Browsing by Author "Pais-Vieira, Miguel"
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- Activation of a rhythmic lower limb movement pattern during the use of a multimodal brain-computer interface: a case study of a clinically complete spinal cord injuryPublication . Pais-Vieira, Carla; Figueiredo, José Gabriel; Perrotta, André; Matos, Demétrio; Aguiar, Mafalda; Ramos, Júlia; Gato, Márcia; Poleri, Tânia; Pais-Vieira, MiguelBrain–computer interfaces (BCIs) that integrate virtual reality with tactile feedback are increasingly relevant for neurorehabilitation in spinal cord injury (SCI). In our previous case study employing a BCI-based virtual reality neurorehabilitation protocol, a patient with complete T4 SCI experienced reduced pain and emergence of non-spastic lower limb movements after 10 sessions. However, it is still unclear whether these effects can be sustained, enhanced, and replicated, as well as the neural mechanisms that underlie them. The present report outlines the outcomes of extending the previous protocol with 24 more sessions (14 months, in total). Clinical, behavioral, and neurophysiological data were analyzed. The protocol maintained or reduced pain levels, increased self-reported quality of life, and was frequently associated with the appearance of non-spastic lower limb movements when the patient was engaged and not experiencing stressful events. Neural activity analysis revealed that changes in pain were encoded in the theta frequency band by the left frontal electrode F3. Examination of the lower limbs revealed alternating movements resembling a gait pattern. These results suggest that sustained use of this BCI protocol leads to enhanced quality of life, reduced and stable pain levels, and may result in the emergence of rhythmic patterns of lower limb muscle activity reminiscent of gait.
- Ceftriaxone modulates the acute corticosterone effects in local field potentials in the primary somatosensory cortex of anesthetized micePublication . Pais-Vieira, Miguel; Kunicki, Carolina; Peres, André; Sousa, NunoStress responses are associated with elevations in corticosterone levels and, as a consequence, increases in glutamate in the central nervous system which can lead to neurological impairment. Ceftriaxone promotes glutamate transport and has been used to reduce glutamate toxicity, but so far it is not known whether ceftriaxone is able to reverse the effects of corticosterone administration. Here we describe the separate and combined effects of acute ceftriaxone and acute corticosterone administration in local field potentials (LFPs) recorded from the somatosensory cortex (S1) of anesthetized mice. For this, LFPs were recorded from groups of anesthetized mice injected with saline, corticosterone, ceftriaxone, or both. Comparison of global state maps, and their displacements, as measured by ratios of different frequency bands (Ratio 1: 0.5–20 Hz/0.5–45 Hz; and Ratio 2: 0.5–4.5 Hz/0.5–9 Hz) revealed distinct and opposite effects for corticosterone and for ceftriaxone. Corticosterone specifically increased the displacement in Ratio 2, while ceftriaxone decreased it; in addition, when both corticosterone and ceftriaxone were injected, Ratio 2 displacement values were again similar to those of the control group. The present results suggest that ceftriaxone and corticosterone modulate specific frequency bands in opposite directions and reveal a potential role for ceftriaxone in counteracting the effects of corticosterone.
- A closed loop brain-machine interface for epilepsy control using dorsal column electrical stimulationPublication . Pais-Vieira, Miguel; Yadav, Amol P.; Moreira, Derek; Guggenmos, David; Santos, Amílcar; Lebedev, Mikhail; Nicolelis, Miguel A. L.Although electrical neurostimulation has been proposed as an alternative treatment for drug-resistant cases of epilepsy, current procedures such as deep brain stimulation, vagus, and trigeminal nerve stimulation are effective only in a fraction of the patients. Here we demonstrate a closed loop brainmachine interface that delivers electrical stimulation to the dorsal column (DCS) of the spinal cord to suppress epileptic seizures. Rats were implanted with cortical recording microelectrodes and spinal cord stimulating electrodes, and then injected with pentylenetetrazole to induce seizures. Seizures were detected in real time from cortical local field potentials, after which DCS was applied. This method decreased seizure episode frequency by 44% and seizure duration by 38%. We argue that the therapeutic effect of DCS is related to modulation of cortical theta waves, and propose that this closedloop interface has the potential to become an effective and semi-invasive treatment for refractory epilepsy and other neurological disorders.
