IntroductionThis study investigates the effects of visual distractors in virtual reality (VR) environments on sustained attention, focusing on how visual distraction modulates neural mechanisms of attentional allocation and regulation.MethodsBehavioral and electroencephalographic (EEG) data were collected from 66 participants performing a Go/No-go continuous performance test (CPT) in a virtual classroom under conditions with (Y-D) and without (N-D) visual distractors. We analyzed behavioral performance (commission/omission errors, multipress, reaction time), event-related potential (P300) characteristics (latency, amplitude), and nonlinear dynamics (sample entropy, fuzzy entropy) of the EEG signals.ResultsBehavioral results revealed that visual distractors significantly increased commission errors, omission errors, and multipress (all p < 0.001), with no significant difference in reaction time. EEG analysis demonstrated that distractors significantly prolonged P300 latency, particularly at CPz, Pz, and Oz electrodes, and increased P300 amplitude at Fz, FCz, and Oz. Furthermore, both sample entropy and fuzzy entropy values were significantly higher under distraction conditions in the frontal, central, and parietal regions.DiscussionThese findings indicate that visual distractors disrupt cognitive processes related to visual information integration, attentional control, and decision-making, leading to decreased behavioral performance and increased neural complexity. This study deepens the understanding of the neural mechanisms of attention processing under ecological conditions and provides a scientific basis for optimizing educational environments and developing attention assessment tools based on neuroengineering.

BackgroundMental health issues pose a significant challenge for medical providers and the general public. The World Health Organization predicts that by 2030, mental health problems will become the leading cause of global disease burden, highlighting the urgent need for effective mental health interventions. Virtual reality-cognitive behavioral therapy (VR-CBT) has emerged as a promising treatment for neuropsychiatric disorders, offering immersive and engaging therapeutic experiences.ObjectiveThis study aims to assess the advancements in applying virtual reality (VR) technology for diagnosing and treating mental illnesses such as anxiety, depression, and attention deficit hyperactivity disorder (ADHD). It also explores the integration of artificial intelligence (AI) with VR technology in mental health treatment and introduces the CBT-CHAT Treatment Framework to enhance cognitive behavioral therapy.MethodA systematic search was conducted across the databases of Google Scholar, PubMed, and Web of Science, followed by a scoping review. Duplicates were removed using the EndNote literature management software. Each article was then carefully read and evaluated for its research content, methodology, results, and contribution to the application of VR technology in mental health domains.ResultsThe search retrieved 686 articles, and after applying inclusion and exclusion criteria, 32 articles were ultimately selected. These articles covered the application of VR in anxiety, depression, and ADHD. The research results indicate that VR shows promising outcomes in the diagnosis, treatment, and rehabilitation of anxiety, depression, and ADHD, particularly in the diagnosis, treatment, and rehabilitation of ADHD.ConclusionThe previously published studies consistently demonstrate that VR is an effective tool for supporting the treatment of mental illnesses across various settings and recommend its incorporation into clinical practice.

Compared to traditional continuous performance tasks, virtual reality-based continuous performance tests (VR-CPT) offer higher ecological validity. While previous studies have primarily focused on behavioral outcomes in VR-CPT and incorporated various distractors to enhance ecological realism, little attention has been paid to the effects of distractors on EEG. Therefore, our study aimed to investigate the influence of distractors on EEG during VR-CPT. We studied visual distractors and auditory distractors separately, recruiting 68 subjects (M =20.82, SD =1.72) and asking each to complete four tasks. These tasks were categorized into four groups according to the presence or absence of visual and auditory distractors. We conducted paired t-tests on the mean relative power of the five electrodes in the ROI region across different frequency bands. Significant differences were found in theta waves between Group 3 (M =2.49, SD =2.02) and Group 4 (M =2.68, SD =2.39) (p < 0.05); in alpha waves between Group 3 (M =2.08, SD =3.73) and Group 4 (M =3.03, SD =4.60) (p < 0.001); and in beta waves between Group 1 (M = -4.44 , SD =2.29) and Group 2 (M = -5.03 , SD =2.48) (p < 0.001), as well as between Group 3 (M = -4.48 , SD =2.03) and Group 4 (M = -4.67 , SD =2.23) (p < 0.05). The incorporation of distractors in VR-CPT modulates EEG signals across different frequency bands, with visual distractors attenuating theta band activity, auditory distractors enhancing alpha band activity, and both types of distractors reducing beta oscillations following target stimuli. This insight holds significant promise for the rehabilitation of children and adolescents with attention deficits.

