BACKGROUND: Planning and executing movements requires the integration of different sensory modalities, such as vision and proprioception. However, neurological diseases like stroke can lead to full or partial loss of proprioception, resulting in impaired movements. Recent advances focused on providing additional sensory feedback to patients to compensate for the sensory loss, proving vibrotactile stimulation to be a viable option as it is inexpensive and easy to implement. Here, we test how such vibrotactile information can be integrated with visual signals to estimate the spatial location of a reach target.
METHODS: We used a center-out reach paradigm with 31 healthy human participants to investigate how artificial vibrotactile stimulation can be integrated with visual-spatial cues indicating target location. Specifically, we provided multisite vibrotactile stimulation to the moving dominant arm using eccentric rotating mass (ERM) motors. As the integration of inputs across multiple sensory modalities becomes especially relevant when one of them is uncertain, we additionally modulated the reliability of visual cues. We then compared the weighing of vibrotactile and visual inputs as a function of visual uncertainty to predictions from the maximum likelihood estimation (MLE) framework to decide if participants achieve quasi-optimal integration.
RESULTS: Our results show that participants could estimate target locations based on vibrotactile instructions. After short training, combined visual and vibrotactile cues led to higher hit rates and reduced reach errors when visual cues were uncertain. Additionally, we observed lower reaction times in trials with low visual uncertainty when vibrotactile stimulation was present. Using MLE predictions, we found that integration of vibrotactile and visual cues followed optimal integration when vibrotactile cues required the detection of one or two active motors. However, if estimating the location of a target required discriminating the intensities of two cues, integration violated MLE predictions.
CONCLUSIONS: We conclude that participants can quickly learn to integrate visual and artificial vibrotactile information. Therefore, using additional vibrotactile stimulation may serve as a promising way to improve rehabilitation or the control of prosthetic devices by patients suffering loss of proprioception.

BACKGROUND: Restoration of limb function for individuals with unilateral weakness typically requires volitional muscle control, which is often not present for individuals with severe impairment. Mirror therapy-interventions using a mirror box to reflect the less-impaired limb onto the more-impaired limb-can facilitate corticospinal excitability, leading to enhanced recovery in severely impaired clinical populations. However, the mirror box applies limitations on mirror therapy, namely that all movements appear bilateral and are confined to a small area, impeding integration of complex activities and multisensory feedback (e.g., visuo-tactile stimulation). These limitations can be addressed with virtual reality, but the resulting effect on corticospinal excitability is unclear.
OBJECTIVE: Examine how virtual reality-based unilateral mirroring, complex activities during mirroring, and visuo-tactile stimulation prior to mirroring affect corticospinal excitability.
METHODS: Participants with no known neurological conditions (n = 17) donned a virtual reality system (NeuRRoVR) that displayed a first-person perspective of a virtual avatar that matched their motions. Transcranial magnetic stimulation-induced motor evoked potentials in the nondominant hand muscles were used to evaluate corticospinal excitability in four conditions: resting, mirroring, mirroring with prior visuo-tactile stimulation (mirroring + TACT), and control. During mirroring, the movements of each participant\'s dominant limb were reflected onto the nondominant limb of the virtual avatar, and the avatar\'s dominant limb was kept immobile (i.e., unilateral mirroring). The mirroring + TACT condition was the same as the mirroring condition, except that mirroring was preceded by visuo-tactile stimulation of the nondominant limb. During the control condition, unilateral mirroring was disabled. During all conditions, participants performed simple (flex/extend fingers) and complex (stack virtual blocks) activities.
RESULTS: We found that unilateral mirroring increased corticospinal excitability compared to no mirroring (p < 0.001), complex activities increased excitability compared to simple activities during mirroring (p < 0.001), and visuo-tactile stimulation prior to mirroring decreased excitability (p = 0.032). We also found that these features did not interact with each other.
CONCLUSIONS: The findings of this study shed light onto the neurological mechanisms of mirror therapy and demonstrate the unique ways in which virtual reality can augment mirror therapy. The findings have important implications for rehabilitation for design of virtual reality systems for clinical populations.

