Virtual Reality (VR) offers a unique research tool in behavioural neuroscience to investigate how humans interact with their surroundings under realistic conditions, allowing both precise control over stimuli (i.e the virtual world) and experience of a realistic interactive environment. VR has been successfully used in studies on obstacle avoidance, interceptive actions, path perception, and visuo-locomotor adaptation. Recently, research studies have focused on the development of novel robotic interfaces working in conjunction with Virtual Reality (VR) systems for a more efficient neuro-motor rehabilitation of stroke patients.
We study human interaction with the environment in different conditions and in non-clinical and clinical populations. The novelty of our approach resides in the combination of behavioral observation and functional monitoring, respectively performed with VR, tracking devices (e.g. Trackhold) and HR-EEG systems. Particularly interesting is the possibility of using the results of human movement analysis to map behavioral information onto the brain activity, in order to correlate motor tasks planning/execution to brain commands and environmental interaction.
Neuro-motor Rehabilitation
In this research line the conjoint use of a passive robotic device (Trackhold), Virtual Reality (VR) scenarios and high-resolution EEG (HR-EEG) is employed for the first time for the rehabilitation of upper limbs in sub-acute stroke patients. The Trackhold is a rehabilitation device, capable of registering all relevant kinematic data of the patient’s arm and of compensating gravity compensation without limiting the range of movements. A set of VR applications have been specifically developed in order to simulate a wide range of arm movements. HR-EEG is synchronously registered in order to monitor the neural responses during performance of the various motor tasks.
The combined use of robotic devices and VR environments for post-stroke rehabilitation offers significant advantages over the traditional, manually assisted movement training, namely: exact control and repeatability of stimuli, greater variability of exercises, objective estimation of the rehabilitation progress, online feedback of patient performance, higher patient motivation, and thus maximization of the effectiveness of the rehabilitative process.
We monitor the effects of neuro-motor rehabilitation performed with the Trackhold and the dedicated videogame-like applications not only at the kinematic level, but also at the cortical level by means of high-resolution EEG. It is known that the damaged adult brain is able to reorganize in order to compensate for motor deficits. To date, the most common pattern of functional reorganization observed in patients with focal injury is a dynamic reorganization of the topography of task-related functional responses. Involvement of non-motor and contra-lesional motor areas has been consistently reported, but the emerging notion is that the greater the involvement of the ipsi-lesional motor network, the better is the recovery.
Ongoing projects:
- Longitudinal study in sub-acute stroke patients on neuro-motor rehabilitation by means of the Trackhold rehabilitation device and a set of five videogame-like applications.
We aim at assessing I) the effectiveness of this innovative therapy in sub-acute stroke patients, II) the persistence of recovery after therapy, III) the neuro-biological and neuro-physiological mechanisms sustaining brain plasticity, aiming at identifying more successful therapeutic strategies, IV) how tailored VR environments may increase patient motivation and therapy effectiveness.
We perform the study in collaboration with:
- Prof. Sandro Sorbi, Dr. Biancamaria Guarnieri, Dr. Gianluigi Cerroni, Dr. Antonio Serio, Dr. Lucia Velluto, Dr. Francesco D’Andrea and Dr. Sandro Buzzelli, Institute for Clinical Research Villa Serena, Casa di Cura Villa Serena, Città S. Angelo, Italy
- Prof. Massimo Bergamasco and Prof. Antonio Frisoli, PERCRO Lab, Scuola Superiore Sant’Anna, Pisa, Italy
Proceeding paper:
Steinisch M., Tana M.G. and Comani S.: A passive robotic device for VR-augmented upper limb rehabilitation in stroke patients. Biomedical Engineering/Biomedizinische Technik, 2012, 57(Suppl. 1):841-844.
Steinisch M., Guarnieri B.M., Haueisen J., Serio A. and Comani S.: Virtual Reality and Robotics for neuro-motor rehabilitation of ischemic stroke patients. IFMBE Proceedings, World Congress on Medical Physics and Biomedical Engineering, September 7 – 12, 2009, Munich, Germany, 2009, 25/9:61-63.
Meeting Abstracts:
Steinisch M., Tana M.G., Guarnieri B., Cerroni G., Serio A., Buzzelli S. and Comani S.: Combining a passive robotic device, virtual reality and high-resolution EEG for post-stroke neuro-motor rehabilitation. ANT Burgundy Neuromeeting, Beaune (France) January 24-26, 2013.
Steinisch M., Tana M.G. and Comani S.: A passive robotic device for VR-augmented upper limb rehabilitation in stroke patients. 46th DGBMT Annual Conference, Jena (Germany), September 16-19, 2012.
Steinisch M., Tana M.G. and Comani S.: HR-EEG imaging of post-stroke brain recovery induced by VR-augmented rehabilitation performed with a passive robotic device. 18th International Conference on Biomagnetism, Paris (France), August 26-30, 2012.
Steinisch M., Guarnieri B.M., Haueisen J., Serio A. and Comani S.: Virtual Reality and Robotics for neuro-motor rehabilitation of ischemic stroke patients. World Congress on Medical Physics and Biomedical Engineering, Munich (Germany), September 7-12, 2009.