Attention problems are common problems in adolescents and even adults. In this study, a training protocol based on flashcard game paradigm was designed, and reaction time and eye movement data were recorded during the training. The subjects received attention training twice a week for one month. Subjects took the IVA-CPT attention test before and after training. The study compared and analysed parameters such as reaction time, fixation distribution, fixation time, scanning length, etc. The experimental results showed that the task reaction time of the subjects was significantly shortened after attention training, and various parameters of eye movements were improved and statistically different. After training the attention quotients of IVA-CPT test were greatly improved and statistically different from those before training. This study provides a theoretical basis and technical support for the study of attention training and training effects.

探索相位幅度耦合和复杂网络方法在酒精依赖患者事件相关电位的脑网络机制研究中的应用.以开源的76例酒精依赖患者和45例健康对照在延迟匹配样本范式中的事件相关电位为研究对象.首先对数据进行预处理,然后使用调制指数方法,计算所有导联对间theta-gamma、alpha-gamma相位幅度耦合(TGC、AGC)强度,构建因果脑网络,并计算网络密度为0.3时的脑网络图论参数.此外,还计算导联内theta、alpha、beta、gamma节律小波包能量,以及疲劳因子,数据以四分位数表示50％(25％,75％).结果表明,只有非靶刺激时两组之间的耦合强度有显著差异.酒精依赖患者多个导联对间的TGC、AGC均显著降低(分别占比15.29％、1.29％,均P＜0.05),平均耦合强度显著降低,以TGC 尤为明显[TGC:0.014(0.011,0.018)vs 0.012(0.010,0.014),P=0.002;AGC:0.012(0.010,0.014)vs 0.011(0.010,0.012),P=0.005].在TGC网络中,酒精依赖患者的特征路径长度[84.13(60.96,110.33)vs 104.24(86.93,118.98),P=0.005]、直径[222.40(154.78,254.39)vs 253.39(207.82,307.99),P=0.003]显著增加,平均聚类系数[0.013(0.010,0.019)vs 0.009(0.008,0.012),P＜0.001]、全局效率[0.014(0.011,0.016)vs 0.011(0.010,0.013),P＜0.001]、平均局部效率[0.017(0.013,0.022)vs 0.013(0.011,0.017),P＜0.001]、传递性[0.011(0.008,0.016)vs 0.008(0.007,0.010),P＜0.001]均显著降低.AGC网络的结果与TGC网络的结果相似,但是其直径无统计学差异.酒精依赖患者多个导联的theta、alpha、beta节律小波包能量显著降低(分别占比95.08％、100％、50.82％,均P＜0.05),部分导联的疲劳因子显著降低(占比45.90％,均P＜0.05).在非靶刺激试验时,酒精依赖患者的皮层兴奋性增强,大脑抑制控制能力减弱,TGC和AGC脑网络的功能分离和整合能力降低,脑网络拓扑组织紊乱.

Abstract Objectives The aim of this study was to investigate how thermal pain stimulation on the oral mucosa affects the brain’s pain perception and brain network connectivity using electroencephalograms (EEGs) and to reveal the central systemic mechanisms of oral chronic pain such as burning mouth syndrome (BMS). Materials and methods EEG data were collected from 40 healthy volunteers (24 males and 16 females) at rest and during thermal stimulation of the oral mucosa at 45°C, 48°C, 51°C, and 54°C. The power of six frequency bands was calculated for the acquired EEG data. A directed transform function (DTF) was used to construct the network and calculate the network connection parameters. Results The results showed that subjective pain scores increased significantly with increasing temperature (p < 0.001). Compared with the resting baseline state, the average power of both theta and alpha bands decreased with increasing temperature (p < 0.001), while the average power of the gamma band increased (p < 0.001). Moreover, the mean values decreased, as did the clustering coefficients and global efficiency in the low and middle frequency bands. Conclusions The thermal stimulation of the oral mucosa mainly affects the alpha power decreasing in the contralateral somatosensory area. Clinical Relevance This experiment provides a theoretical basis and technical support for studying the mechanism of transmission and perception of oral thermal pain through the trigeminal pathway to the central nervous system in human subjects and provides a theoretical basis for the central system mechanism of chronic pain syndromes such as BMS.