- Differential width discrimination task for active and passive tactile discrimination in humansPublication . Perrotta, André; Pais-Vieira, Carla; Allahdad, Mehrab K.; Bicho, Estela; Pais-Vieira, Miguel
- Does symptom recognition improve self-care in patients with heart failure? A pilot study randomised controlled trialPublication . Sousa, Joana Pereira; Neves, Hugo; Pais-Vieira, MiguelPatients with heart failure have difficulty in self-care management, as daily monitoring and recognition of symptoms do not readily trigger an action to avoid hospital admissions. The purpose of this study was to understand the impact of a nurse-led complex intervention on symptom recognition and fluid restriction. A latent growth model was designed to estimate the longitudinal effect of a nursing-led complex intervention on self-care management and quality-of-life changes in patients with heart failure and assessed by a pilot study performed on sixty-three patients (33 control, 30 intervention). Patients in the control group had a higher risk of hospitalisation (IRR 11.36; p < 0.001) and emergency admission (IRR 4.24; p < 0.001) at three-months follow-up. Analysis of the time scores demonstrated that the intervention group had a clear improvement in self-care behaviours (beta Slope. Assignment_group = -0.881; p < 0.001) and in the quality of life (beta Slope. Assignment_group = 1.739; p < 0.001). This study supports that a nurse-led programme on symptom recognition and fluid restriction can positively impact self-care behaviours and quality of life in patients with heart failure.
- Embodiment comfort levels during motor imagery training combined with immersive virtual reality in a spinal cord injury patientPublication . Pais-Vieira, Carla; Gaspar, Pedro; Matos, Demétrio; Alves, Leonor Palminha; Cruz, Bárbara Moreira da; Azevedo, Maria João; Gago, Miguel; Poleri, Tânia; Perrotta, André; Pais-Vieira, MiguelBrain–machine interfaces combining visual, auditory, and tactile feedback have been previously used to generate embodiment experiences during spinal cord injury (SCI) rehabilitation. It is not known if adding temperature to these modalities can result in discomfort with embodiment experiences. Here, comfort levels with the embodiment experiences were investigated in an intervention that required a chronic pain SCI patient to generate lower limb motor imagery commands in an immersive environment combining visual (virtual reality -VR), auditory, tactile, and thermal feedback. Assessments were made pre-/ post-, throughout the intervention (Weeks 0–5), and at 7 weeks follow up. Overall, high levels of embodiment in the adapted three-domain scale of embodiment were found throughout the sessions. No significant adverse effects of VR were reported. Although sessions induced only a modest reduction in pain levels, an overall reduction occurred in all pain scales (Faces, Intensity, and Verbal) at follow up. A high degree of comfort in the comfort scale for the thermal-tactile sleeve, in both the thermal and tactile feedback components of the sleeve was reported. This study supports the feasibility of combining multimodal stimulation involving visual (VR), auditory, tactile, and thermal feedback to generate embodiment experiences in neurorehabilitation programs.
- Frequency-specific coupling in fronto-parieto-occipital cortical circuits underlie active tactile discriminationPublication . Kunicki, Carolina; Moioli, Renan C.; Pais-Vieira, Miguel; Peres, André Salles Cunha; Morya, Edgard; Nicolelis, Miguel A. L.Processing of tactile sensory information in rodents is critically dependent on the communication between the primary somatosensory cortex (S1) and higher-order integrative cortical areas. Here, we have simultaneously characterized single-unit activity and local field potential (LFP) dynamics in the S1, primary visual cortex (V1), anterior cingulate cortex (ACC), posterior parietal cortex (PPC), while freely moving rats performed an active tactile discrimination task. Simultaneous single unit recordings from all these cortical regions revealed statistically significant neuronal firing rate modulations during all task phases (anticipatory, discrimination, response, and reward). Meanwhile, phase analysis of pairwise LFP recordings revealed the occurrence of long-range synchronization across the sampled fronto-parieto-occipital cortical areas during tactile sampling. Causal analysis of the same pairwise recorded LFPs demonstrated the occurrence of complex dynamic interactions between cortical areas throughout the fronto-parietal-occipitl loop. These interactions changed significantly between cortical regions as a function of frequencies (i.e. beta, theta and gamma) and according to the different phases of the behavioral task. Overall, these findings indicate that active tactile discrimination by rats is characterized by much more widespread and dynamic complex interactions within the fronto-parieto-occipital cortex than previously anticipated.
