Search Results (91)

Parkinson’s disease (PD) is a progressive neurological disorder with motor and non-motor symptoms that are inadequately addressed by current pharmacological and surgical therapies. Brain–computer interfaces (BCIs), particularly those based on electroencephalography (eBCIs), provide a promising, non-invasive approach to personalized neurorehabilitation. This narrative review explores the clinical potential of BCIs in PD, discussing signal acquisition, processing, and control paradigms. eBCIs are well-suited for PD due to their portability, safety, and real-time feedback capabilities. Emerging neurophysiological biomarkers—such as beta-band synchrony, phase–amplitude coupling, and altered alpha-band activity—may support adaptive therapies, including adaptive deep brain stimulation (aDBS), as well as motor and cognitive interventions. BCIs may also aid in diagnosis and personalized treatment by detecting these cortical and subcortical patterns associated with motor and cognitive dysfunction in PD. A structured search identified 11 studies involving 64 patients with PD who used BCIs for aDBS, neurofeedback, and cognitive rehabilitation, showing improvements in motor function, cognition, and engagement. Clinical translation requires attention to electrode design and user-centered interfaces. Ethical issues, including data privacy and equitable access, remain critical challenges. As wearable technologies and artificial intelligence evolve, BCIs could shift PD care from intermittent interventions to continuous, brain-responsive therapy, potentially improving patients’ quality of life and autonomy. This review highlights BCIs as a transformative tool in PD management, although more robust clinical evidence is needed. Full article

Motor Imagery (MI) classification plays a crucial role in enhancing the performance of brain–computer interface (BCI) systems, thereby enabling advanced neurorehabilitation and the development of intuitive brain-controlled technologies. However, MI classification using electroencephalography (EEG) is hindered by spatiotemporal variability and the limited interpretability of deep learning (DL) models. To mitigate these challenges, dropout techniques are employed as regularization strategies. Nevertheless, the removal of critical EEG channels, particularly those from the sensorimotor cortex, can result in substantial spatial information loss, especially under limited training data conditions. This issue, compounded by high EEG variability in subjects with poor performance, hinders generalization and reduces the interpretability and clinical trust in MI-based BCI systems. This study proposes a novel framework integrating channel dropout—a variant of Monte Carlo dropout (MCD)—with class activation maps (CAMs) to enhance robustness and interpretability in MI classification. This integration represents a significant step forward by offering, for the first time, a dedicated solution to concurrently mitigate spatiotemporal uncertainty and provide fine-grained neurophysiologically relevant interpretability in motor imagery classification, particularly demonstrating refined spatial attention in challenging low-performing subjects. We evaluate three DL architectures (ShallowConvNet, EEGNet, TCNet Fusion) on a 52-subject MI-EEG dataset, applying channel dropout to simulate structural variability and LayerCAM to visualize spatiotemporal patterns. Results demonstrate that among the three evaluated deep learning models for MI-EEG classification, TCNet Fusion achieved the highest peak accuracy of 74.4% using 32 EEG channels. At the same time, ShallowConvNet recorded the lowest peak at 72.7%, indicating TCNet Fusion’s robustness in moderate-density montages. Incorporating MCD notably improved model consistency and classification accuracy, especially in low-performing subjects where baseline accuracies were below 70%; EEGNet and TCNet Fusion showed accuracy improvements of up to 10% compared to their non-MCD versions. Furthermore, LayerCAM visualizations enhanced with MCD transformed diffuse spatial activation patterns into more focused and interpretable topographies, aligning more closely with known motor-related brain regions and thereby boosting both interpretability and classification reliability across varying subject performance levels. Our approach offers a unified solution for uncertainty-aware, and interpretable MI classification. Full article

