Why brain-controlled neuroprosthetics matter: mechanisms underlying electrical stimulation of muscles and nerves in reha
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REVIEW
BioMedical Engineering OnLine Open Access
Why brain‑controlled neuroprosthetics matter: mechanisms underlying electrical stimulation of muscles and nerves in rehabilitation Matija Milosevic1* , Cesar Marquez‑Chin2,3,4, Kei Masani2,3,4, Masayuki Hirata5, Taishin Nomura1, Milos R. Popovic2,3,4 and Kimitaka Nakazawa6 *Correspondence: [email protected]‑u.ac.jp 1 Graduate School of Engineering Science, Department of Mechanical Science and Bioengineering, Osaka University, 1‑3 Machikaneyama‑cho, Toyonaka, Osaka 560‑8531, Japan Full list of author information is available at the end of the article
Abstract Delivering short trains of electric pulses to the muscles and nerves can elicit action potentials resulting in muscle contractions. When the stimulations are sequenced to generate functional movements, such as grasping or walking, the application is referred to as functional electrical stimulation (FES). Implications of the motor and sensory recruitment of muscles using FES go beyond simple contraction of muscles. Evidence suggests that FES can induce short- and long-term neurophysiological changes in the central nervous system by varying the stimulation parameters and delivery methods. By taking advantage of this, FES has been used to restore voluntary movement in individuals with neurological injuries with a technique called FES therapy (FEST). However, long-lasting cortical re-organization (neuroplasticity) depends on the ability to synchronize the descending (voluntary) commands and the successful execu‑ tion of the intended task using a FES. Brain-computer interface (BCI) technologies offer a way to synchronize cortical commands and movements generated by FES, which can be advantageous for inducing neuroplasticity. Therefore, the aim of this review paper is to discuss the neurophysiological mechanisms of electrical stimulation of muscles and nerves and how BCI-controlled FES can be used in rehabilitation to improve motor function. Keywords: Brain-computer interface (BCI), Functional electrical stimulation (FES), FES therapy (FEST), Hebbian plasticity, Neuroplasticity, Rehabilitation
Background Electrical stimulation can be used to deliver short electric impulses to individual or groups of muscles to cause action potentials under the stimulating electrodes, consequently producing muscle twitches and limb movements. Clinical applications of electrical stimulation first appeared in the 20th century (e.g., [68, 75, 84], to name a few). With significant developments of stimulation technology and electronic circuits, safe applications of electrical stimulation of muscles can now be used to generate controlled limb © The Author(s) 2020. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third part
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