Vol 42, No 1 (2016)

Nine volunteers aged 27 to 42 participated in an experiment with 370-day antiorthostatic hypokinesia at–5°C, and their blood serum samples were tested for the concentrations of lipid peroxidation (LPO) derivatives, including diene conjugates (DCs), malonic dialdehyde (MDA), and Schiff bases (SBs), and indices of the antioxidant defense system, including the tocopherol (TP) concentration and total antioxidant activity (AOA). The subjects were divided into two groups, which differed in physical training regimen and prophylaxis measures. Initial LPO steps were inhibited in both of the groups by 54–73% from day 50, while the level of SBs, which are final LPO products, decreased by 50–61% by day 230 and remained much the same up to the end of the experiment. The MDA and SB concentrations decreased by a factor of 1.6–2.3 during recovery. Total AOA decreased as an aftereffect during recovery to a level far lower than physiologically normal. Based on the significant inhibition of free-radical LPO throughout the experiment, long-term adaptation to simulated hypogravity was accompanied by a pronounced decrease in biological oxidation and caused severe stress. Substantial long-term readaptation stress developed during recovery after 370-day antiorthostatic hypokinesia, as was evident from the facts that the LPO activity was almost halved, TP concentration significantly increased, and the functional reserves of water-soluble antioxidants were exhausted. Lack of LPO activation was assumed to reflect adequate compensation in the subjects.

With the use of functional MRI (fMRI), we studied the changes in brain hemodynamic activity of healthy subjects during motor imagery training with the use brain-computer interface (BCI), which is based on the recognition of EEG patterns of imagined movements. ANOVA dispersion analysis showed there are 14 areas of the brain where statistically significant changes were registered. Detailed analysis of the activity in these areas before and after training (Student’s and Mann-Whitney tests) showed that the real amount of such areas is five; these are Brodmann areas 44 and 45, insula, middle frontal gyrus and anterior cingulate gyrus. We suggest that these changed are caused by the formation of memory traces of those brain activity patterns which are most accurately recognized by BCI classifiers as correspondent with limb movements imagery. We also observed a tendency of increase in the activity of motor imagery after training. The hemodynamic activity in all these 14 areas during real movements was either approximately the same or significantly higher than during motor imagery; activity during imagined leg movements was higher than that during imagines arm movements, except for the areas of representation of arms.

Motor imagery can stimulate the same neuroplastic mechanisms of the brain as their actual execution. The motor imagery can be controlled via the brain–computer interface (BCI), which transforms the EEG signals of the brain appearing during the motor imagery into commands for the external device. The results of the two-stage study of the application of a non-invasive BCI for the rehabilitation of patients with marked hemiparesis resulted from a local brain injury. We have shown that the learning to manage the BCI does not depend on the duration of disease, localization of the damaged site, and the severity of neurological deficit. The results of the first stage of the study carried out in a group of 36 patients showed that the rehabilitation therapy was more effective in the group that was trained to manage the BCI (the ARAT score improved from 1 [0; 2] to 5 [0; 16], p = 0.012 in the BCI group; no significant improvement was detected in the control group). In the second phase of the study, 19 patients participated in the testing of a BCI–exoskeleton system. Rehabilitation based on this technology led to an improvement of the motor function of an arm from 2 [0; 37] to 4 [1; 45.5], p = 0.005, according to the ARAT scale, and from 72 [63; 110] to 79 [68; 115], p = 0.005, according to the Fugl-Meyer scale.

The effect of arm movements and movements of individual arm joints on the electrophysiological and kinematic characteristics of voluntary and vibration-triggered stepping-like leg movements was studied under the conditions of horizontal support of the upper and lower limbs. The horizontal support of arms provided a significant increase in the rate of activation of locomotor automatism by noninvasive impact on tonic sensory inputs. The addition of active arm movements during involuntary stepping-like leg movements led to an increase in the EMG activity of hip muscles and was accompanied by an increase in the amplitude of hip and shin movements. The movement of the shoulder joints led to an increase in the activity of hip muscles and was accompanied by an increase in the amplitude of hip and shin movements. Passive arm movements had the same effect on induced leg movements. The movement of the shoulder joints led to an increase in the activity of hip muscles and an increase in the amplitude of movements of knee and hip joints. At the same time, the movement of forearms and wrists had a similar facilitating effect on the physiological and kinematic characteristics of rhythmic stepping-like movements, but influenced the distal segments of legs to a greater extent. Under the conditions of subthreshold vibration of leg muscles, voluntary arm movements led to activation of involuntary rhythmic stepping movements. During voluntary leg movements, the addition of arm movements had a significantly smaller impact on the parameters of rhythmic stepping than during involuntary leg movements. Thus, the simultaneous movements of the upper and lower limbs are an effective method of activation of neural networks connecting the rhythm generators of arms and legs. Under the conditions of arm and leg unloading, the interactions between the cervical and lumbosacral segments of the spinal cord seem to play the major role in the impact of arm movements on the patterns of leg movements. The described methods of activation of interlimb interactions can be used in the rehabilitation of post-stroke patients and patients with spinal cord injuries, Parkinson’s disease, and other neurological diseases.

The mechanism of interactions between receptor activation in the musculoskeletal system and stimulation of the spinal cord in the regulation of locomotor behavior was studied in healthy subjects. Afferent stimulation was tested for effect on the patterns of stepping movements induced by percutaneous stimulation of the spinal cord. A combination of percutaneous spinal cord stimulation and vibratory stimulation was shown to increase the amplitude of leg movements. It was demonstrated that vibratory stimulation of limb muscles at a frequency of less than 30 Hz can be used to control involuntary movements elicited by noninvasive stimulation of the spinal cord.

A series of observations have provided important insight into properties of the spinal as well as supraspinal circuitries that control posture and movement. We have demonstrated that spinal rats can regain full weight-bearing standing and stepping over a range of speeds and directions with the aid of electrically enabling motor control (eEmc), pharmacological modulation (fEmc), and training [1, 2]. Also, we have reported that voluntary control movements of individual joints and limbs can be regained after complete paralysis in humans [3, 4]. However, the ability to generate significant levels of voluntary weight-bearing stepping with or without epidural spinal cord stimulation remains limited. Herein we introduce a novel method of painless transcutaneous electrical enabling motor control (pcEmc) and sensory enabling motor control (sEmc) strategy to neuromodulate the physiological state of the spinal cord. We have found that a combination of a novel non-invasive transcutaneous spinal cord stimulation and sensory-motor stimulation of leg mechanoreceptors can modulate the spinal locomotor circuitry to state that enables voluntary rhythmic locomotor movements.

During the last two decades, considerable progress has been made in the studies of brain–computer interfaces (BCIs)—devices in which motor signals from the brain are registered by multi-electrode arrays and transformed into commands for artificial actuators such as cursors and robotic devices. This review is focused on one problem. Voluntary motor control is based on neurophysiological processes, which strongly depend on the afferent innervation of skin, muscles, and joints. Thus, invasive BCI has to be based on a bidirectional system in which motor control signals are registered by multichannel microelectrodes implanted in motor areas, whereas tactile, proprioceptive, and other useful signals are transported back to the brain through spatiotemporal patterns of intracortical microstimulation (ICMS) delivered to sensory areas. In general, the studies of invasive BCIs have advanced in several directions. The progress of BCIs with artificial sensory feedback will not only help patients, but will also expand base knowledge in the field of human cortical functions.