Motor Imagery (MI) based Brain Computer Interfaces (BCIs) have promising applications in neurorehabilitation for individuals who have lost mobility and control over parts of their body due to brain injuries, such as stroke patients. Accurately classifying MI tasks is essential for effective BCI performance, but this task remains challenging due to the complex and non-stationary nature of EEG signals. This study aims to improve the classification of left and right-hand MI tasks by utilizing high-resolution time-frequency features extracted from EEG signals, enhanced with deep learning-based data augmentation techniques. We propose a novel deep learning framework named the Generalized Wavelet Transform-based Deep Convolutional Network (GDC-Net), which integrates multiple components. First, EEG signals recorded from the C3, C4, and Cz channels are transformed into detailed time-frequency representations using the Generalized Morse Wavelet Transform (GMWT). The selected features are then expanded using a Deep Convolutional Generative Adversarial Network (DCGAN) to generate additional synthetic data and address data scarcity. Finally, the augmented feature maps data are subsequently fed into a hybrid CNN-LSTM architecture, enabling both spatial and temporal feature learning for improved classification. The proposed approach is evaluated on the BCI Competition IV dataset 2b. Experimental results showed that the mean classification accuracy and Kappa value are 89.24% and 0.784, respectively, making them the highest compared to the state-of-the-art algorithms. The integration of GMWT and DCGAN significantly enhances feature quality and model generalization, thereby improving classification performance. These findings demonstrate that GDC-Net delivers superior MI classification performance by effectively capturing high-resolution time-frequency dynamics and enhancing data diversity. This approach holds strong potential for advancing MI-based BCI applications, especially in assistive and rehabilitation technologies. Full article

The ongoing exploration of brain–computer interfaces (BCIs) provides deeper insights into the workings of the human brain. Motor imagery (MI) tasks, such as imagining movements of the tongue, left and right hands, or feet, can be identified through the analysis of electroencephalography (EEG) signals. The development of BCI systems opens up opportunities for their application in assistive devices, neurorehabilitation, and brain stimulation and brain feedback technologies, potentially helping patients to regain the ability to eat and drink without external help, move, or even speak. In this context, the accurate recognition and deciphering of a patient’s imagined intentions is critical for the development of effective BCI systems. Therefore, to distinguish motor tasks in a manner differing from the commonly used methods in this context, we propose a fractal dimension (FD)-based approach, which effectively captures the self-similarity and complexity of EEG signals. For this purpose, all four classes provided in the BCI Competition IV 2a dataset are utilized with nine different combinations of seven FD methods: Katz, Petrosian, Higuchi, box-counting, MFDFA, DFA, and correlation dimension. The resulting features are then used to train five machine learning models: linear, Gaussian, polynomial support vector machine, regression tree, and stochastic gradient descent. As a result, the proposed method obtained top-tier results, achieving 79.2% accuracy when using the Katz vs. box-counting vs. correlation dimension FD combination (KFD vs. BCFD vs. CDFD) classified by LinearSVM, thus outperforming the state-of-the-art TWSB method (achieving 79.1% accuracy). These results demonstrate that fractal dimension features can be applied to achieve higher classification accuracy for online/offline MI-BCIs, when compared to traditional methods. The application of these findings is expected to facilitate the enhancement of motor imagery brain–computer interface systems, which is a key issue faced by neuroscientists. Full article

Background: Recent advancements in machine learning (ML) have significantly influenced the analysis of brain signals, particularly electroencephalography (EEG), enhancing the detection of complex neural patterns. ML enables large-scale data processing, offering novel opportunities for diagnosing and treating mental disorders. However, challenges such as data variability, noise, and model interpretability remain significant. This study reviews the current limitations of EEG-based anxiety detection and explores the potential of advanced AI models, including transformers and VAE-D2GAN, to improve diagnostic accuracy and real-time monitoring. Methods: The paper presents the application of ML algorithms, with a focus on convolutional neural networks (CNN) and recurrent neural networks (RNN), in identifying biomarkers of anxiety disorders and predicting therapy responses. Additionally, it discusses the role of brain–computer interfaces (BCIs) in assisting individuals with disabilities by enabling device control through brain activity. Results: Experimental EEG research on BCI applications was conducted, focusing on motor imagery-based brain activity. Findings indicate that successive training sessions improve signal classification accuracy, emphasizing the need for personalized and adaptive EEG analysis methods. Challenges in BCI usability and technological constraints in EEG processing are also addressed. Conclusions: By integrating ML with EEG analysis, this study highlights the potential for future healthcare applications, including neurorehabilitation, anxiety disorder therapy, and predictive clinical models. Future research should focus on optimizing ML algorithms, enhancing personalization, and addressing ethical concerns related to patient privacy. Full article