- Fronto-central changes in multiple frequency bands in active tactile width discrimination taskPublication . Ramos, Tiago; Ramos, Júlia; Pais-Vieira, Carla; Pais-Vieira, MiguelThe neural basis of tactile processing in humans has been extensively studied; however, the neurophysiological basis of human width discrimination remains relatively unexplored. In particular, the changes that occur in neural networks underlying active tactile width discrimination learning have yet to be described. Here, it is hypothesized that subjects learning to perform the active version of the width discrimination task would present changes in behavioral data and in the neurophysiological activity, specifically in networks of electrodes relevant for tactile and motor processing. The specific hypotheses tested here were that the performance and response latency of subjects would change between the first and the second blocks; the power of the different frequency bands would change between the first and the second blocks; electrode F4 would encode task performance and response latency through changes in the power of the delta, theta, alpha, beta, and low-gamma frequency bands; the relative power in the alpha and beta frequency bands in electrodes C3 and C4 (Interhemispheric Spectral Difference—ISD) would change because of learning between the first and the second blocks. To test this hypothesis, we recorded and analyzed electroencephalographic (EEG) activity while subjects performed a session where they were tested twice (i.e., two different blocks) in an active tactile width discrimination task using their right index finger. Subjects (n = 18) presented high performances (high discrimination accuracy) already in their first block, and therefore no significant improvements were found in the second block. Meanwhile, a reduction in response latency was observed between the two blocks. EEG recordings revealed an increase in power for the low-gamma frequency band (30–45 Hz) for electrodes F3 and C3 from the first to the second block. This change was correlated with neither performance nor latency. Analysis of the neural activity in electrode F4 revealed that the beta frequency band encoded the subjects’ performance. Meanwhile, the delta frequency band in the same electrode revealed a complex pattern where blocks appeared clustered in two different patterns: an Upper Pattern (UP), where power and latency were highly correlated (Rho = 0.950), and a sparser and more uncorrelated Lower Pattern (LP). Blocks belonging to the UP or LP patterns did not differ in performance and were not specific to the first or the second block. However, blocks belonging to the LP presented an increase in response latency, increased variability in performance, and an increased ISD in alpha and beta frequency bands for the pair of electrodes C3–C4, suggesting that the LP may reflect a state related to increased cognitive load or task difficulty. These results suggest that changes in performance and latency in an active tactile width discrimination task are encoded in the delta, alpha, beta, and low-gamma frequency bands in a fronto-central network. The main contribution of this study is therefore related to the description of neural dynamics in frontal and central networks involved in the learning process of active tactile width discrimination.
- Method for positioning and rehabilitation training with the ExoAtlet® powered exoskeletonPublication . Pais-Vieira, Carla; Khazraei, Mehrab; Neves-Amado, João; Perrotta, André; Morya, Edgard; Moioli, Renan; Shapkova, Elena; Pais-Vieira, MiguelExoskeletons for locomotion, support, or other uses are becoming more common. An increasing number of studies are demonstrating relevant results in rehabilitation. Here we describe the steps required to properly place and train patients in ExoAtlet ® powered exoskeletons (Moscow, Russia), for which there is currently limited information available. These steps combine actions related to the hardware, software, as well as safety, rehabilitation, and psycho-emotional state of the subject. Training starts with a general preparation of the environment, the equipment, and the patient. When the actual training program begins, the patient needs to gradually learn to perform the different actions that will be required to control the exoskeleton. Initially, training requires transferring weight between legs to guarantee adequate equilibrium control. Then, actions assisted by computer-controlled motors begin, namely: standing up, walking in place, moving small distances and sitting down. As the patient becomes comfortable with the exoskeleton and the cardiovascular system becomes adjusted to the upright position, training can then include walking over longer distances, inclined planes, opening doors, and climbing stairs.
- Neurophysiological correlates of tactile width discrimination in humansPublication . Pais-Vieira, Carla; Allahdad, Mehrab K.; Perrotta, André; Peres, André S.; Kunicki, Carolina; Aguiar, Mafalda; Oliveira, Manuel; Pais-Vieira, MiguelIntroduction: Tactile information processing requires the integration of sensory, motor, and cognitive information. Width discrimination has been extensively studied in rodents, but not in humans. Methods: Here, we describe Electroencephalography (EEG) signals in humans performing a tactile width discrimination task. The first goal of this study was to describe changes in neural activity occurring during the discrimination and the response periods. The second goal was to relate specific changes in neural activity to the performance in the task. Results: Comparison of changes in power between two different periods of the task, corresponding to the discrimination of the tactile stimulus and the motor response, revealed the engagement of an asymmetrical network associated with fronto-temporo-parieto-occipital electrodes and across multiple frequency bands. Analysis of ratios of higher [Ratio 1: (0.5–20 Hz)/(0.5–45 Hz)] or lower frequencies [Ratio 2: (0.5–4.5 Hz)/(0.5–9 Hz)], during the discrimination period revealed that activity recorded from frontal-parietal electrodes was correlated to tactile width discrimination performance between-subjects, independently of task difficulty. Meanwhile, the dynamics in parieto-occipital electrodes were correlated to the changes in performance within-subjects (i.e., between the first and the second blocks) independently of task difficulty. In addition, analysis of information transfer, using Granger causality, further demonstrated that improvements in performance between blocks were characterized by an overall reduction in information transfer to the ipsilateral parietal electrode (P4) and an increase in information transfer to the contralateral parietal electrode (P3). Discussion: The main finding of this study is that fronto-parietal electrodes encoded between-subjects’ performances while parieto-occipital electrodes encoded within-subjects’ performances, supporting the notion that tactile width discrimination processing is associated with a complex asymmetrical network involving fronto-parieto-occipital electrodes.