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Background  Several neurorehabilitation strategies have been introduced over the last decade based on the so-called simulation hypothesis. This hypothesis states that a neural network located in primary and secondary motor areas is activated not only during overt motor execution, but also during observation or imagery of the same motor action. Based on this hypothesis, we investigated the combination of a virtual reality (VR) based neurorehabilitation system together with a wireless functional near infrared spectroscopy (fNIRS) instrument. This combination is particularly appealing from a rehabilitation perspective as it may allow minimally constrained monitoring during neurorehabilitative training.    Methods  fNIRS was applied over F3 of healthy subjects during task performance in a virtual reality (VR) environment: 1) 'unilateral' group (N = 15), contralateral recording during  observation ,  motor imagery ,  observation & motor imagery , and  imitation  of a grasping task performed by a virtual limb (first-person perspective view) using the right hand; 2) 'bilateral' group (N = 8), bilateral recording during  observation  and  imitation  of the same task using the right and left hand alternately.    Results  In the unilateral group, significant within-condition oxy-hemoglobin concentration Δ[O 2 Hb] changes (mean ± SD μmol/l) were found for  motor imagery  (0.0868 ± 0.5201 μmol/l) and  imitation  (0.1715 ± 0.4567 μmol/l). In addition, the bilateral group showed a significant within-condition Δ[O 2 Hb] change for  observation  (0.0924 ± 0.3369 μmol/l) as well as between-conditions with lower Δ[O 2 Hb] amplitudes during  observation  compared to  imitation , especially in the ipsilateral hemisphere (p < 0.001). Further, in the bilateral group,  imitation  using the non-dominant (left) hand resulted in larger Δ[O 2 Hb] changes in both the ipsi- and contralateral hemispheres as compared to using the dominant (right) hand.    Conclusions  This study shows that our combined VR-fNIRS based neurorehabilitation system can activate the action-observation system as described by the simulation hypothesis during performance of observation, motor imagery and imitation of hand actions elicited by a VR environment. Further, in accordance with previous studies, the findings of this study revealed that both inter-subject variability and handedness need to be taken into account when recording in untrained subjects. These findings are of relevance for demonstrating the potential of the VR-fNIRS instrument in neurofeedback applications.

journal of neuroengineering and rehabilitation

Testing the potential of a virtual reality neurorehabilitation system during performance of observation, imagery and imitation of motor actions recorded by wireless functional near-infrared spectroscopy (fNIRS)