Neuropsychology of action and space
It has been demonstrated that the space around us is not passively reproduced by our brain, but rather continuously constructed depending on our intentions and possibility to act within it. Space is indeed mentally represented as a personal or bodily space, a near peripersonal or reaching space, and a far extrapersonal space. In line with this data, the sensory-motor system, far from being a mere executor of movements, is actively involved in both action and space representation. However, its causal involvement on such cognitive processes is still to be ascertained.
Within this framework, a further critical issue is that of spatial reference frames: egocentric (centered on body parts) and allocentric (centered on external references) spatial representations are indeed used in parallel by our brain and allows us to both properly interact with and orient within the surrounding space. The former are the first to appear in the growing infant, and the latter are likely the first to decline in elderly people and in specific clinical populations.
In this research line we intend to explore the cognitive and neural mechanisms related to action and space representation in clinical populations (schizophrenia/schizotipy, Alzheimer/MCI and apraxia).
Ongoing projects:
Visuo-spatial perspective taking in schizophrenic patients.
We aim at assessing I) the ability to use egocentric and allocentric (both object-based and person-based) spatial frames of reference by means of a VR environment, II) the cortical activity during the processes of allocentric and egocentric simulation by means of HR-EEG.
We perform the study in collaboration with:
Prof. Alessandro Rossi, Istituto di Ricerca Clinica Villa Serena, Casa di Cura Villa Serena, Città S. Angelo (Pescara, Italy), using our Virtual Reality system, as well as a 128 channel EEG (EBNeuro, Electro-Cap)
Prof. Alain Berthoz and Dr. Simon Lambrey, LPPA – Laboratoire de physiologie de la perception et de l’action, Collège de France-CNRS, Paris (France)
Egocentric and allocentric spatial coding in patients affected by Mild Cognitive Impairment (MCI).
We aim at assessing I) the basic processes in egocentric and allocentric spatial coding in subjects affected by mild Alzheimer disease, II) the presence of deficits in the phases antecedent to the inception of Alzheimer disease (MCI).
We perform the study in collaboration with:
Prof. Sandro Sorbi, Dr. Antonio Serio, Dr. Bianca Maria Guarnieri, Istituto di Ricerca Clinica Villa Serena, Casa di Cura Villa Serena, Città S. Angelo (Pescara, Italy)
Evaluation of the role of the sensori-motor system in action representation in patients affected by Apraxia.
We aim at: I) investigating the potential causal role of the sensori-motor system in the processes accompanying the mental representation of actions in patients affected by Apraxia, II) evaluating the presence of dissociations in the processes accompanying the mental representation of actions presented visually or verbally in patients affected by Apraxia, as hypothesized by recent neuro-psychological models.
We perform the study in collaboration with:
Prof. Sandro Sorbi, Dr. Antonio Serio, Dr. Bianca Maria Guarnieri, Istituto di Ricerca Clinica Villa Serena, Casa di Cura Villa Serena, Città S. Angelo (Pescara, Italy)
Publications:
Steinisch M., Sulpizio V., Iorio A.A., Di Naccio A., Haueisen J., Committeri G. and Comani S.: A virtual environment for egocentric and allocentric mental transformations: a study on a non clinical population of adults with distinct levels of schizotypy. Biomedical Engineering/Biomedizinische Technik, 56(5):291-299.
Iaria G., Palermo L., Committeri G. and Barton J.J. 2009 Age differences in the formation and use of cognitive maps. Behavioral Brain Research, 196:187-191.
Costantini M., Committeri G. and Galati G. 2008 Effector- and target-independent representation of observed actions: evidence from incidental repetition priming. Experimental Brain Research, 188(3):341-351.
Galati G, Committeri G, Spitoni G, Aprile T, Di Russo F, Pitzalis S, Pizzamiglio L. 2008 A selective representation of the meaning of actions in the auditory mirror system. Neuroimage, 40(3):1274-86.
Committeri G., Pitzalis S., Galati G., Patria F., Pelle G., Sabatini U., Castriota-Scanderbeg A., Piccardi L., Guariglia C. and Pizzamiglio L. 2007 Neural bases of personal and extrapersonal neglect in humans. Brain, 130: 431-441.
Costantini M. and Haggard P. 2007 The Rubber hand illusion: Sensitivity and reference frame for body ownership. Consciousness and Cognition, 16:229-240.
Meeting abstracts:
Steinisch M., Tana M.G., Committeri G. and Comani S.: Virtual reality and perspective taking in adults with schizophrenia. ANT Burgundy Neuromeeting, Beaune (France), January 25-28, 2012.
Steinisch M., Sulpizio V., Iorio A.A., Haueisen J., Committeri G. and Comani S.: A virtual environment for self rotation and array rotation in adults with schizophrenia: preliminary results of a pilot study. Real Actions / Virtual Environments, Barcelona (Spain) , April 3, 2010.
Busiello M., Committeri G., Galati G. and Costantini M.: Il ruolo del sistema sensori-motorio nel riconoscimento delle azioni. Associazione Italiana di Psicologia, sezione di Psicologia Sperimentale. Chieti (Italy), September 24-26, 2009.
Labate E. and Committeri G.: Codifica spaziale egocentrica e allocentrica in pazienti con deterioramento cognitivo. Associazione Italiana di Psicologia, sezione di Psicologia Sperimentale. Chieti (Italy), September 24-26, 2009.