alternative to MI for BCI classification. The study contributes to the growing body of evidence supporting the use of TI in BCI applications, and future research can build on this work to explore the potential of TI-based BCI for motor rehabilitation and the control of external devices.

Evaluation of EEG Oscillatory Patterns and Classification of Compound Limb Tactile Imagery.

The purpose of this study was to investigate the effects of the location of transverse carpal ligament (TCL) transection on the biomechanical property of the carpal arch structure. It was hypothesized that carpal tunnel release would lead to an increase of the carpal arch compliance (CAC) in a location-dependent manner.

A finite element analysis of the carpal arch with various locations of carpal tunnel release.

Elevated carpal tunnel pressure in carpal tunnel syndrome (CTS) patients is one of the major causes of nerve damage but cannot be measured non-invasively. This study proposed to use shear wave velocity (SWV) in the transverse carpal ligament (TCL) to measure the surrounding carpal tunnel pressure. The relationship between the carpal tunnel pressure and the SWV in the TCL was investigated through a subject-specific carpal tunnel finite element model reconstrued by MRI imaging. Parametric analysis was conducted to study the effect of TCL Young's modulus and carpal tunnel pressure on the TCL SWV. The SWV in TCL was found to be strongly dependent on the carpal tunnel pressure and TCL Young's modulus. The calculated SWV ranged from 8.0 m/s to 22.6 m/s under a combination of carpal tunnel pressure (0-200 mmHg) and TCL Young's modulus (1.1-11 MPa). An empirical equation was used to fit the relationship between the SWV in TCL and carpal tunnel pressure, with TCL Young's modulus as a confounding factor. The equation proposed in this study provided an approach to estimate carpal tunnel pressure by measuring the SWV in the TCL for a potential non-invasive diagnosis of CTS and may shed light on the mechanical nerve damage mechanism.

The relationship between shear wave velocity in transverse carpal ligament and carpal tunnel pressure: A finite element analysis.

In the past, various techniques have been used to improve motor imagery (MI), such as immersive virtual-reality (VR) and kinesthetic rehearsal. While electroencephalography (EEG) has been used to study the differences in brain activity between VR-based action observation and kinesthetic motor imagery (KMI), there has been no investigation into their combined effect. Prior research has demonstrated that VR-based action observation can enhance MI by providing both visual information and embodiment, which is the perception of oneself as part of the observed entity. Additionally, KMI has been found to produce similar brain activity to physically performing a task. Therefore, we hypothesized that utilizing VR to offer an immersive visual scenario for action observation while participants performed kinesthetic motor imagery would significantly improve cortical activity related to MI.

The effect of combining action observation in virtual reality with kinesthetic motor imagery on cortical activity.

This study aimed to assess the usability of a virtual reality-assisted sensorimotor activation (VRSMA) apparatus for individual digit rehabilitation. The study had two main objectives: Firstly, to collect preliminary data on the expectations and preferences of patients with carpal tunnel syndrome (CTS) regarding virtual reality (VR) and an apparatus-assisted therapy for their affected digits. Secondly, to evaluate the usability of the VRSMA apparatus that was developed.

Article	Year
Relations between the Crowe classification and the 3D femoral head displacement in patients with developmental dysplasia of the hip. BMC musculoskeletal disorders\| PubMed ID: 31711458	2019
Walking stability in patients with benign paroxysmal positional vertigo: an objective assessment using wearable accelerometers and machine learning. Journal of neuroengineering and rehabilitation\| PubMed ID: 33789693	2021
The effects of wrist position and radioulnar wrist compression on median nerve longitudinal mobility. Clinical biomechanics (Bristol, Avon)\| PubMed ID: 36057239	2022
A Retrospective Clinical Study of Endoscopic Treatment of Carpal Tunnel Syndrome using the Modified Soft Tissue Release kit. Orthopaedic surgery\| PubMed ID: 36414546	2023
Cationic micelles as nanocarriers for enhancing intra-cartilage drug penetration and retention. Journal of materials chemistry. B\| PubMed ID: 36621526	2023
The Effects of Subthreshold Vibratory Noise on Cortical Activity During Motor Imagery. Motor control\| PubMed ID: 36801814	2023
Stiffening of the gluteal muscle increased the intramuscular stress: An in-silico implication of deep tissue injury. Heliyon\| PubMed ID: 36816309	2023
Hydrogen peroxide preconditioning is of dual role in cardiac ischemia/reperfusion. European journal of pharmacology\| PubMed ID: 36997049	2023
The effect of thickness and elastic modulus of the anterior talofibular ligament on anterior ankle joint stiffness: A subject-specific finite element study. Frontiers in bioengineering and biotechnology\| PubMed ID: 37180042	2023
Evaluation of EEG Oscillatory Patterns and Classification of Compound Limb Tactile Imagery. Brain sciences\| PubMed ID: 37190621	2023
A finite element analysis of the carpal arch with various locations of carpal tunnel release. Frontiers in surgery\| PubMed ID: 37206350	2023
The relationship between shear wave velocity in transverse carpal ligament and carpal tunnel pressure: A finite element analysis. Medical engineering & physics\| PubMed ID: 37230698	2023
The effect of combining action observation in virtual reality with kinesthetic motor imagery on cortical activity. Frontiers in neuroscience\| PubMed ID: 37383098	2023
Feasibility and usability of a virtual-reality-based sensorimotor activation apparatus for carpal tunnel syndrome patients. PloS one\| PubMed ID: 37819927	2023

Yifei Yao

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