In cognitive neuroscience, there is an increasing interest in identifying and understanding the synchronization of distinct neural oscillations with different frequencies that might support dynamic communication within the brain. This study explored the cross-frequency phase-amplitude coupling brain network characteristics of resting-state electroencephalograms between 30 children with attention-deficit/hyperactivity disorder (ADHD) and 30 age-matched typically developing children. Compared with control group, children with ADHD show increased coupling intensity and altered distribution patterns of dominant paired channels, especially in the δ-γH, θ-γH, α-γH, βL-γH, and βH-γH coupling networks. Regarding graph theory properties, the characteristic path length, the mean clustering coefficient, the global efficiency, and the mean local efficiency significant difference in many cross-frequency coupling networks, especially in the δ-γH, θ-γH, α-γH, βL-γH, and βH-γH coupling networks. The area under the receiver operating characteristic curve (AUC) in low-frequency coupling with a high-gamma frequency was larger than that in coupling with low-gamma frequency (AUC values of δ-γL, θ-γL, α-γL, βL-γL, βH-γL, δ-γH, θ-γH, α-γH, βL-γH, and βH-γH were 0.794, 0.722, 0.666, 0.570, 0.881, 0.992, 0.998, 0.998, 0.989, and 0.974, respectively). These findings demonstrate altered coupling intensity and disrupted topological organization of coupling networks, support the altered brain network theory in children with ADHD. The coupling intensity and graph theory properties of low-frequency coupling with high-gamma frequency were promising resting-state electroencephalogram biomarkers of ADHD in children.

Objective To investigate the temporospatial changes in sympathetic skin response (SSR) and electroencephalogram (EEG) under thermal stimuli and to draw a topographic map of SSR threshold temperature of the oral mucosa. Materials and Methods A total of 40 healthy volunteers (24 men, 16 women, mean age of 23 ± 3) were enrolled. Thermal stimuli were applied to the 35 partitions of oral mucosa starting from 36°C at the gradience of 1°C and the lowest temperature evoked SSR was defined as SSR threshold temperature. SSR and EEG signals at 45, 48, 51, and 54°C were then recorded synchronously. Results The SSR threshold temperature increased from the anterior areas to the posterior areas. No significant difference between bilateral corresponding areas or between genders was observed. The SSR amplitude value increased from 45 to 54°C in the same area, while the highest value was recorded on the tip of the tongue and decreased backwardly from the anterior area. There were significant differences in latency of SSR between the tip of the tongue and the molar areas of the oral cavity ( p < 0.05). Reduction in the alpha frequency band was observed after thermal stimuli, and there were statistical differences between baseline and thermal stimuli in all four degrees of temperatures ( p < 0.05). Conclusion The result of the experiment revealed that the autonomic and central nervous system (CNS) played important roles in thermal perception of oral mucosa and could be helpful for better understanding of pathological mechanism of burning mouth syndrome (BMS).

