Application of BCI systems in neurorehabilitation: a scoping review

Purpose: To review various types of electroencephalographic activities of the brain and present an overview of brain–computer interface (BCI) systems’ history and their applications in rehabilitation. Methods: A scoping review of published English literature on BCI application in the field of rehabilitation was undertaken. IEEE Xplore, ScienceDirect, Google Scholar and Scopus databases were searched since inception up to August 2012. All experimental studies published in English and discussed complete cycle of the BCI process was included in the review. Results and discussion: In total, 90 articles met the inclusion criteria and were reviewed. Various approaches that improve the accuracy and performance of BCI systems were discussed. Based on BCI’s clinical application, reviewed articles were categorized into three groups: motion rehabilitation, speech rehabilitation and virtual reality control (VRC). Almost half of the reviewed papers (48%) concentrated on VRC. Speech rehabilitation and motion rehabilitation made up 33% and 19% of the reviewed papers, respectively. Among different types of electroencephalography signals, P300, steady state visual evoked potentials and motor imagery signals were the most common. Conclusions: This review discussed various applications of BCI in rehabilitation and showed how BCI can be used to improve the quality of life for people with neurological disabilities. It will develop and promote new models of communication and finally, will create an accurate, reliable, online communication between human brain and computer and reduces the negative effects of external stimuli on BCI performance.

• Implications for Rehabilitation

• The field of brain–computer interfaces (BCI) is rapidly advancing and it is expected to fulfill a critical role in rehabilitation of neurological disorders and in movement restoration in the forthcoming years.

• In the near future, BCI has notable potential to become a major tool used by people with disabilities to control locomotion and communicate with surrounding environment and, consequently, improve the quality of life for many affected persons.

• Electrical field recording at the scalp (i.e. electroencephalography) is the most likely method to be of practical value for clinical use as it is simple and non-invasive. However, some aspects need future improvements, such as the ability to separate close imagery signal (motion of extremities and phalanges that are close together).

     

Functional assessment of executive abilities following traumatic brain injury

Primary objective: The Test of Functional Executive Abilities (TOFEA) is a measure of real-world planning/problem-solving abilities. The present study sought to identify the relationship between the TOFEA and traditional executive measures.

Design: Correlational and principal components factor analyses were conducted using the TOFEA and traditional neuropsychological executive measures.

Methods: Participants were 340 patients with traumatic brain injury. All participants underwent neuropsychological and speech-language assessments.

Results: Factor analysis of the TOFEA yielded a two-factor solution, planning/initiation and awareness/ comprehension. Correlational analysis between the TOFEA and traditional measures demonstrated only a weak relationship. Factor analysis indicated a four factor executive solution with the TOFEA loading on the third planning/initiation and reasoning factor.

Conclusions: The data support the notion that there is no one single measure of frontal-executive functioning, but rather these tests represent different executive components and, as such, more than one measure should be used in a comprehensive assessment.     

Midterm outcomes of penetrating keratoplasty after cultivated oral mucosal epithelial transplantation in chemical burn

Purpose

To evaluate the midterm outcomes of penetrating keratoplasty (PKP) after cultivated oral mucosal epithelial transplantation (COMET) in patients with bilateral total limbal stem cell deficiency (LSCD) due to chemical burn.

Acute morphine administration reduces white blood cells' capability to induce innate resistance against HSV-1 infection in BALB/c mice

