Begell House Inc.
Critical Reviews™ in Biomedical Engineering
CRB
0278-940X
44
1-2
2016
Haptic Neurorehabilitation and Virtual Reality for Upper Limb Paralysis: A Review
1-32
10.1615/CritRevBiomedEng.2016016046
Leah
Piggott
Psychology Department, Northern Michigan University, 1401 Presque Isle Avenue, Marquette, MI, 49855
Samantha
Wagner
Psychology Department, Northern Michigan University, 1401 Presque Isle Avenue, Marquette, MI, 49855
Mounia
Ziat
Department of Psychology, Northern Michigan University, Marquette, MI, 1401 Presque Isle Avenue, Marquette, MI, 49855
brain injury
haptic devices
exoskeleton devices
neurorehabilitation
robotics
virtual reality
Motor and sensory loss or dysfunction affects the quality of life for thousands of individuals daily. The upper limb,
and especially the hand, are important for a person's ability to complete activities of daily living. Traditional therapy methods focus on motor recovery, but future methods should include sensory recovery and should promote the use of the affected limb(s) at home. In this review, we highlight the current state-of-art robotic devices for the upper limb, and we discuss benefits of including haptic feedback and virtual reality environments during neurorehabilitation. Robotic devices, such as end-effector devices, grounded and
ungrounded exoskeletons, have been developed to assist with various functions including individual finger, whole hand, and shoulder movements. Many robots highlighted in this paper are inexpensive and are small enough to be in a patient's home, or allow for telerehabilitation. Virtual reality creates safe environments for patients to practice motor movements and interactive games improve enjoyment of therapy. Haptic feedback creates more immersive virtual reality, and contributes to the recovery of sensory function. Physiological studies conducted after brain trauma and with robotic devices contribute to the understanding of brain plasticity, and illustrate the efficacy of these technologies. We conclude by addressing the future direction of neurorehabilitation research.
Neural Correlates of Cognitive Modulation of Pain Perception in the Human Brainstem and Cervical Spinal Cord using Functional Magnetic Resonance Imaging: A Review
33-45
10.1615/CritRevBiomedEng.2016016540
Roxanne H.
Leung
Center for Neuroscience Studies, Department of Biomedical and Molecular Sciences, Queen's University, Kingston, Ontario K7L 3N6, Canada
Patrick W.
Stroman
Centre for Neuroscience Studies, Queen's University, 2nd floor, Botterell Hall, 18 Stuart Street, Kingston, ON, Canada K7L 3N6; Department of Physics, Queen's University, Kingston, ON, Canada, K7L 3N6
cognitive modulation
pain processing
brainstem
spinal cord
dorsal horn
fMRI
Pain is a multifaceted and malleable sensory experience that is processed at all levels of the central nervous system
(CNS). The experience of pain can vary widely across a healthy population and even within an individual and can be influenced
by cognitive factors such as attention, expectation, suggestion, and attitudes. The neurophysiological role of attention in cognitive modulation of pain is the focus for the work presented in this review. Behavioral studies show that pain perception was reduced under cognitive loads that placed a continuous demand on executive functions such as working memory. Neuroimaging, pharmacological studies, and electrophysiological studies provide evidence that the underpinnings of cognitive modulation of pain involve a
network of descending modulation of pain among cortical and brainstem structures. However, the role and relationship of subcortical regions in the brainstem and spinal cord during cognitive modulation of pain are not well understood. This review examines the neurophysiology of pain, processing in the CNS, and how cognitive factors such as attention can modulate nociceptive signaling and alter the perception of pain, especially at the subcortical level.
Functional Magnetic Resonance Imaging of the Human Brainstem and Cervical Spinal Cord during Cognitive Modulation of Pain
47-71
10.1615/CritRevBiomedEng.2016016541
Roxanne H.
Leung
Center for Neuroscience Studies, Department of Biomedical and Molecular Sciences, Queen's University, Kingston, Ontario K7L 3N6, Canada
Patrick W.
