{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T21:34:48Z","timestamp":1793741688627,"version":"4.6.1"},"reference-count":52,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2025,3,28]],"date-time":"2025-03-28T00:00:00Z","timestamp":1743120000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Kyoto Tachibana University Research Fund"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Brain Sciences"],"abstract":"<jats:p>Background\/Objectives: This study evaluated the effects of a tactile-discrimination compensatory real-time feedback device on hand sensorimotor function in cervical spinal cord injury patients. The study assessed changes in hand numbness, dexterity, and electroencephalogram (EEG) activity, particularly \u03b3-wave power in the sensorimotor area during skilled finger movements. Methods: Three patients with cervical spinal cord injury who presented with hand sensorimotor dysfunction underwent treatment with this device. All cases underwent the intervention using an AB design; A is the exercise task without the system device, and B is the exercise task under the system device. To confirm the reproducibility and minimize the influence of confounding factors, a multiple-baseline design, in which the intervention period was staggered for each subject, was applied. To determine efficacy, the hand numbness numerical rating scale, peg test, and EEG were measured daily, and Tau-U calculations were performed. Results: In two of three cases, moderate or very large changes were observed in numbness in B. In all cases, there was a large or very large change in the peg test results in the B. Regarding EEG activity, the non-skilled participants showed amplification of \u03b3-wave power in the sensorimotor area during the B. Conversely, in the skilled participants, the \u03b3-wave power of the sensorimotor area was attenuated during skillful movements. Conclusions: These findings indicate that the ability of the brain to compare and align predictive control with sensory feedback might be compromised in patients with damage to the afferent pathways of the central nervous system. Moreover, the use of this device appears to have played a role in supporting functional recovery.<\/jats:p>","DOI":"10.3390\/brainsci15040352","type":"journal-article","created":{"date-parts":[[2025,3,28]],"date-time":"2025-03-28T04:36:48Z","timestamp":1743136608000},"page":"352","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Enhancing Hand Sensorimotor Function in Individuals with Cervical Spinal Cord Injury: A Novel Tactile Discrimination Feedback Approach Using a Multiple-Baseline Design"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8929-2393","authenticated-orcid":false,"given":"Ken","family":"Kitai","sequence":"first","affiliation":[{"name":"Rehabilitation Department, Maizuru Red Cross Hospital, Maizuru City 624-0906, Kyoto, Japan"},{"name":"Graduate School of Health Sciences, Kyoto Tachibana University, Kyoto City 607-8175, Kyoto, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kaichi","family":"Nishigaya","sequence":"additional","affiliation":[{"name":"Rehabilitation Department, Zenjokai Rehabilitation Hospital, Nagoya City 457-0046, Aichi, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasuhisa","family":"Mizomoto","sequence":"additional","affiliation":[{"name":"Rehabilitation Department, Watanabe Hospital, Chita 470-3235, Aichi, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-3387-4438","authenticated-orcid":false,"given":"Hiroki","family":"Ito","sequence":"additional","affiliation":[{"name":"Graduate School of Health Sciences, Kyoto Tachibana University, Kyoto City 607-8175, Kyoto, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3790-5439","authenticated-orcid":false,"given":"Ryosuke","family":"Yamauchi","sequence":"additional","affiliation":[{"name":"Graduate School of Health Sciences, Kyoto Tachibana University, Kyoto City 607-8175, Kyoto, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1885-527X","authenticated-orcid":false,"given":"Osamu","family":"Katayama","sequence":"additional","affiliation":[{"name":"Department of Preventive Gerontology, Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, Obu City 474-8511, Aichi, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kiichiro","family":"Morita","sequence":"additional","affiliation":[{"name":"Cognitive and Molecular Research Institute of Brain Diseases, Kurume University, Kurume 830-0011, Fukuoka, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shin","family":"Murata","sequence":"additional","affiliation":[{"name":"Graduate School of Health Sciences, Kyoto Tachibana University, Kyoto City 607-8175, Kyoto, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8784-6452","authenticated-orcid":false,"given":"Takayuki","family":"Kodama","sequence":"additional","affiliation":[{"name":"Graduate School of Health Sciences, Kyoto Tachibana University, Kyoto City 607-8175, Kyoto, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,3,28]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Hodler, J. (2020). Spinal trauma and spinal cord injury (SCI). Diseases of the Brain, Head and Neck, Diagnostic Imaging, Springer.","DOI":"10.1007\/978-3-030-38490-6"},{"key":"ref_2","unstructured":"Fakhoury, J., and Dowling, T.J. (2023). Cervical degenerative disc disease. StatPearls, StatPearls Publishing."