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Lowenthal-Raz, J., Liebermann, D. G., Friedman, J., & Soroker, N. (2024). Kinematic descriptors of arm reaching movement are sensitive to hemisphere-specific immediate neuromodulatory effects of transcranial direct current stimulation post stroke. Sci Rep, 14(1), 11971.
Abstract: Transcranial direct current stimulation (tDCS) exerts beneficial effects on motor recovery after stroke, presumably by enhancement of adaptive neural plasticity. However, patients with extensive damage may experience null or deleterious effects with the predominant application mode of anodal (excitatory) stimulation of the damaged hemisphere. In such cases, excitatory stimulation of the non-damaged hemisphere might be considered. Here we asked whether tDCS exerts a measurable effect on movement quality of the hemiparetic upper limb, following just a single treatment session. Such effect may inform on the hemisphere that should be excited. Using a single-blinded crossover experimental design, stroke patients and healthy control subjects were assessed before and after anodal, cathodal and sham tDCS, each provided during a single session of reaching training (repeated point-to-point hand movement on an electronic tablet). Group comparisons of endpoint kinematics at baseline-number of peaks in the speed profile (NoP; smoothness), hand-path deviations from the straight line (SLD; accuracy) and movement time (MT; speed)-disclosed greater NoP, larger SLD and longer MT in the stroke group. NoP and MT revealed an advantage for anodal compared to sham stimulation of the lesioned hemisphere. NoP and MT improvements under anodal stimulation of the non-lesioned hemisphere correlated positively with the severity of hemiparesis. Damage to specific cortical regions and white-matter tracts was associated with lower kinematic gains from tDCS. The study shows that simple descriptors of movement kinematics of the hemiparetic upper limb are sensitive enough to demonstrate gain from neuromodulation by tDCS, following just a single session of reaching training. Moreover, the results show that tDCS-related gain is affected by the severity of baseline motor impairment, and by lesion topography.
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Friedman, J., Raveh, E., Weiss, T., Itkin, S., Niv, D., Hani, M., et al. (2019). Applying Incongruent Visual-Tactile Stimuli during Object Transfer with Vibro-Tactile Feedback (Vol. 147).
Abstract: The application of incongruent sensory signals that involves disrupted tactile feedback is rarely explored, specifically with the presence of vibrotactile feedback (VTF). This protocol aims to test the effect of VTF on the response to incongruent visual-tactile stimuli. The tactile feedback is acquired by grasping a block and moving it across a partition. The visual feedback is a real-time virtual presentation of the moving block, acquired using a motion capture system. The congruent feedback is the reliable presentation of the movement of the block, so that the subject feels that the block is grasped and see it move along with the path of the hand. The incongruent feedback appears as the movement of the block diverts from the actual movement path, so that it seems to drop from the hand when it is actually still held by the subject, thereby contradicting the tactile feedback. Twenty subjects (age 30.2 +/- 16.3) repeated 16 block transfers, while their hand was hidden. These were repeated with VTF and without VTF (total of 32 block transfers). Incongruent stimuli were presented randomly twice within the 16 repetitions in each condition (with and without VTF). Each subject was asked to rate the difficulty level of performing the task with and without the VTF. There were no statistically significant differences in the length of the hand paths and durations between transfers recorded with congruent and incongruent visual-tactile signals – with and without the VTF. The perceived difficulty level of performing the task with the VTF significantly correlated with the normalized path length of the block with VTF (r = 0.675, p = 0.002). This setup is used to quantify the additive or reductive value of VTF during motor function that involves incongruent visual-tactile stimuli. Possible applications are prosthetics design, smart sport-wear, or any other garments that incorporate VTF.
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