BACKGROUND: The patient with pusher syndrome (PS) is characterized by showing postural control alterations due to a lack of perception of his own body in the space. It appears when the patient actively pushes with his unaffected limbs towards the injured side, reacting with resistance to passive straightening towards the midline. Between 10% and 50% of strokes present PS. Nowadays, there is no clearly defined treatment for PS.
OBJECTIVE: To design and validate an exercise program using visual feedback and specific core stability exercises (FeViCoS) for the treatment of patients with PS.
METHODS: Validation was conducted by expert consensus using the Delphi method. Thirteen neurorehabilitation experts participated in the process. An online questionnaire with 18 Likert-type questions was used to evaluate the designed program. Consensus was considered reached if there was convergence between the quartile 1 and 3 values (RIQ = Q1-Q3) or if the relative interquartile range (RIR) was less than 20%. The degree of agreement between experts was measured by calculating the Fleiss\' kappa coefficient.
RESULTS: A total of 2 rounds were required to achieve 97.44% consensus with 100% participation. The RIR was less than or equal to 20% for all questions. The Fleiss\' kappa index (0.831) showed that the degree of agreement between experts was excellent.
CONCLUSIONS: Neurorehabilitation experts considered FeViCoS valid for the therapeutic approach to patients with PS. Expert consensus suggests a novel strategy in physical therapy clinical practice to improve balance and postural orientation in patients with subacute stroke and PS.

Stroke is an acute cerebrovascular disease in which sudden interruption of blood supply to the brain or rupture of cerebral blood vessels cause damage to brain cells and consequently impair the patient\'s motor and cognitive abilities. A novel rehabilitation training model integrating brain-computer interface (BCI) and virtual reality (VR) not only promotes the functional activation of brain networks, but also provides immersive and interesting contextual feedback for patients. In this paper, we designed a hand rehabilitation training system integrating multi-sensory stimulation feedback, BCI and VR, which guides patients\' motor imaginations through the tasks of the virtual scene, acquires patients\' motor intentions, and then carries out human-computer interactions under the virtual scene. At the same time, haptic feedback is incorporated to further increase the patients\' proprioceptive sensations, so as to realize the hand function rehabilitation training based on the multi-sensory stimulation feedback of vision, hearing, and haptic senses. In this study, we compared and analyzed the differences in power spectral density of different frequency bands within the EEG signal data before and after the incorporation of haptic feedback, and found that the motor brain area was significantly activated after the incorporation of haptic feedback, and the power spectral density of the motor brain area was significantly increased in the high gamma frequency band. The results of this study indicate that the rehabilitation training of patients with the VR-BCI hand function enhancement rehabilitation system incorporating multi-sensory stimulation can accelerate the two-way facilitation of sensory and motor conduction pathways, thus accelerating the rehabilitation process.
脑卒中（stroke）是由于脑部血液供应突然中断或脑血管破裂，导致脑细胞损伤进而损害患者运动和认知能力的一种急性脑血管疾病。融合脑—机接口（BCI）和虚拟现实（VR）的新型康复训练模式，不仅能促进脑网络功能激活，而且能为患者提供沉浸感强、趣味性强的情境反馈。本文设计了融合多感官刺激反馈、BCI和VR的手部康复训练系统，通过虚拟场景的任务引导患者运动想象，获取患者运动意图，进而在虚拟场景下进行人机交互；同时，融入触觉反馈进一步增加患者本体感受，从而实现基于视、听、触觉多感官刺激反馈的手功能康复训练。本研究通过对比分析加入触觉反馈前后的脑电信号数据内不同频段功率谱密度的差异，发现加入触觉反馈后运动脑区被明显激活，运动脑区的功率谱密度在高γ频段有显著提升。研究结果说明，患者在融合多感官刺激的VR—BCI手功能增强康复系统中进行康复训练，能够加速感觉传导通路和运动传导通路的双向促通，从而加速康复进程。.

Notification systems that convey urgency without adding cognitive burden are crucial in human-computer interaction. Haptic feedback systems, particularly those utilizing vibration feedback, have emerged as a compelling solution, capable of providing desirable levels of urgency depending on the application. High-risk applications require an evaluation of the urgency level elicited during critical notifications. Traditional evaluations of perceived urgency rely on subjective self-reporting and performance metrics, which, while useful, are not real-time and can be distracting from the task at hand. In contrast, EEG technology offers a direct, non-intrusive method of assessing the user\'s cognitive state. Leveraging deep learning, this study introduces a novel approach to evaluate perceived urgency from single-trial EEG data, induced by vibration stimuli on the upper body, utilizing our newly collected urgency-via-vibration dataset. The proposed model combines a 2D convolutional neural network with a temporal convolutional network to capture spatial and temporal EEG features, outperforming several established EEG models. The proposed model achieves an average classification accuracy of 83% through leave-one-subject-out cross-validation across three urgency classes (not urgent, urgent, and very urgent) from a single trial of EEG data. Furthermore, explainability analysis showed that the prefrontal brain region, followed by the central brain region, are the most influential in predicting the urgency level. A follow-up neural statistical analysis revealed an increase in event-related synchronization (ERS) in the theta frequency band (4-7 Hz) with the increased level of urgency, which is associated with high arousal and attention in the neuroscience literature. A limitation of this study is that the proposed model\'s performance was tested only the urgency-via-vibration dataset, which may affect the generalizability of the findings.