Electroencephalography (EEG) remains an essential method for monitoring brain activity, but the limitations of conventional systems due to the complexity of installation and lack of portability have led to the introduction and development of in-ear EEG technology. In-ear EEG is an emerging method of recording electrical activity in the brain and is an innovative concept that offers multiple advantages both from the point of view of the device itself, which is easily portable, and from the user’s point of view, who is more comfortable with it, even in long-term use. One of the fundamental components of this type of device is the electrodes used to capture the EEG signal. This innovative method allows bioelectrical signals to be captured through electrodes integrated into an earpiece, offering significant advantages in terms of comfort, portability, and accessibility. Recent studies have demonstrated that in-ear EEG can record signals qualitatively comparable to scalp EEG, with an optimized signal-to-noise ratio and improved electrode stability. Furthermore, this review provides a comparative synthesis of performance parameters such as signal-to-noise ratio (SNR), common-mode rejection ratio (CMRR), signal amplitude, and comfort, highlighting the strengths and limitations of in-ear EEG systems relative to conventional scalp EEG. This study also introduces a visual model outlining the stages of technological development for in-ear EEG, from initial research to clinical and commercial deployment. Particular attention is given to current innovations in electrode materials and design strategies aimed at balancing biocompatibility, signal fidelity, and anatomical adaptability. This article analyzes the evolution of EEG in the ear, briefly presents the comparative aspects of EEG—EEG in the ear from the perspective of the electrodes used, highlighting the advantages and challenges of using this new technology. It also discusses aspects related to the electrodes used in EEG in the ear: types of electrodes used in EEG in the ear, improvement of contact impedance, and adaptability to the anatomical variability of the ear canal. A comparative analysis of electrode performance in terms of signal quality, long-term stability, and compatibility with use in daily life was also performed. The integration of intra-auricular EEG in wearable devices opens new perspectives for clinical applications, including sleep monitoring, epilepsy diagnosis, and brain–computer interfaces. This study highlights the challenges and prospects in the development of in-ear EEG electrodes, with a focus on integration into wearable devices and the use of biocompatible materials to improve durability and enhance user comfort. Despite its considerable potential, the widespread deployment of in-ear EEG faces challenges such as anatomical variability of the ear canal, optimization of ergonomics, and reduction in motion artifacts. Future research aims to improve device design for long-term monitoring, integrate advanced signal processing algorithms, and explore applications in neurorehabilitation and early diagnosis of neurodegenerative diseases. Full article

(1) Background: Brain–computer interfaces (BCIs) enable direct communication between the brain and external devices using electroencephalography (EEG) signals, offering potential applications in assistive technology and neurorehabilitation. Code-modulated visual evoked potential (cVEP)-based BCIs employ code-pattern-based stimulation to evoke neural responses, which can then be classified to infer user intent. While increasing the number of EEG electrodes across the visual cortex enhances classification accuracy, it simultaneously reduces user comfort and increases setup complexity, duration, and hardware costs. (2) Methods: This online BCI study, involving thirty-eight able-bodied participants, investigated how reducing the electrode count from 16 to 6 affected performance. Three experimental conditions were tested: a baseline 16-electrode configuration, a reduced 6-electrode setup without retraining, and a reduced 6-electrode setup with retraining. (3) Results: Our results indicate that, on average, performance declines with fewer electrodes; nonetheless, retraining restored near-baseline mean Information Transfer Rate (ITR) and accuracy for those participants for whom the system remained functional. The results reveal that for a substantial number of participants, the classification pipeline fails after electrode removal, highlighting individual differences in the cVEP response characteristics or inherent limitations of the classification approach. (4) Conclusions: Ultimately, this suggests that minimal cVEP-BCI electrode setups capable of reliably functioning across all users might only be feasible through other, more flexible classification methods that can account for individual differences. These findings aim to serve as a guideline for what is currently achievable with this common cVEP paradigm and to highlight where future research should focus in order to move closer to a practical and user-friendly system. Full article