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1533","DOI":"10.1007\/s00586-011-1811-9","article-title":"Cervical spondylotic myelopathy: Conservative surgical versus surgical treatment after 10 years","volume":"20","year":"2011","journal-title":"Eur. Spine J."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"89S","DOI":"10.1177\/2192568219830943","article-title":"Management of acute traumatic central cord syndrome: A narrative review","volume":"9","author":"Divi","year":"2019","journal-title":"Glob. Spine J."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1548","DOI":"10.1089\/neu.2011.2226","article-title":"The health and life priorities of individuals with spinal cord injury: A systematic review","volume":"29","author":"Simpson","year":"2012","journal-title":"J. Neurotrauma"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"380","DOI":"10.1007\/s002640050190","article-title":"Acute central cervical cord injury presenting with only upper extremity involvement","volume":"21","author":"Dai","year":"1997","journal-title":"Int. Orthop."},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Walker, J.R., and Detloff, M.R. (2021). Plasticity in cervical motor circuits following spinal cord injury and rehabilitation. Biology, 10.","DOI":"10.3390\/biology10100976"},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Rehman, M.U., Sneed, D., Sutor, T.W., Hoenig, H., and Gorgey, A.S. (2023). Optimization of Transspinal Stimulation Applications for Motor Recovery After Spinal Cord Injury: Scoping Review. J. Clin. Med., 12.","DOI":"10.3390\/jcm12030854"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1395","DOI":"10.1177\/21925682231210468","article-title":"Diagnostic criteria incubator. The frequency of symptoms in patients with a diagnosis of degenerative cervical myelopathy: Results of a scoping review","volume":"14","author":"Jiang","year":"2024","journal-title":"Glob. Spine J."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"317","DOI":"10.1007\/978-0-387-77064-2_16","article-title":"The roles of vision and proprioception in the planning of reaching movements","volume":"629","author":"Sarlegna","year":"2009","journal-title":"Adv. Exp. Med. Biol."},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Khojasteh, B., Janko, M., and Visell, Y. (2018). Complexity, rate, and scale in sliding friction dynamics between a finger and textured surface. Sci. Rep., 8.","DOI":"10.1038\/s41598-018-31818-3"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"128","DOI":"10.1186\/s12984-020-00748-5","article-title":"Technology-aided assessment of functionally relevant sensorimotor impairments in arm and hand of post-stroke individuals","volume":"17","author":"Kanzler","year":"2020","journal-title":"J. Neuroeng. Rehabil."},{"key":"ref_13","first-page":"CD006331","article-title":"Interventions for sensory impairment in the upper limb after stroke","volume":"2010","author":"Doyle","year":"2010","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"561","DOI":"10.1093\/cercor\/bhx338","article-title":"Treatment with the neutralizing antibody against repulsive guidance molecule-A promotes recovery from impaired manual dexterity in a primate model of spinal cord injury","volume":"29","author":"Nakagawa","year":"2019","journal-title":"Cereb. Cortex"},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Hoogewoud, F., Hamadjida, A., Wyss, A.F., Mir, A., Schwab, M.E., Belhaj-Saif, A., and Rouiller, E.M. (2013). Comparison of functional recovery of manual dexterity after unilateral spinal cord lesion or motor cortex lesion in adult macaque monkeys. Front. Neurol., 4.","DOI":"10.3389\/fneur.2013.00101"},{"key":"ref_16","first-page":"649","article-title":"Effectiveness of sensory compensation approach for hand sensory-motor dysfunction following central cervical spinal cord injury","volume":"10","author":"Kitai","year":"2022","journal-title":"Int. J. Phys. Med. Rehabil."},{"key":"ref_17","first-page":"1950","article-title":"Verifying the efficacy of a tactile perceptual discrimination stimulation approach for individuals with finger sensorimotor dysfunction: A case report and literature review","volume":"9","author":"Kitai","year":"2024","journal-title":"Ann. Case Rep."