Neurofeedback (NF) is a drug-free training intervention aimed at reducing symptoms of attention deficit/hyperactivity disorder (ADHD) by self-regulation of EEG rhythm features. It is worth exploring the effects on EEG rhythm characteristics and ADHD symptoms during training, as it can serve as crucial evidence of the efficacy and efficiency of NF training. Theta/beta NF training was performed by 21 children with ADHD, and EEG data were recorded during training. The average power of five EEG rhythmic features and the theta/beta ratio (TBR) were calculated using power spectrum analysis. The differences in therapeutic effects at each stage of NF training were assessed with the SWAN scale. Mean theta power calculated at Cz decreased significantly and relative beta power increased significantly during the last training compared to the first training period in children with ADHD. Moreover, TBR values decreased significantly at both Fz and Cz, which were highly suppressed in sessions 3 (approximately 36 trials) and 5 (approximately 60 trials) of the 5 stages. Mean gamma power at the last training increased significantly, as did the gamma activity in session 5 calculated at Cz during the training stage. The progressively increased SWAN scale values at each stage also showed the role of NF in the improvement of ADHD symptoms. This study shows that children with ADHD can self-regulate EEG rhythmic features and that ADHD symptoms are improved during NF. Changes in task-state EEG rhythmic power can be used as neurophysiological biomarkers of the efficacy and efficiency of NF training in ADHD.Funding Information: This work was supported by the National Natural Science Foundation of China (61175118 and 61977050) and Scientific Research Foundation of Tianjin Education Commission (2018KJ083).Declaration of Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.Ethics Approval Statement: The entire experiment was performed voluntarily by the children and their guardians, and written informed consent was signed. The study was approved by the Ethics Committees of Tianjin Medical University on 4 January 2020., Study no: TMUHMEC202031.

目的 研究注意力缺陷多动障碍(ADHD)儿童的格兰杰因果网络异常特征,分析二值化网络与权重网络拓扑属性差异.方法 采集22例ADHD儿童与14例健康儿童闭眼静息态脑电数据,使用定向传递函数构建因果连接矩阵,计算两组儿童二值化与权重网络的聚类系数与特征路径长度,并比较两组儿童优势导联对分布差异.结果 ADHD儿童聚类系数增加、特征路径长度降低,且权重网络差异更明显;两组儿童优势导联对都呈现自下而上的信息流模式,ADHD儿童优势导联对分布更加规则,优势导联对信息流主要流向F7、F8两个节点.结论 ADHD儿童脑网络存在异常密集连接和异常高速信息传递,脑网络模块化增强,集成能力减弱,脑网络趋向于规则网络.

Altered functional networks in attention deficit/hyperactivity disorder (ADHD) have been frequently reported, but effective connectivity has hardly been studied. Especially the differences of effective connectivity in children with ADHD after receiving neurofeedback (NF) training have been merely reported. Therefore, this study aimed to explore the effective networks of ADHD and the positive influence of NF on the effective networks. Electroencephalogram (EEG) data were recorded from 22 children with ADHD (including data from children pretraining and posttraining) and 15 age-matched healthy controls during an eyes-closed resting state. Phase transfer entropy (PTE) was used to construct the effective connectivity. The topological properties of networks and flow gain were measured separately in four bands (delta, theta, alpha, and beta). Results revealed the following: pretraining children with ADHD manifested a higher clustering coefficient and lower characteristic path length in the delta band than healthy controls; weakened anterior-to-posterior flow gain in the delta band, strengthened posterior-to-anterior flow gain in the alpha band and strengthened anterior-to-posterior flow gain in the beta band were observed in pretraining children with ADHD; The topological properties and flow gain in posttraining children with ADHD were close to those of healthy controls. Moreover, parent’s SWAN presented significant improvements of ADHD symptoms after NF. Our findings revealed that the effective connectivity of ADHD was altered and that NF could improve the brain function of ADHD. The present study provided the first evidence that children with ADHD differed from healthy children in phase-based effective connectivity and that NF could reduce the differences.

根据我国医疗卫生事业发展对医工复合型人才的需求,为培养能够适应我国社会经济,促进健康和医疗卫生事业发展的高素质生物医学工程专业人才,对生物医学工程专业必修课“电子工艺实训”实验分级化教学模式进行研究和探索.论文从构建分级化教学体系、分级化教学模式的实施以及课程考核方式等方面来探讨实验课程教学模式改革的可行性和必要性,由此提出三级教学体系.通过实验内容分级和学生分级来组织实施,激发学生对实验课程的兴趣,不断强化学生动手组装、焊接和调试电路的能力,提高课堂效率和教学质量,培养学生自主设计和研究开发电路的能力.