Sensor technology plays a fundamental role in neuro-motor rehabilitation by enabling precise movement analysis and control. This study explores the integration of brain–machine interfaces (BMIs) and wearable sensors to enhance motor recovery in individuals with neuro-motor impairments. Specifically, different time-frequency transforms are evaluated to analyze the correlation between electroencephalographic (EEG) activity and ankle position, measured by using inertial measurement units (IMUs). A low-cost ankle exoskeleton was designed to conduct the experimental trials. Six subjects performed plantar and dorsal flexion movements while the EEG and IMU signals were recorded. The correlation between brain activity and foot kinematics was analyzed using the Short-Time Fourier Transform (STFT), Stockwell (ST), Hilbert–Huang (HHT), and Chirplet (CT) methods. The 8–20 Hz frequency band exhibited the highest correlation values. For motor imagery classification, the STFT achieved the highest accuracy (92.9%) using an EEGNet-based classifier and a state-machine approach. This study presents a dual approach: the analysis of EEG-movement correlation in different cognitive states, and the systematic comparison of four time-frequency transforms for both correlation and classification performance. The results support the potential of combining EEG and IMU data for BMI applications and highlight the importance of cognitive state in motion analysis for accessible neurorehabilitation technologies. Full article

Background: Gait and balance alterations in post-stroke patients are one of the most disabling symptoms that can persist in chronic stages of the disease. In this context, rehabilitation has the fundamental role of promoting functional recovery, mitigating gait and balance deficits, and preventing falling risk. Robotic end-effector devices, like the G-EO system (e.g., G-EO system, Reha Technology, Olten, Switzerland), can be a useful device to promote gait recovery in patients with chronic stroke. Materials and Methods: Twelve chronic stroke patients were enrolled and evaluated at baseline (T0) and at post-treatment (T1). These patients received forty sessions of robotic gait training (RGT) with the G-EO system (experimental group, EG), for eight weeks consecutively, in addition to standard rehabilitation therapy. The data of these subjects were compared with those coming from a sample of twelve individuals (control group, CG) matched for clinical and demographic features who underwent the same amount of conventional gait training (CGT), in addition to standard rehabilitation therapy. Results: All patients completed the trial, and none reported any side effects either during or following the training. The EG showed significant improvements in balance (p = 0.012) and gait (p = 0.004) functions measured with the Tinetti Scale (TS) after RGT. Both groups (EG and CG) showed significant improvement in functional independence (FIM, p < 0.001). The Fugl-Meyer Assessment—Lower Extremity (FMA-LE) showed significant improvements in motor function (p = 0.001, p = 0.031) and passive range of motion (p = 0.031) in EG. In EG, gait and balance improvements were influenced by session, age, gender, time since injury (TSI), cadence, and velocity (p < 0.05), while CG showed fewer significant effects, mainly for age, TSI, and session. EG showed significantly greater improvements than CG in balance (p = 0.003) and gait (p = 0.05) based on the TS. Conclusions: RGT with end-effectors, like the G-EO system, can be a valuable complementary treatment in neurorehabilitation, even for chronic stroke patients. Our findings suggest that RGT may improve gait, balance, and lower limb motor functions, enhancing motor control and coordination. Full article