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"905","DOI":"10.1089\/neu.2010.1504","article-title":"The Graded Redefined Assessment of Strength Sensibility and prehension: Reliability and validity","volume":"29","author":"Beaton","year":"2012","journal-title":"J. Neurotrauma"},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Gruenwald, J., Znobishchev, A., Kapeller, C., Kamada, K., Scharinger, J., and Guger, C. (2019). Time-variant linear discriminant analysis improves hand gesture and finger movement decoding for invasive brain-computer interfaces. Front. Neurosci., 13.","DOI":"10.3389\/fnins.2019.00901"},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Salis, F., Costaggiu, D., and Mandas, A. (2023). Mini-Mental State Examination: Optimal cut-off levels for mild and severe cognitive impairment. Geriatrics, 8.","DOI":"10.3390\/geriatrics8010012"},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Kitai, K., Odagiri, M., Yamauchi, R., and Kodama, T. (2021). Evaluation of intervention effectiveness of sensory compensatory training with tactile discrimination feedback on sensorimotor dysfunction of the hand after stroke. Brain Sci., 11.","DOI":"10.3390\/brainsci11101314"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"210","DOI":"10.1589\/jpts.32.210","article-title":"Introduction of the purdue pegboard test for fine assessment of severity of cervical myelopathy before and after surgery","volume":"32","author":"Irie","year":"2020","journal-title":"J. Phys. Ther. Sci."},{"key":"ref_23","first-page":"15","article-title":"Roughness evaluation by wearable tactile sensor utilizing human active sensing","volume":"3","author":"Tanaka","year":"2016","journal-title":"Mech. Eng. J."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1035","DOI":"10.2165\/00007256-200434150-00003","article-title":"Single-subject research designs and data analyses for assessing elite athletes\u2019 conditioning","volume":"34","author":"Kinugasa","year":"2004","journal-title":"Sports Med."},{"key":"ref_25","unstructured":"Kratochwill, T.R., Hitchcock, J., Horner, R.H., Levin, J.R., Odom, S.L., Rindskopf, D.M., and Shadish, W.R. (2025, January 03). Single-Case Designs Technical Documentation, Available online: https:\/\/files.eric.ed.gov\/fulltext\/ED510743.pdf."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1045","DOI":"10.1161\/01.STR.0000206463.66461.97","article-title":"A placebo-controlled trial of constraint-induced movement therapy for upper extremity after stroke","volume":"37","author":"Taub","year":"2006","journal-title":"Stroke"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"411","DOI":"10.1016\/S0893-6080(00)00026-5","article-title":"Independent component analysis: Algorithms and applications","volume":"13","author":"Oja","year":"2000","journal-title":"Neural Netw."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1016\/j.jneumeth.2003.10.009","article-title":"EEGLAB: An open source toolbox for analysis of single-trial EEG dynamics including independent component analysis","volume":"134","author":"Delorme","year":"2004","journal-title":"J. Neurosci. Methods"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1129","DOI":"10.1162\/neco.1995.7.6.1129","article-title":"An information-maximization approach to blind separation and blind deconvolution","volume":"7","author":"Bell","year":"1995","journal-title":"Neural Comput."},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Zhang, S., Zhu, Z., Zhang, B., Feng, B., Yu, T., and Li, Z. (2020). The CSP-based new features plus non-convex log sparse feature selection for motor imagery EEG classification. Sensors, 20.","DOI":"10.3390\/s20174749"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"284","DOI":"10.1016\/j.beth.2010.08.006","article-title":"Combining nonoverlap and trend for single\u2013case research: Tau\u2013U","volume":"42","author":"Parker","year":"2011","journal-title":"Behav. Ther."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"510","DOI":"10.1177\/0145445515581327","article-title":"Interrater agreement between visual analysts of single-case data: A meta-analysis","volume":"39","author":"Ninci","year":"2015","journal-title":"Behav. Modif."},{"key":"ref_33","unstructured":"Vannest, K.J., Parker, R.I., Gonen, O., and Adiguzel, T. (2016). Single Case Res.: Web-Based Calculators for SCR Analysis. (Version 2.0), Texas A&M University. Available online: https:\/\/singlecaseresearch.org\/."},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Quandt, F., B\u00f6nstrup, M., Schulz, R., Timmermann, J.E., Zimerman, M., Nolte, G., and Hummel, F.C. (2016). Spectral variability in the aged brain during fine motor control. Front. Aging Neurosci., 8.","DOI":"10.3389\/fnagi.2016.00305"},{"key":"ref_35","first-page":"1675","article-title":"Pre-Movement Cortico-Muscular Dynamics Underlying Improved Parkinson Gait Initiation After Instructed Arm Swing","volume":"10","author":"Weersink","year":"2020","journal-title":"J. Park. Dis."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"1476264","DOI":"10.3389\/fnins.2025.1476264","article-title":"The influence of time and visualization on neurofeedback-guided parietal alpha downregulation and sense of presence in virtual reality","volume":"19","author":"Botrel","year":"2025","journal-title":"Front. Neurosci."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"108696","DOI":"10.1016\/j.celrep.2021.108696","article-title":"Gamma frequency activation of inhibitory neurons in the acute phase after stroke attenuates vascular and behavioral dysfunction","volume":"34","author":"Balbi","year":"2021","journal-title":"Cell Rep."