目的 比较基于非目标导向的动态视频和静态动作图片观察对慢性非流畅性失语症脑卒中患者言语功能的影响.方法 2016年1月至2018年12月,脑卒中非流畅性失语患者30例随机分为两组,对照组(n=15)予以非目标导向手动作图片和动词复述,试验组(n=15)予非目标导向手动作视频和动词复述,共4周.治疗前及治疗后每周末,采用西方失语症成套测验(WAB)进行测试.结果 两组失语商均随时间而改善(F＞ 32.922,P＜0.001),各时间点两组间均无显著性差异(t＜0.699,P＞0.05),时间和分组交互效应显著(F=6.398,P＜0.001),试验组失语商增加更多.结论 动态手动作观察可能较静态观察更有利于脑卒中慢性非流畅性失语患者言语功能的恢复.

目的 研究不同呈现方式(即动态视频及静态动作图片)的同种类视频(如均为非目标导向)对慢性非流畅性失语症的脑卒中患者言语功能的影响.方法 前瞻性研究,选取2016年1月至2018年12月在首都医科大学附属北京友谊医院康复科住院及门诊收治的脑卒中非流畅性失语患者30例,按照完全随机原则分为两组,其中试验组15例,予以动态非目标导向手动作视频+动词复述;对照组15例,予以静态非目标导向手动作视频+动词复述.每天训练1次,每次30 min,每周训练6 d,共4周.所有患者均在治疗前及治疗4周后接受西方失语症成套测验(WAB).采用两独立样本t检验分析治疗后组间差异,采用配对样本t检验分析治疗前后的组内变化.结果 两组患者的WAB检查在治疗前组间差异无统计学意义,两组具有可比性(P流畅度=0.125,P复述=0.362,P听理解=0.418,P命名=0.719).4周训练后,两组患者的言语流畅性、复述检查在各自组内分数的提高具有统计学意义(试验组治疗前后对比:流畅度评分:治疗前2.24±1.266,治疗后5.76±0.861,P流畅度=0.023,复述评分:治疗前56.51±6.612,治疗后81.27±8.992,P复述=0.037;对照组治疗前后对比:流畅度评分:治疗前2.41±1.409,治疗后3.33±0.126,P流畅度=0.012,复述评分:治疗前62.79±5.237,治疗后75.11±9.713,P复述=0.035;),组间分析提示动态视频组的流畅性和复述测试增加更为显著(P流畅度=0.045,P复述=0.034).听理解及命名测试结果显示,两组内及组间治疗前后差异均无统计学意义(P>0.05).结论 基于镜像神经元理论的手动作视频观察疗法(动态非目标导向手动作视频+动词复述)可提高脑卒中慢性非流畅性失语患者的言语流畅度和复述功能.

To achieve optical biopsy for gastro-intestinal (GI) endosopy with the use of nonlinear optical (NLO) endomicroscopes, integration of NLO technology with the design of a conventional flexible GI endoscope is necessary. One key challenge has been to design an NLO distal tip which can be compatible with flexible GI endoscopy retroflexion curvature radius as small as 20 mm to provide bending angle up to 210 degrees; the state-of-the-art NLO miniaturized design still consists of a long rigid "needle" shape probe at the distal end that can be damaged during the retroflex procedure when passing through the instrument channel of a flexible GI endoscope for in vivo imaging. To circumvent this design challenge, authors present a line scan multiphoton endomicroscope utilizing a novel simplified microelectromechanical systems (MEMS) scanner. This unique MEMS scanner consists of a customized single-axis dichroic MEMS scanner (SADMS) and vibrates at the back focal point of a customized micro-objective lens. This work demonstrates the new NLO scanner design can be compatible with conventional flexible GI endoscope to offer in situ functional microscopic imaging capability.

研究比较theta/beta神经反馈治疗前后注意力缺陷多动障碍(attention deficit hyperactivity disorder,ADHD)儿童脑电相位同步的改变,分析不同脑区脑电相位耦合情况.研究数据为神经反馈前后16例ADHD儿童和16例健康儿童闭眼静息态脑电,计算theta和beta频段左右半球中心区与各脑区相位同步值.研究结果表明,神经反馈治疗后左右半球中心区与前额叶、左颞中叶的theta频段相位同步显著降低,与右半球颞叶的相位同步显著增加;beta频段额叶、中心区、顶叶和枕叶的相位同步性显著增加,左颞中叶相位同步性降低,右颞叶相位同步性增加,并趋向健康儿童水平.神经反馈训练对脑电相位同步有积极的影响,相位同步分析法结合ADHD临床量表将更加充分、准确地评估ADHD神经反馈治疗效果.