Stroman
Centre for Neuroscience Studies, Queen's University, 2nd floor, Botterell Hall, 18 Stuart Street, Kingston, ON, Canada K7L 3N6; Department of Physics, Queen's University, Kingston, ON, Canada, K7L 3N6
spinal fMRI
structural equation modeling
cognitive modulation of pain
descending modulation
Pain is a complex sensory experience, and cognitive factors such as attention can influence its perception. Modulation
of pain involves a network of subcortical structures; however, the role and relationship of these regions in cognitive modulation of pain are not well understood. The aims of this research were to evaluate the behavioral effect of cognitive modulation of pain and investigate the neural correlates of this mechanism in the brainstem and cervical spinal cord (SC), using functional magnetic resonance imaging (fMRI) and structural equation modeling (SEM). We applied noxious thermal stimulation on the C6 dermatome to 12 healthy female participants while they performed the n-Back task. Our findings demonstrate a significant attenuation in pain perception across the group as a result of the task, along with high intersubject variability in the degree of modulation. Using fMRI, our studies characterize neural responses in subcortical regions that are involved in the modulation of pain. SEM analysis
reveals connectivity between the brainstem and SC at the group and individual levels, depending on cognitive load and degree of pain modulation, respectively. All together, our research demonstrates the behavioral effect of cognitive modulation on pain and provides insight into the subcortical neural response to the process.
Opportunities and Challenges of 7 Tesla Magnetic Resonance Imaging: A Review
73-89
10.1615/CritRevBiomedEng.2016016365
Muhammad Irfan
Karamat
Department of Medical Physics and Applied Radiation Sciences, McMaster University, Hamilton, ON, Canada
Sahar
Darvish-Molla
Department of Medical Physics and Applied Radiation Sciences, McMaster University, Hamilton, ON, Canada
Alejandro
Santos-Diaz
McMaster School of Biomedical Engineering, McMaster University, Hamilton, ON, Canada; Imaging Research Centre,
St. Joseph's Healthcare, Hamilton, ON, Canada
ultra high field magnetic resonance imaging
7T MRI system
B0 inhomogeneity
B1 inhomogeneity
specific absorption
rate
brain MRI
extracranial MRI
magnetic resonance spectroscopy
The desire to achieve clinical ultra-high magnetic resonance imaging (MRI) systems stems from the fact that higher
field strength leads to higher signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), and spatial resolution. During last few years 7T MRI systems have become a quasi standard for ultra-high field MRI (UhFMRI) systems. This review presents a detailed account of opportunities and challenges associated with a clinical 7T MRI system for cranial and extracranial imaging. As with all of the previous transitions to higher field strengths, the switch from high to UhFMRI is not easy. The engineering and scientific community have to overcome challenges like magnetic field inhomogeneity, patient safety and comfort issues, and cost and related problems in order to achieve a clinically viable UhFMRI system. In addition, a large number of clinical studies are still required to show the
improvements in quality of diagnostics that would come with 7T MRI, in order to bring such a research tool to the clinic.
Hydrocephalus and Ventriculoperitoneal Shunts: Modes of Failure and Opportunities for Improvement
91-97
10.1615/CritRevBiomedEng.2016017149
Julianne
Jorgensen
Franklin W. Olin College of Engineering, Needham, Massachusetts, USA
Corin
Williams
Tufts University, Medford, Massachusetts, USA
Alisha
Sarang-Sieminski
Franklin W. Olin College of Engineering, Needham, Massachusetts, USA
central nervous system
cerebrospinal fluid
VP shunt
ventricles
catheter
Between 0.5 and 4 of every 1000 children are born with hydrocephalus. Hydrocephalus is an over-accumulation
of cerebrospinal fluid (CSF) in the ventricles of the brain, which can affect cognitive function, vision, appetite, and cranial nerve function. Left untreated, hydrocephalus can result in death. The current treatment for hydrocephalus uses ventriculoperitoneal (VP) shunts with valves to redirect CSF from the ventricles into the peritoneum. Shunt technology is limited by a number of complications, which include infection after implantation, shunt obstruction due to clot formation or catheter obstruction by scar tissue or
choroid plexus, disconnection and tubing migration, and overdrainage or underdrainage of CSF due to valve malfunction. While modifications to surgical procedures and shunt design have been introduced, only modest improvements in outcomes have been observed. Here we provide an overview of hydrocephalus, VP shunts, and their modes of failure, and we identify numerous areas of opportunity for biomedical engineers and physicians to collaborate to improve the performance of VP shunts.