OBJECTIVE: This study investigates the development of sensorimotor relationships by examining adaptation to real-time perturbations of auditory feedback.
METHODS: Acoustic signals were recorded while preschoolers and adult speakers of Canadian French produced several utterances of the front rounded vowel /ø/ for which F2 was gradually shifted up to a maximum of 40%.
RESULTS: The findings indicate that, although preschool-aged children produced overall similar responses to the perturbed feedback, they displayed significantly more trial-to-trial variability than adults. Furthermore, whereas the magnitude of the adaptation in adults was positively correlated with the slope of the perceptual categorical function, the amount of adaptation in children was linked to the variability of their productions in the baseline condition. These patterns suggest that the immature motor control observed in children, which contributes to increased variability in their speech production, plays a role in shaping adaptive behavior, as it allows children to explore articulatory/acoustic spaces and learn sensorimotor relationships.

A case of successful correction of the pitch frequency using the computer program Circ FFT is described.
Описан случай успешной коррекции частоты основного тона голоса с применением компьютерной программы Circ FFT.

Integrating tactile feedback through haptic interfaces enhances experiences in virtual and augmented reality. However, electrotactile systems, which stimulate mechanoreceptors directly, often yield inconsistent tactile results due to variations in pressure between the device and the finger. In this study, we present the integration of a transparent electrotactile screen with pressure-sensitive transistors, ensuring highly consistent quantitative haptic sensations. These transistors effectively calibrate tactile variations caused by touch pressure. Additionally, we explore remote-distance tactile stimulations achieved through the interference of electromagnetic waves. We validated tactile perception using somatosensory evoked potentials, monitoring the somatosensory cortex response. Our haptic screen can stimulate diverse electrotactile sensations and demonstrate various tactile patterns, including Morse code and Braille, when integrated with portable smart devices, delivering a more immersive experience. Furthermore, interference of electric fields allows haptic stimulation to facilitate diverse stimulus positioning at lower current densities, extending the reach beyond direct contact with electrodes of our screen.

Sensorimotor adaptation alters mappings between motor commands and their predicted outcomes. Such remapping has been extensively studied in the visual domain, but the degree to which it occurs in modalities other than vision remains less well understood. Here, we manipulated the modality of reach target presentation to compare sensorimotor adaptation in response to perturbations of visual and auditory feedback location. We compared the extent of adaptation to perturbed sensory feedback for visual and auditory sensory modalities, and the magnitude of reach-direction aftereffects when the perturbation was removed. To isolate the contribution of implicit sensorimotor recalibration to adaptation in reach direction, we held sensory prediction errors and task-performance errors constant via a task-irrelevant clamp of sensory feedback. Seventy-two participants performed one of three experiments in which target location information and endpoint reach direction feedback were presented by loudspeakers (n = 24), headphones (n = 24), or a visual display (n = 24). Presentation durations for target stimuli (500 ms) and (non-veridical) endpoint feedback of reach direction (100 ms) were matched for visual and auditory modalities. For all three groups, when endpoint feedback was perturbed, adaptation was evident: reach-directions increased significantly in the direction opposite the clamped feedback, and a significant aftereffect persisted after participants were instructed that the perturbation had been removed. This study provides new evidence that implicit sensorimotor adaptation occurs in response to perturbed auditory feedback of reach direction, suggesting that an implicit neural process to recalibrate sensory to motor maps in response to sensory prediction errors may be ubiquitous across sensory modalities.

This paper proposes measurement and reduction of eye dose in real time for the physician and the assistant performing fluoroscopy guided arterial puncture. Eye dose rates were measured for 30 fluoroscopy-guided punctures of bilateral femoral arteries in pigs. Fifteen fluoroscopy-guided punctures were performed using real time radiation dosimeter without auditory and visual feedback and other fifteen punctures were done using real time radiation dosimeter with visual and auditory feedback worn on forehead by an interventional cardiologist having experience of more than 10 years. The mean radiation dose rate for eyes of physician during arterial puncturing with real time radiation dosimeter with auditory feedback was 0.07 mSv/h (n = 15) whereas it was 0.18 mSv/h (n = 15) without visual and auditory feedback. The percentage of reduction with the device was 61% for eyes. In case of assistant the reduction was 33% for eyes (n = 15). The real time visual and auditory feedback dosimeter has reduced the eye dose rate of the physician and assistant and also helped him staying away from the X-ray source. Real time radiation dosimeters can be an effective tool to measure and reduce the dose to the eyes. The radiation eye dose rate for physician and assistant was significantly reduced by using real time radiation dosimeter with visual and auditory feedback. The real time radiation dosimeter not only helps in measuring but also help in minimizing the radiation dose rate for the physician and assistant in real time.