To assess the feasibility of estimating lateralization and localization of the epileptogenic zone (EZ) in temporal and extratemporal lobe epilepsy by combining Electric Source Imaging (ESI) with functional connectivity analysis of high-density EEG from the preictal to the ictal phase. Adults with drug-resistant focal epilepsy and at least one recorded seizure during 40- or 64 channels EEG monitoring were retrospectively included. Granger causality and hubness centrality were computed over the 10-s preictal interval and the first 5 s of the ictal period, with ictal onset defined as the first EEG change identified by experienced epileptologists. The reference standard for EZ localization was based on resective surgical outcome or stereo-EEG findings. Thirteen patients (7 females; median age 35 years) were included. Connectivity analyses showed higher concordance with clinical findings during the preictal phase than during the ictal phase for both lateralization (91% vs 46%) and localization (73% vs 27%). Performance was highest in temporal (7/7 lateralization; 6/7 localization) and frontal lobe epilepsy (2/2 for both), and lower in parieto-occipital epilepsy (1/2 and 0/2, respectively). In two cases with poor surgical outcome or no surgical indication, connectivity findings were discordant with clinical estimates. Connectivity analysis across the preictal to ictal transition provides relevant lateralizing and localizing information, particularly in temporal and frontal lobe epilepsy, and may reveal clinically meaningful discordance. Integrating high-density EEG, ESI, and functional connectivity during the phase preceding the first EEG change may support non-invasive presurgical evaluation.

Purpose: Reinforcement learning with reversal is a paradigm frequently employed in neuropsychology to assess the adaptive capacity and flexibility in individuals in non-stationary environments. Each single behavior, however, depends on the superimposition of multiple factors, which are still not completely understood. Methods: We optimize a neurocomputational model of the Basal Ganglia to simulate the behavior of 18 patients with Parkinson’s disease (both ON and OFF medication) and 14 control subjects during a two-choice probabilistic reversal learning task (with 80–20% reward probabilities). The individual behavior (in terms of the cumulative number of correct responses during a 40-trials direct phase and a 40-trial reversal phase) is reproduced by fitting a few model parameters for each individual, representing the tonic dopamine level, Hebbian learning, and the exploratory attitude (noise level). Results: Results show that very different responses can be explained quite well, ascribing them to the varying combination of the aforementioned individual factors. The tonic dopamine level is significantly different for patients in ON and OFF medication, while the other parameters were not statistically different. A regression analysis reveals that the value of the Hebbian learning rate is correlated with the subject's sensitivity to punishments. In contrast, the noise standard deviation is correlated with exploration, i.e., the tendency to modify the choice even after a reward. Conclusion: The results provide a mechanistic explanation of the various factors that affect adaptation and flexibility in reinforcement learning, representing a first step toward characterizing and understanding the diverse behaviors on an individual basis.

Background: Developing Brain–Computer Interfaces (BCIs) for children with severe neuromotor disabilities remains challenging due to developmental neurophysiology and the high cognitive demands of motor imagery. Hybrid BCIs integrating electroencephalography (EEG) and electrooculography (EOG) can overcome these limitations by combining continuous motor-related control with reliable discrete commands. This multiple-case study investigated the feasibility of a hybrid EEG–EOG BCI integrated with a virtual reality (VR) powered wheelchair simulator for mobility training. Methods: Six participants (mean age: 13.00 ± 3.52 years; 1 female, 5 males) with severe neuromotor disabilities (i.e., Central Core Myopathy, LAMA2 related Congenital Muscular Dystrophy, Spinal Muscular Atrophy Type II, and Cerebral Palsy) completed repeated sessions using a self-paced BCI. The system combined continuous kinesthetic motor imagery (KMI) for steering and EOG-detected voluntary blinks for discrete commands. We evaluated online classification performance (accuracy, sensitivity, specificity), user workload (NASA-TLX), and simulator-related discomfort (MSAQ) under fully and semi-immersive VR conditions. Results: Across the selected session-level evaluations, mean online classification accuracy was 67%, increasing to 77% when considering only successful evaluations. Four of the six participants completed the experimental protocol, whereas two discontinued after T3 because sufficiently stable BCI control could not be achieved. NASA-TLX scores indicated increasing perceived workload but generally low frustration, while low MSAQ scores suggested good VR tolerability. No participants withdrew because of VR-related discomfort or adverse effects. Conclusions: This exploratory study provides preliminary evidence supporting the feasibility of hybrid EEG–EOG BCI control within a VR-based powered mobility simulator for children and adolescents with severe neuromotor disabilities. Although simulated navigation was feasible for four participants, substantial variability in BCI control highlights the need for further technological refinement and validation in larger cohorts.

Background: Developing Brain–Computer Interfaces (BCIs) for children with severe neuromotor disabilities remains challenging due to developmental neurophysiology and the high cognitive demands of motor imagery. Hybrid BCIs integrating electroencephalography (EEG) and electrooculography (EOG) can overcome these limitations by combining continuous motor-related control with reliable discrete commands. This multiple-case study investigated the feasibility of a hybrid EEG–EOG BCI integrated with a virtual reality (VR) powered-wheelchair simulator for mobility training. Methods: Six participants (one child, five adolescents) with severe neuromotor disabilities completed repeated sessions using a self-paced BCI. The system combined continuous kinesthetic motor imagery (KMI) for steering and EOG-detected voluntary blinks for discrete commands. We evaluated online classification performance (accuracy, sensitivity, specificity), user workload (NASA-TLX), and simulator-related discomfort (MSAQ) under fully and semi-immersive VR conditions. Results: Despite expected inter-subject variability, most participants achieved functional online VR wheelchair control, reaching a mean accuracy of 77% in successful sessions with balanced sensitivity and specificity. NASA-TLX scores indicated moderate cognitive workload but consistently low frustration. Zero dropouts and low MSAQ scores demonstrated excellent protocol tolerability, high engagement, and minimal cybersickness across both VR modalities. Conclusions: This study demonstrates the feasibility of combining hybrid EEG–EOG BCI control with VR for pediatric powered mobility training. The framework enabled functional control with high usability and minimal adverse effects, supporting the clinical potential of hybrid BCI–VR systems as accessible assistive technologies and providing a foundation for larger clinical trials.