OBJECTIVE: It has been reported that acute morphine administration modulates innate immune response to herpes simplex virus 1 (HSV-1) infection. In this study, the effect of acute morphine on innate resistance and its probable mechanisms in increasing the mortality rate during HSV-1 infection were investigated. METHODS: Mice were infected with HSV-1 24 h prior to different doses of morphine or saline administration and the mortality rate was recorded. Spleen cells were obtained from morphine- or saline-treated mice, then natural killer (NK) cell activity and interferon-gamma (IFN-gamma) production were evaluated. The effect of morphine on white blood cells' capacity to induce protection against HSV-1 infection was evaluated by adoptive transfer of spleen cells to cyclophosphamide-treated mice that were previously infected with HSV-1. Furthermore, in a separate experiment, a different group of mice received corticosterone 24 h after HSV-1 infection. RESULTS: Mortality rate in high-dose acute morphine-treated mice increased significantly compared to saline-treated mice (p = 0.035). NK cell cytotoxicity and IFN-gamma mRNA levels also showed a significant reduction compared to those of control groups (p < 0.001 and p = 0.014, respectively). Corticosterone administration reduces innate resistance against HSV-1 infection compared to saline-treated mice (p = 0.044). Furthermore, adoptive transfer of normal but not morphine-treated spleen cells induces resistance against HSV infection in cyclophosphamide-injected mice (p = 0.009). CONCLUSIONS: The current study shows that acute morphine administration reduces white blood cells' capability to induce protection against HSV-1 infection via suppression of IFN-gamma production and NK cells activity. This may be due to the increase in corticosteroids. Further studies are needed to test the effect of acute morphine on other immune cells.     

MUC1* is a determinant of trastuzumab (Herceptin) resistance in breast cancer cells

In the United States, 211,000 women are diagnosed each year with breast cancer. Of the 42,000 breast cancer patients who overexpress the HER2 growth factor receptor, <35% are responsive to treatment with the HER2-disabling antibody, called trastuzumab (Herceptin). Despite those statistics, women diagnosed with breast cancer are now tested to determine how much of this important growth factor receptor is present in their tumor because patients whose treatment includes trastuzumab are three-times more likely to survive for at least 5 years and are two-times more likely to survive without a cancer recurrence. Unfortunately, even among the group whose cancers originally respond to trastuzumab, 25% of the metastatic breast cancer patients acquire resistance to trastuzumab within the first year of treatment. Follow-on “salvage” therapies have prolonged life for this group but have not been curative. Thus, it is critically important to understand the mechanisms of trastuzumab resistance and develop therapies that reverse or prevent it. Here, we report that molecular analysis of a cancer cell line that was induced to acquire trastuzumab resistance showed a dramatic increase in the amount of the cleaved form of the MUC1 protein, called MUC1*. We recently reported that MUC1* functions as a growth factor receptor on cancer cells and on embryonic stem cells. Here, we show that treating trastuzumab-resistant cancer cells with a combination of MUC1* antagonists and trastuzumab, reverses the drug resistance. Further, HER2-positive cancer cells that are intrinsically resistant to trastuzumab became trastuzumab-sensitive when treated with MUC1* antagonists and trastuzumab. Additionally, we found that tumor cells that had acquired Herceptin resistance had also acquired resistance to standard chemotherapy agents like Taxol, Doxorubicin, and Cyclophosphamide. Acquired resistance to these standard chemotherapy drugs was also reversed by combined treatment with the original drug plus a MUC1* inhibitor.     

Drosophila melanogaster p-glycoprotein: a membrane detoxification system toward polycyclic aromatic hydrocarbon pollutants

Polycyclic aromatic hydrocarbons (PAHs) are well-known ubiquitous environmental contaminants. Permeability glycoprotein (P-gp) is a transmembrane detoxification efflux pump transporting various lipophilic xenobiotics, such as PAHs, out of the cells. The existence of a P-gp detoxification system inducible by PAHs was investigated in Drosophila melanogaster. Western blot experiments showed that D. melanogaster expressed a 140-kDa P-gp in S12 cells, embryos, and adult flies. Permeability glycoprotein was expressed in adult flies in the head, abdomen, and thorax and sublocalized in the sexual and olfactory organs. Flow cytometry experiments using Drosophila S12 cells in the presence of PAHs and target P-gp drug compounds revealed that Drosophila P-gp acted as an efflux detoxification pump. In Drosophila exposed to benzo[a]pyrene or to ambient air polluted by higher or lower PAH concentrations, P-gp expression was clearly showed a dose-dependent increase response. The P-gp induction was detected both in adult flies and in different fly parts, such as the head, thorax, and antennae. Drosophila P-gp acts as a membrane barrier against PAH pollutants.