Electrophysiological Cardiac Modeling: A Review
99-122
10.1615/CritRevBiomedEng.2016016454
Mohammadali
Beheshti
Department of Electrical and Computer Engineering, Ryerson University, Toronto, Canada
Karthikeyan
Umapathy
Department of Electrical and Computer Engineering, Ryerson University, Toronto, Canada
Sridhar
Krishnan
Department of Electrical and Computer Engineering, Ryerson University 350, Victoria Street, Toronto, ON M5B 2k3, Canada
cardiac electrophysiology
mathematical models
computer simulation
Cardiac electrophysiological modeling in conjunction with experimental and clinical findings has contributed to better
understanding of electrophysiological phenomena in various species. As our knowledge on underlying electrical, mechanical, and chemical processes has improved over time, mathematical models of the cardiac electrophysiology have become more realistic and detailed. These models have provided a testbed for various hypotheses and conditions that may not be easy to implement experimentally. In addition to the limitations in experimentally validating various scenarios implemented by the models, one of the major obstacles for these models is computational complexity. However, the ever-increasing computational power of supercomputers facilitates the clinical application of cardiac electrophysiological models. The potential clinical applications include testing and
predicting effects of pharmaceutical agents and performing patient-specific ablation and defibrillation. A review of studies involving these models and their major findings are provided.
The Evolution of Neuroprosthetic Interfaces
123-152
10.1615/CritRevBiomedEng.2016017198
Dayo O.
Adewole
Center for Brain Injury and Repair, Department of Neurosurgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; Corporal Michael J. Crescenz Veterans Affairs Medical Center, Philadelphia, PA, USA;
Department of Bioengineering, School of Engineering and Applied Science, University of Pennsylvania, Philadelphia,
PA, USA; Penn Center for Neuroengineering and Therapeutics, University of Pennsylvania, Philadelphia, PA, USA
Mijail D.
Serruya
Department of Neurology, Jefferson University, Philadelphia, PA, USA
James P.
Harris
Center for Brain Injury and Repair, Department of Neurosurgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; Corporal Michael J. Crescenz Veterans Affairs Medical Center, Philadelphia, PA, USA
Justin C.
Burrell
Center for Brain Injury and Repair, Department of Neurosurgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; Corporal Michael J. Crescenz Veterans Affairs Medical Center, Philadelphia, PA, USA
Dmitriy
Petrov
Center for Brain Injury and Repair, Department of Neurosurgery, Perelman School of Medicine, University of Pennsylvania,
Philadelphia, PA, USA; Corporal Michael J. Crescenz Veterans Affairs Medical Center, Philadelphia, PA, USA
H. Isaac
Chen
Center for Brain Injury and Repair, Department of Neurosurgery, Perelman School of Medicine, University of Pennsylvania,
Philadelphia, PA, USA; Corporal Michael J. Crescenz Veterans Affairs Medical Center, Philadelphia, PA, USA; Penn Center for Neuroengineering and Therapeutics, University of Pennsylvania, Philadelphia, PA, USA
John A.
Wolf
Center for Brain Injury and Repair, Department of Neurosurgery, Perelman School of Medicine, University of Pennsylvania,
Philadelphia, PA, USA; Corporal Michael J. Crescenz Veterans Affairs Medical Center, Philadelphia, PA, USA
D. Kacy
Cullen
University of Pennsylvania, Philadelphia, PA 19104, USA
neural engineering
brain-machine interface
prosthetic
challenges
recording
stimulation
The ideal neuroprosthetic interface permits high-quality neural recording and stimulation of the nervous system while reliably providing clinical benefits over chronic periods. Although current technologies have made notable strides in this direction, significant improvements must be made to better achieve these design goals and satisfy clinical needs. This article provides an overview of the state of neuroprosthetic interfaces, starting with the design and placement of these interfaces before exploring the stimulation and recording platforms yielded from contemporary research. Finally, we outline emerging research trends in an effort to explore the potential next generation of neuroprosthetic interfaces.