Neurorehabilitation for stroke is important for upper limb motor recovery. Conventional rehabilitation such as occupational therapy has been used, but novel technologies are expected to open new opportunities for better recovery. Virtual reality (VR) is a technology with a set of informatics that provides interactive environments to patients. VR can enhance neuroplasticity and recovery after a stroke by providing more intensive, repetitive, and engaging training due to several advantages, including: (1) tasks with various difficulty levels for rehabilitation, (2) augmented real-time feedback, (3) more immersive and engaging experiences, (4) more standardized rehabilitation, and (5) safe simulation of real-world activities of daily living. In this comprehensive narrative review of the application of VR in motor rehabilitation after stroke, mainly for the upper limbs, we cover: (1) the technologies used in VR rehabilitation, including sensors; (2) the clinical application of and evidence for VR in stroke rehabilitation; and (3) considerations for VR application in stroke rehabilitation. Meta-analyses for upper limb VR rehabilitation after stroke were identified by an online search of Ovid-MEDLINE, Ovid-EMBASE, the Cochrane Library, and KoreaMed. We expect that this review will provide insights into successful clinical applications or trials of VR for motor rehabilitation after stroke.

We provide an open access multimodal brain-imaging dataset of simultaneous electroencephalography (EEG) and near-infrared spectroscopy (NIRS) recordings. Twenty-six healthy participants performed three cognitive tasks: 1) n-back (0-, 2- and 3-back), 2) discrimination/selection response task (DSR) and 3) word generation (WG) tasks. The data provided includes: 1) measured data, 2) demographic data, and 3) basic analysis results. For n-back (dataset A) and DSR tasks (dataset B), event-related potential (ERP) analysis was performed, and spatiotemporal characteristics and classification results for ‘target’ versus ‘non-target’ (dataset A) and symbol ‘O’ versus symbol ‘X’ (dataset B) are provided. Time-frequency analysis was performed to show the EEG spectral power to differentiate the task-relevant activations. Spatiotemporal characteristics of hemodynamic responses are also shown. For the WG task (dataset C), the EEG spectral power and spatiotemporal characteristics of hemodynamic responses are analyzed, and the potential merit of hybrid EEG-NIRS BCIs was validated with respect to classification accuracy. We expect that the dataset provided will facilitate performance evaluation and comparison of many neuroimaging analysis techniques.

Most event-related potential (ERP)-based braincomputer interface (BCI) spellers primarily use matrix layouts, and generally require moderate eye movement for successful operation. The fundamental objective of this study is to enhance the perceptibility of target characters by introducing motion stimuli to classical rapid serial visual presentation (RSVP) spellers that do not require any eye movement, thereby applying them to paralyzed patients with oculomotor dysfunctions. To test the feasibility of the proposed motion-based RSVP paradigm, we implemented three RSVP spellers: i) fixed-direction motion (FM-RSVP), ii) random-direction motion (RM-RSVP), and iii) (the conventional) non-motion stimulation (NM-RSVP), and evaluated the effect of the three different stimulation methods on spelling performance. The two motion-based stimulation methods, FM- and RM-RSVP, showed shorter P300 latency and higher P300 amplitudes (i. e., 360.4-379.6 ms; 5.5867-5.7662 mV) than the NM-RSVP (i. e., 480.4 ms; 4.7426 mV). This led to higher and more stable performances for FM- and RMRSVP spellers than NM-RSVP speller (i. e., 79.06±6.45% for NM-RSVP, 90.60±2.98% for RM-RSVP, and 92.74±2.55% for FM-RSVP). In particular, the proposed motion-based RSVP paradigm was significantly beneficial for about half of the subjects who might not accurately perceive rapidly presented static stimuli. These results indicate that the use of proposed motion-based RSVP paradigm is more beneficial for target recognition when developing BCI applications for severely paralyzed patients with complex ocular dysfunctions.

The accurate discrimination between bipolar disorder (BD) and schizophrenic patients is crucial because of the considerable overlap between their clinical signs and symptoms (e.g., hallucination and delusion). Recently, electroencephalograms (EEGs) measured in the resting state have been vastly analyzed as a means for classifying the BD and schizophrenic patients, but EEGs evoked by external audio/visual stimuli have been rarely investigated, despite their high signal-to-noise ratio (SNR). In this study, in order to investigate whether EEGs evoked by external stimuli can be used for classifying the BD and schizophrenic patients, we used a visual stimulus modulated at a specific frequency to induce steady-state visual evoked potential (SSVEP). In the experiment, a photic stimulation modulated at 16 Hz was presented to two groups of the schizophrenic and BD patients for 95 s, during which the EEG data were recorded. Statistical measures of SSVEPs (mean, skewness, and kurtosis) described in SNR units were extracted as features to characterize and classify the variations of brain activity patterns in the two groups. Two brain areas, O1 and Fz, showed a statistically significant difference between the two groups for SNR mean and kurtosis, respectively. Among five applied classifiers, k -nearest neighbor provided the highest classification accuracy of 91.30% with the best feature set selected by Fisher score. An acceptable accuracy for binary classification (>70%) was retained until analysis time was reduced up to 10 s using a support vector machine classifier, and 20 s for other classifiers. Our results demonstrate the potential applicability of the proposed SSVEP-based classification approach with relatively short single-trial EEG signals.

In recent years, machine learning techniques have been frequently applied to uncovering neuropsychiatric biomarkers with the aim of accurately diagnosing neuropsychiatric diseases and predicting treatment prognosis. However, many studies did not perform cross validation (CV) when using machine learning techniques, or others performed CV in an incorrect manner, leading to significantly biased results due to overfitting problem. The aim of this study is to investigate the impact of CV on the prediction performance of neuropsychiatric biomarkers, in particular, for feature selection performed with high-dimensional features. To this end, we evaluated prediction performances using both simulation data and actual electroencephalography (EEG) data. The overall prediction accuracies of the feature selection method performed outside of CV were considerably higher than those of the feature selection method performed within CV for both the simulation and actual EEG data. The differences between the prediction accuracies of the two feature selection approaches can be thought of as the amount of overfitting due to selection bias. Our results indicate the importance of correctly using CV to avoid biased results of prediction performance of neuropsychiatric biomarkers.

There are some practical factors, such as arm position change and donning/doffing, which prevent robust myoelectric control. The objective of this study is to precisely characterize the impacts of the two representative factors on myoelectric controllability in practical control situations, thereby providing useful references that can be potentially used to find better solutions for clinically reliable myoelectric control. To this end, a real-time target acquisition task was performed by fourteen subjects including one individual with congenital upper-limb deficiency, where the impacts of arm position change, donning/doffing and a combination of both factors on control performance was systematically evaluated. The changes in online performance were examined with seven different performance metrics to comprehensively evaluate various aspects of myoelectric controllability. As a result, arm position change significantly affects offline prediction accuracy, but not online control performance due to real-time feedback, thereby showing no significant correlation between offline and online performance. Donning/doffing was still problematic in online control conditions. It was further observed that no benefit was attained when using a control model trained with multiple position data in terms of arm position change, and the degree of electrode shift caused by donning/doffing was not severely associated with the degree of performance loss under practical conditions (around 1 cm electrode shift). Since this study is the first to concurrently investigate the impacts of arm position change and donning/doffing in practical myoelectric control situations, all findings of this study provide new insights into robust myoelectric control with respect to arm position change and donning/doffing.