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JNER: Increased motor cortical activation during grasping by novel robotic mirror hand therapy, a pilot fNIRS study

 Last Update: 2022-04-24
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Stroke patients tend to lose motor function, and more than 70% of them have upper limbs affected
.

In particular, hand function was the most affected and the least responsive to standard-of-care therapy

Stroke patients tend to lose motor function, and more than 70% of them have upper limbs affected

Wearable robotics can assist people with paralysis and other movement disorders with limb locomotion, and the use of wearable robotics has expanded into rehabilitation therapy for various functional tasks

In this paper, the neural effects of machine translation, robotic therapy (RT), and RMT in repetitive squeezing movements are analyzed

Here, functional near-infrared spectroscopy (fNIRS) was used to analyze the activation of bilateral motor cortex during task performance in 9 healthy subjects and 5 chronic stroke survivors under conditions of MT, RT, and RMT
.

In the MT state, the patient moves the unaffected hand and looks in the mirror, while the affected hand remains stationary

Design Overview of Soft Robotic Gloves

Change the resistance according to the amount of bending
.

Bend sensors are placed on the back of the joints to measure the joint angles of the fingers and thumb

Change the resistance according to the amount of bending

Sensor Glove Overview and Bend Sensor Location

Experiments in each condition were arranged in a block design paradigm
.

Each 30-second block consisted of 20 crush trials

Experiments in each condition were arranged in a block design paradigm

For both groups, mean cortical activation was greatest on the contralateral side of the motor cortex on the affected side (non-dominant in the healthy group) in the RMT condition compared to the other conditions

The joint angles measured by the sensor glove and the angular displacement of the motor driving the soft robotic glove during experiments under RMT conditions

RMT induced the strongest activation of the contralateral channel
.

In particular, on the contralateral side of the RMT, this is the area known to be responsible for hand movement
.
MT induced activation on both sides, but stronger activation in the ipsilateral hemisphere for the robotic glove, which was the opposite of the hand performing the pressing action
.
RT showed primary activation in the contralateral hemisphere, but its magnitude was smaller than that of RMT
.
Activation of the contralateral cerebral hemisphere was significantly enhanced in stroke survivors in the RMT state compared to the RT state, although both states involved robotic glove-moving hands
.
Specifically, RMT induced greater activation in the contralateral primary motor cortex and contralateral somatosensory cortex compared to RT
.
This effect was not observed in the healthy group
.
As expected, motor cortical activation was greater in the ipsilateral hemisphere of the RMT robotic glove in the stroke and healthy groups compared to RT due to the presence of contralateral hand torque
.
The activation of the contralateral primary motor cortex in the healthy group was significantly higher in the RMT condition than in the MT condition, while the magnitude of the activation in the contralateral was higher than that in the MT in the RT stroke group, but did not reach significance at the group level (0.
1

RMT induced the strongest activation of the contralateral channel
.
In particular, on the contralateral side of the RMT, this is the area known to be responsible for hand movement
.
MT induced activation on both sides, but stronger activation in the ipsilateral hemisphere for the robotic glove, which was the opposite of the hand performing the pressing action
.
RT showed primary activation in the contralateral hemisphere, but its magnitude was smaller than that of RMT
.
Activation of the contralateral cerebral hemisphere was significantly enhanced in stroke survivors in the RMT state compared to the RT state, although both states involved robotic glove-moving hands
.
Specifically, RMT induced greater activation in the contralateral primary motor cortex and contralateral somatosensory cortex compared to RT
.
This effect was not observed in the healthy group
.
As expected, motor cortical activation was greater in the ipsilateral hemisphere of the RMT robotic glove in the stroke and healthy groups compared to RT due to the presence of contralateral hand torque
.
Activation of the contralateral primary motor cortex in the healthy group was significantly higher in the RMT condition than in the MT condition, while the magnitude of the activation in the contralateral was higher than that in the MT in the RT stroke group, but did not reach significance at the group level (0.
1in the healthy group).
This effect was not observed
.
As expected, motor cortical activation was greater in the ipsilateral hemisphere of the RMT robotic glove in the stroke and healthy groups compared to RT due to the presence of contralateral hand torque
.
The healthy group had greater motor cortical activation under RMT conditions.
Activation in the lateral primary motor cortex was significantly higher than in the MT condition, whereas the magnitude of activation in the contralateral was higher than that in the MT in the RT stroke group, but did not reach significance at the group level (0.
1stroke ).

Neural effects of MT, RT, and RMT opponents were analyzed by cortical activation measured by fNIRS
.
RMT is enabled by a proposed hand rehabilitation system that assists the affected hand (the dominant hand in healthy subjects) with a soft robotic glove based on the motion of the unaffected hand (the non-dominant hand in healthy subjects) measured by the sensor glove ) of 4 degrees of freedom motion
.
Compared with MT and RT, RMT induced greater activation in the contralateral motor cortex of the affected hand
.
Through comparisons between test groups, significantly higher activation of the contralateral primary motor cortex was observed in stroke subjects than in healthy subjects under RMT conditions alone, which may indicate a combination of exercise intensity, visual feedback, and somatosensory feedback Important for inducing greater activation of the motor cortex after stroke
.
Compared with MT and RT, RMT induced greater activation in the contralateral motor cortex of the affected hand
.
Through comparisons between test groups, significantly higher activation of the contralateral primary motor cortex was observed in stroke subjects than in healthy subjects under RMT conditions alone, which may indicate a combination of exercise intensity, visual feedback, and somatosensory feedback Important for inducing greater activation of the motor cortex after stroke
.

Experimental results suggest that a combination of visual feedback, somatosensory feedback, and motor intent is important to generate greater stimulation of the contralateral motor cortex of the affected hand
.

Kim, DH, Lee, KD.
, Bulea, TC et al.
Increasing motor cortex activation during grasping via novel robotic mirror hand therapy: a pilot fNIRS study.
J NeuroEngineering Rehabil 19, 8 (2022).
https://doi.
org /10.
1186/s12984-022-00988-7 et al.
Increasing motor cortex activation during grasping via novel robotic mirror hand therapy: a pilot fNIRS study.
J NeuroEngineering Rehabil 19, leave a comment here

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