Study of Cerebral Activation During Different Rehabilitation Tasks of Lower Limb in Virtual Mirror Therapy in Healthy Subjects

Study Overview
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Brief Summary
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The purpose of this study is to investigate the cerebral activation during visual motor simulation in healthy subjects in 3 conditions: observation (OBS), observation and imagination (OBS-IM) and observation and realization (OBS-REAL). The investigators goal is to compare cerebral activation during the three different tasks using EEG and fNIRS.

Detailed Description
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Mirror therapy is a rehabilitation technique that has been shown to be effective in restoring upper limb motor skills in patients with stroke. However, it comes up against certain constraints of clinical use such as installation difficulties or the obligation of symmetrical bilateral work. These constraints can be limited by the use of so-called 2nd generation virtual mirror therapy technologies. It is therefore likely that these new technologies will improve the feasibility and effectiveness of mirror therapy in rehabilitation. The brain mechanisms involved in virtual mirror therapy are not yet fully understood. EEG (Electroencephalography) and fNIRS (functional Near Infra Red Spectroscopy) are two functional method that allows to study the cerebral cortex changes during different tasks (like fMRI). These techniques therefore makes it possible to study brain activation under more ecological conditions than fMRI and are therefore particularly suitable for exploring rehabilitation techniques. This research aims to study and compare in healthy subjects, using EEG and fNIRS, the brain regions involved in three tasks using a virtual mirror therapy device (IVS4 apparatus ; Dessintey, France) implying lower limb control. The protocol has 3 conditions : observation (OBS), observation and imagination (OBS-IM) and observation and realization (OBS-REAL). The order of the 3 conditions will then be randomized to avoid potential biases linked to the sequence of conditions. The EEG recording will used the 32 channels ENOBIO apparatus. The fNIRS will used the Brite MKII apparatus

Official Title
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Assessment of Brain Activation With Different Mirror Therapy Tasks - Contribution of EEG and fNIRS in Healthy Subjects.

Conditions
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Healthy

Intervention / Treatment
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* Device: Observation (OBS)
* Device: Observation and imagination (OBS-IM)
* Device: Observation and realization (OBS-REAL)


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Subjects aged 18 to 75 years Sufficient command of the French language to understand the instructions No known neurological medical history With social security coverage Right-handed subjects with a laterality test of Edinburgh QL> 40 (Oldfield 1971) Exclusion Criteria: Minor subjects Adults under guardianship Adults under guardianship Pregnant or breastfeeding women Subjects who have objected to participating in the study

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 75 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Young<br>40 right handed healthy subject aged between 18 and 40 | Device: Observation (OBS)<br>* Subject is seated in a chair facing IVS4. He places his right lower under the screen. The flexion / extension movement of the ankle at a frequency of 0.5 Hz is then recorded. Then for the mirror effect the software reverses the recorded movement, the lower right limb becomes the lower left limb on the screen. The subject only observe the movement on the screen during the recordings. The subject does not produce any movement.<br>Device: Observation and imagination (OBS-IM)<br>* Subject is seated in a chair facing IVS4. He places his right lower under the screen. The flexion / extension movement of the ankle at a frequency of 0.5 Hz is then recorded. Then for the mirror effect the software reverses the recorded movement, the lower right limb becomes the lower left limb on the screen. The subject observe the movement but also imagine to realized it.<br>Device: Observation and realization (OBS-REAL)<br>* Subject is seated in a chair facing IVS4. He places his right lower under the screen. The flexion / extension movement of the ankle at a frequency of 0.5 Hz is then recorded. Then for the mirror effect the software reverses the recorded movement, the lower right limb becomes the lower left limb on the screen. The subject observe the movement on the screen and realized it<br>|
| Old<br>40 right handed healthy subject aged between 41 and 75 | Device: Observation (OBS)<br>* Subject is seated in a chair facing IVS4. He places his right lower under the screen. The flexion / extension movement of the ankle at a frequency of 0.5 Hz is then recorded. Then for the mirror effect the software reverses the recorded movement, the lower right limb becomes the lower left limb on the screen. The subject only observe the movement on the screen during the recordings. The subject does not produce any movement.<br>Device: Observation and imagination (OBS-IM)<br>* Subject is seated in a chair facing IVS4. He places his right lower under the screen. The flexion / extension movement of the ankle at a frequency of 0.5 Hz is then recorded. Then for the mirror effect the software reverses the recorded movement, the lower right limb becomes the lower left limb on the screen. The subject observe the movement but also imagine to realized it.<br>Device: Observation and realization (OBS-REAL)<br>* Subject is seated in a chair facing IVS4. He places his right lower under the screen. The flexion / extension movement of the ankle at a frequency of 0.5 Hz is then recorded. Then for the mirror effect the software reverses the recorded movement, the lower right limb becomes the lower left limb on the screen. The subject observe the movement on the screen and realized it<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in the EEG spectral alpha and beta-band power (8-12 and 12-30Hz) during movement (Event related Desynchronisation) | Beta desynchronization in dB normalized to a baseline before the movement. | Day 0 | 
| Change in the beta band after movement (Beta-Rebound). | Beta Rebound power in dB normalized to a baseline before the movement. | Day 0 | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Mean change in the concentration of oxyhemoglobin during the task | Changes in the concentration of oxyhemoglobin during the task measured with Fnirs device | Day 0 | 
| Mean change in the concentration of deoxyhemoglobin during the task | Changes in the concentration of deoxyhemoglobin during the task measured with Fnirs device | Day 0 | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Virtual Mirror therapy, Electroencephalography, Near infrared spectroscopy