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 injury

Carla Pais-Vieira, José Gabriel Figueiredo, André Perrotta, Demétrio Matos, Mafalda Aguiar, Júlia Ramos, Márcia Gato, Tânia Poleri, Miguel Pais-Vieira*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

1 Citation (Scopus)
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Abstract

Brain–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.
Original languageEnglish
Article number396
Number of pages22
JournalLife
Volume14
Issue number3
DOIs
Publication statusPublished - 16 Mar 2024

Keywords

  • Brain-computer interface
  • Central gait pattern generator
  • Multimodal stimulation
  • Spinal cord injury
  • Virtual reality

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