Background: This study performed an evaluation of technology acceptance of the therapeutic system E-BRAiN (Evidence-Based Robot Assistance in Neurorehabilitation) by stroke survivors receiving therapy with the system. Methods: The evaluation was based on a 49-item questionnaire addressing technology acceptance (I) with its constituents, i.e., perceived usefulness, perceived ease of use, perceived adaptability, perceived enjoyment, attitude, trust, anxiety, social influence, perceived sociability, and social presence (41 items), and (II) more general items exploring user experience in terms of both technology acceptance (3 items) and usability (5 open-question items). Results: Eleven consecutive sub-acute stroke survivors who had received either arm rehabilitation sessions (n = 5) or neglect therapy (n = 6) led by a humanoid robot participated. The multidimensional “strength of acceptance” summary statistic (Part I) indicates a high degree of technology acceptance (mean, 4.0; 95% CI, 3.7 to 4.3), as does the “general acceptance” summary statistic (mean, 4.1; 95% CI, 3.3 to 4.9) (art II) (scores ranging from 1, lowest degree of acceptance, to 5, highest degree of acceptance, with a score of 3 as neutral experience anchor). Positive ratings were also documented for all assessed constituents (Part I), as well as the perception that it makes sense to use the robot technology for stroke therapy and as a supplement for users’ own therapy (Part II). Conclusions: A high degree of technology acceptance and its constituents, i.e., perceived functionality and social behaviour of the humanoid robot and own emotions while using the system, could be corroborated among stroke survivors who used the therapeutic system E-BRAiN. Full article

(1) Background. Eye movement abnormalities are increasingly recognized as early biomarkers of Parkinson’s disease (PD), reflecting both motor and cognitive dysfunction. Advances in eye-tracking technology provide objective, quantifiable measures of saccadic impairments, fixation instability, smooth pursuit deficits, and pupillary changes. These advances offer new opportunities for early diagnosis, disease monitoring, and neurorehabilitation. (2) Objective. This narrative review explores the relationship between oculomotor dysfunction and PD pathophysiology, highlighting the potential applications of eye tracking in clinical and research settings. (3) Methods. A comprehensive literature review was conducted, focusing on peer-reviewed studies examining eye movement dysfunction in PD. Relevant publications were identified through PubMed, Scopus, and Web of Science, using key terms, such as “eye movements in Parkinson’s disease”, “saccadic control and neurodegeneration”, “fixation instability in PD”, and “eye-tracking for cognitive assessment”. Studies integrating machine learning (ML) models and VR-based interventions were also included. (4) Results. Patients with PD exhibit distinct saccadic abnormalities, including hypometric saccades, prolonged saccadic latency, and increased anti-saccade errors. These impairments correlate with executive dysfunction and disease progression. Fixation instability and altered pupillary responses further support the role of oculomotor metrics as non-invasive biomarkers. Emerging AI-driven eye-tracking models show promise for automated PD diagnosis and progression tracking. (5) Conclusions. Eye tracking provides a reliable, cost-effective tool for early PD detection, cognitive assessment, and rehabilitation. Future research should focus on standardizing clinical protocols, validating predictive AI models, and integrating eye tracking into multimodal treatment strategies. Full article