},{"key":"ref_38","doi-asserted-by":"crossref","unstructured":"Amo Usanos, C., Boquete, L., de Santiago, L., Barea Navarro, R., and Cavaliere, C. (2020). Induced gamma-band activity during actual and imaginary movements: EEG analysis. Sensors, 20.","DOI":"10.3390\/s20061545"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"927","DOI":"10.1093\/schbul\/sbn062","article-title":"The role of oscillations and synchrony in cortical networks and their putative relevance for the pathophysiology of schizophrenia","volume":"34","author":"Uhlhaas","year":"2008","journal-title":"Schizophr. Bull."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"151","DOI":"10.1016\/S1364-6613(99)01299-1","article-title":"Oscillatory gamma activity in humans and its role in object representation","volume":"3","author":"Bertrand","year":"1999","journal-title":"Trends Cogn. Sci."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"fcac249","DOI":"10.1093\/braincomms\/fcac249","article-title":"Cortical theta-gamma coupling governs the adaptive control of motor commands","volume":"4","author":"Spooner","year":"2022","journal-title":"Brain Commun."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"118645","DOI":"10.1016\/j.neuroimage.2021.118645","article-title":"Brain oscillatory correlates of visuomotor adaptive learning","volume":"245","author":"Struber","year":"2021","journal-title":"NeuroImage"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"771","DOI":"10.1177\/0269215514556087","article-title":"Cortical vs. afferent Stimulation as an Adjunct to Functional Task Practice Training: A Randomized, Comparative Pilot Study in People with Cervical Spinal Cord Injury","volume":"29","year":"2015","journal-title":"Clin. Rehabil."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"567","DOI":"10.1016\/j.humov.2011.07.001","article-title":"Differences in cortical activity related to motor planning between experienced guitarists and non-musicians during guitar playing","volume":"31","author":"Wright","year":"2012","journal-title":"Hum. Mov. Sci."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"pzab250","DOI":"10.1093\/ptj\/pzab250","article-title":"Updates in motor learning: Implications for physical therapist practice and education","volume":"102","author":"Leech","year":"2022","journal-title":"Phys. Ther."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"1477","DOI":"10.1016\/j.neuron.2013.10.059","article-title":"Membrane potential dynamics of neocortical projection neurons driving target-specific signals","volume":"80","author":"Yamashita","year":"2013","journal-title":"Neuron"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"353","DOI":"10.1002\/ana.22613","article-title":"Electrocorticographic control of a prosthetic arm in paralyzed patients","volume":"71","author":"Yanagisawa","year":"2012","journal-title":"Ann. Neurol."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"254","DOI":"10.1002\/dev.20508","article-title":"Recovery of motor function after stroke","volume":"54","author":"Sharma","year":"2012","journal-title":"Dev. Psychobiol."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"219","DOI":"10.1016\/j.concog.2007.03.010","article-title":"Beyond the comparator model: A multifactorial two-step account of agency","volume":"17","author":"Synofzik","year":"2008","journal-title":"Conscious. Cogn."},{"key":"ref_50","doi-asserted-by":"crossref","unstructured":"Chen, L., Meng, F., Huo, C., Shao, G., Pan, G., Zhang, X., Zhang, S., and Li, Z. (2025). Effects of tactile feedback in post-stroke hand rehabilitation on functional connectivity and cortical activation: An fNIRS study. Biomed. Opt. Express, 16.","DOI":"10.1364\/BOE.541820"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"334","DOI":"10.4103\/aian.aian_207_23","article-title":"Minimal clinically important difference (MCID) in patient-reported outcome measures for neurological conditions: Review of concept and methods","volume":"26","author":"Mishra","year":"2023","journal-title":"Ann. Indian Acad. Neurol."},{"key":"ref_52","doi-asserted-by":"crossref","unstructured":"Reuter, E.M., Booms, A., and Leow, L.A. (2022). Using EEG to study sensorimotor adaptation. Neurosci. Biobehav. Rev., 134.","DOI":"10.1016\/j.neubiorev.2021.104520"}],"container-title":["Brain Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-3425\/15\/4\/352\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T17:03:56Z","timestamp":1760029436000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-3425\/15\/4\/352"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3,28]]},"references-count":52,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2025,4]]}},"alternative-id":["brainsci15040352"],"URL":"https:\/\/doi.org\/10.3390\/brainsci15040352","relation":{},"ISSN":["2076-3425"],"issn-type":[{"value":"2076-3425","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,3,28]]}}}