03126nas a2200313   4500008004100000022001400041245013900055210006900194260001500263520206900278653002002347653002602367653002102393653002202414653001302436653001102449653002702460653002502487100001702512700001702529700001902546700002402565700002302589700002102612700001402633700002402647700002202671856011902693       2022                        eng d  a1940-087X00aThe Evoked Potential Operant Conditioning System (EPOCS): A Research Tool and an Emerging Therapy for Chronic Neuromuscular Disorders.0 aEvoked Potential Operant Conditioning System EPOCS A Research To  c2022 08 253 a<p>The Evoked Potential Operant Conditioning System (EPOCS) is a software tool that implements protocols for operantly conditioning stimulus-triggered muscle responses in people with neuromuscular disorders, which in turn can improve sensorimotor function when applied appropriately. EPOCS monitors the state of specific target muscles-e.g., from surface electromyography (EMG) while standing, or from gait cycle measurements while walking on a treadmill-and automatically triggers calibrated stimulation when pre-defined conditions are met. It provides two forms of feedback that enable a person to learn to modulate the targeted pathway's excitability. First, it continuously monitors ongoing EMG activity in the target muscle, guiding the person to produce a consistent level of activity suitable for conditioning. Second, it provides immediate feedback of the response size following each stimulation and indicates whether it has reached the target value. To illustrate its use, this article describes a protocol through which a person can learn to decrease the size of the Hoffmann reflex-the electrically-elicited analog of the spinal stretch reflex-in the soleus muscle. Down-conditioning this pathway's excitability can improve walking in people with spastic gait due to incomplete spinal cord injury. The article demonstrates how to set up the equipment; how to place stimulating and recording electrodes; and how to use the free software to optimize electrode placement, measure the recruitment curve of direct motor and reflex responses, measure the response without operant conditioning, condition the reflex, and analyze the resulting data. It illustrates how the reflex changes over multiple sessions and how walking improves. It also discusses how the system can be applied to other kinds of evoked responses and to other kinds of stimulation, e.g., motor evoked potentials to transcranial magnetic stimulation; how it can address various clinical problems; and how it can support research studies of sensorimotor function in health and disease.</p>10aChronic Disease10aConditioning, Operant10aElectromyography10aEvoked Potentials10aH-Reflex10aHumans10aNeuromuscular Diseases10aSpinal Cord Injuries1 aHill, Jeremy1 aGupta, Disha1 aEftekhar, Amir1 aBrangaccio, Jodi, A1 aNorton, James, J S1 aMcLeod, Michelle1 aFake, Tim1 aWolpaw, Jonathan, R1 aThompson, Aiko, K  uhttps://neurotechcenter.org/publications/2022/evoked-potential-operant-conditioning-system-epocs-research-tool-and02566nas a2200325   4500008004100000022001400041245013800055210006900193260001200262300001100274490000800285520150800293653002601801653002601827653001601853653001301869653001101882653003101893100002001924700002301944700002001967700002001987700001802007700002302025700001902048700001902067700002402086700001902110856011102129       2020                        eng d  a1873-423500aBreathable, large-area epidermal electronic systems for recording electromyographic activity during operant conditioning of H-reflex.0 aBreathable largearea epidermal electronic systems for recording   c10/2020  a1124040 v1653 a<p>Operant conditioning of Hoffmann's reflex (H-reflex) is a non-invasive and targeted therapeutic intervention for patients with movement disorders following spinal cord injury. The reflex-conditioning protocol uses electromyography (EMG) to measure reflexes from specific muscles elicited using transcutaneous electrical stimulation. Despite recent advances in wearable electronics, existing EMG systems that measure muscle activity for operant conditioning of spinal reflexes still use rigid metal electrodes with conductive gels and aggressive adhesives, while requiring precise positioning to ensure reliability of data across experimental sessions. Here, we present the first large-area epidermal electronic system (L-EES) and demonstrate its use in every step of the reflex-conditioning protocol. The L-EES is a stretchable and breathable composite of nanomembrane electrodes (16 electrodes in a four by four array), elastomer, and fabric. The nanomembrane electrode array enables EMG recording from a large surface area on the skin and the breathable elastomer with fabric is biocompatible and comfortable for patients. We show that L-EES can record direct muscle responses (M-waves) and H-reflexes, both of which are comparable to those recorded using conventional EMG recording systems. In addition, L-EES may improve the reflex-conditioning protocol; it has potential to automatically optimize EMG electrode positioning, which may reduce setup time and error across experimental sessions.</p>10aBiosensing Techniques10aConditioning, Operant10aElectronics10aH-Reflex10aHumans10aReproducibility of Results1 aKwon, Young-Tae1 aNorton, James, J S1 aCutrone, Andrew1 aLim, Hyo-Ryoung1 aKwon, Shinjae1 aChoi, Jeongmoon, J1 aKim, Hee, Seok1 aJang, Young, C1 aWolpaw, Jonathan, R1 aYeo, Woon-Hong  uhttps://neurotechcenter.org/publications/2020/breathable-large-area-epidermal-electronic-systems-recording