Background/Objectives: Guided imagery techniques, which include mentally picturing motions or activities to help motor recovery, are an important part of neuroplasticity-based motor therapy in stroke patients. Motor imagery (MI) is a kind of guided imagery in neurorehabilitation that focuses on mentally rehearsing certain motor actions in order to improve performance. This systematic review aims to evaluate the current evidence on guided imagery techniques and identify their therapeutic potential in stroke motor rehabilitation. Methods: Randomized controlled trials (RCTs) published in the English language were identified from an online search of PubMed, Web of Science, Embase, EBSCOhost, and Scopus databases without a specific search time frame. The inclusion criteria take into account guided imagery interventions and evaluate their impact on motor recovery through validated clinical, neurophysiological, or functional assessments. This review has been registered on Open OSF with the following number: DOI 10.17605/OSF.IO/3D7MF. Results: This review synthesized 41 RCTs on MI in stroke rehabilitation, with 996 participants in the intervention group and 757 in the control group (average age 50–70, 35% female). MI showed advantages for gait, balance, and upper limb function; however, the RoB 2 evaluation revealed ‘some concerns’ related to allocation concealment, blinding, and selective reporting issues. Integrating MI with gait training or action observation (AO) seems to improve motor recovery, especially in balance and walking. Technological methods like brain–computer interfaces (BCIs) and hybrid models that combine MI with circuit training hold potential for enhancing functional mobility and motor results. Conclusions: Guided imagery shows promise as a beneficial adjunct in stroke rehabilitation, with the potential to improve motor recovery across several domains such as gait, upper limb function, and balance. Full article

This case report explores the innovative integration of robotic and biomechatronic technologies, including the Motore and Ultra+ devices and neuro-suits, in a 10-session rehabilitation program for a young adult with dystonic spastic tetraparesis. Notable improvements were observed in upper limb motor function, coordination, and quality of life as measured by an increase of 18 pints on the Fugl-Meyer scale and a 25% improvement in the Bartle Index. Range of motion measurements showed consistent improvements, with task execution times improving by 10 s. These findings suggest the potential of combining wearable, robotic, and biomechatronic systems to enhance neurorehabilitation. Further refinement of these technologies might support clinicians in maximizing their integration in therapeutics, despite technical issues like synchronization issues that must be overcome. Full article

Enhancing motor disability assessment and its imagery classification is a significant concern in contemporary medical practice, necessitating reliable solutions to improve patient outcomes. One promising avenue is the use of brain–computer interfaces (BCIs), which establish a direct communication pathway between users and machines. This technology holds the potential to revolutionize human–machine interaction, especially for individuals diagnosed with motor disabilities. Despite this promise, extracting reliable control signals from noisy brain data remains a critical challenge. In this paper, we introduce a novel approach leveraging the collaborative synergy of five convolutional neural network (CNN) models to improve the classification accuracy of motor imagery tasks, which are essential components of BCI systems. Our method demonstrates exceptional performance, achieving an accuracy of 79.44% on the BCI Competition IV 2a dataset, surpassing existing state-of-the-art techniques in using multiple CNN models. This advancement offers significant promise for enhancing the efficacy and versatility of BCIs in a wide range of real-world applications, from assistive technologies to neurorehabilitation, thereby providing robust solutions for individuals with motor disabilities. Full article

In recent years, extended reality (XR) and telerehabilitation (TR) technologies have increasingly been used in the neurorehabilitation of motor dysfunctions in patients with cerebral palsy (CP). The Khymeia Virtual Reality Rehabilitation System (K-VRRS) is a medical device specifically designed for neuromotor rehabilitation, and it can also be used in TR mode. This pilot study aims to evaluate the effectiveness and adherence to a “two-step neuromotor program” (TS-NP) approach using K-VRRS to enhance upper limb motor functions in children with CP. The TS-NP protocol consists of two phases. In the first phase, patients undergo intensive motor training with K-VRRS during a period of hospitalization. In the second phase, initiated after discharge, patients continue K-VRRS treatment at home through TR, building upon the progress made during their hospital stay. A total of seven children with unilateral spastic CP (ages 4–10 years) were assessed at three time points: baseline (T0), after the first phase of in-person hospital treatment (T1), and following the second phase of TR treatment at home (T2). Standardized outcome measures were used, with the primary measure being the Melbourne Assessment 2. Preliminary data support the hypothesis that intensive K-VRRS treatment during hospitalization enhances motor function in the affected upper limb of children with CP. Furthermore, continuing K-VRRS treatment at home through TR appears crucial for maintaining the motor gains achieved during the hospital phase. Full article