目的 从 theta-gamma相位幅度耦合因果脑网络角度探讨注意力缺陷/多动障碍(ADHD)儿童可能的神经电生理机制.方法 22例 ADHD儿童作为病例组,14例健康儿童作为对照.采集两组受试者静息态脑电,使用平均向量长度方法计算所有导联对间 theta节律相位对 gamma节律幅度的耦合值,分别构建两受试组的因果连接脑网络,使用非参数检验分析两受试组间的耦合差异.结果 ADHD组导联内的耦合强度减弱,Fpl 、Fp2导联内的耦合强度显著低于对照组(P<0.05).两组受试者导联内的耦合强度与其作为幅度导联被其他脑区耦合的平均强度具有极强的正相关关系(对照组 rs=0.863 , ADHD组 rs=O.787 ,均 P<0.001).对照组以左额区(Fpl 、F3)、右枕区(O2)被其他脑区耦合为主,而ADHD组则以枕区(O1 、O2)被其他脑区耦合为主.与对照组相比,ADHD组前额区 (Fpl 、Fp2)被其他多个脑区耦合的强度显著降低,同时还存在脑区内和脑区间耦合模式转变.结论 前额区为主的多个脑区内耦合减弱,前额区被其他脑区耦合减弱,被耦合中心部分转移等因果脑网络异常,以及相位幅度耦合模式的转变可能是ADHD儿童静息态脑电特有的神经电生理特征.

In this article authors present a miniaturized scanning optical probe for multimodal nonlinear endomicroscopic imaging. The miniaturized scanning optical probe includes a two-axis gimbal-less MEMS scanner for beam scanning and a group of miniature optics for laser collimation and optical signal collection. Both second harmonic generation and two-photon excited autofluorescence signals are collected. The imaging rate is tested as 30 Hz and FOV is 130 um by 130 um. Different from traditional “needle” shape optical imaging catheters, our design highlights its “mushroom” shape and has been demonstrated to work with a dual-instrument channel commercially available gastroscope as an apparatus.

比较Theta/beta神经反馈治疗前后脑电相干性的变化,从而证明神经反馈对注意力缺陷多动障碍(attention deficit hyperactivity disorder,ADHD)儿童脑电存在积极正向影响.通过采集16例ADHD患者神经反馈前后清醒闭眼脑电和16例正常儿童清醒闭眼脑电数据.研究了6个频段半球间和半球内脑电相干性.结果表明,神经反馈训练后ADHD儿童中短距离半球内theta频段相干性显著降低,长距离半球内theta和alpha频段相干性显著增加.在额区和颞区半球间alpha频段相干性显著增加并且theta频段相干性显著降低,在中央区-顶区-枕区半球间delta和theta频段相干性显著降低.可见,theta/beta神经反馈能影响ADHD儿童异常脑电活动,从而改善ADHD症状.神经反馈干预训练对脑电相干性有积极的影响,脑电相干性参数能够为评价神经反馈的作用提供一种客观的技术方法.

In this paper, we present a miniaturized two-dimensional (2-D) optical scanner for endoscopic imaging applications. The optical scanner is based on a hybrid actuation, which is composed of a planar waveguide (PWG) beam deflector for the fast axis and an electrothermally actuated flexible printed circuit beam deflector for the slow axis. The PWG beam deflector utilizing a microheater prism array to rapidly modulate the refractive index of three layers of the PWG is based on the thermo-optic effect. Maximum optical deflection angles of 8.6° for the PWG and 12.4° for the FPC beam deflectors are experimentally achieved. A 1.2-Hz 2-D imaging rate is tested. By assembling two beam deflectors together as well as two rod lenses, an optical scanner highlights small outline dimensions and low-drive voltages, which makes it feasible for endoscopic imaging purposes.