Brain–Computer Interfaces in Neurorecovery and Neurorehabilitation

Seminars in Neurology, Journal Year: 2021, Volume and Issue: 41(02), P. 206 - 216

Published: March 19, 2021

Abstract Recent advances in brain–computer interface technology to restore and rehabilitate neurologic function aim enable persons with disabling conditions communicate, interact the environment, achieve other key activities of daily living personal goals. Here we evaluate principles, benefits, challenges, future directions interfaces context neurorehabilitation. We then explore clinical translation these technologies propose an approach facilitate implementation for disease.

Language: Английский

---

A Robotic System with EMG-Triggered Functional Eletrical Stimulation for Restoring Arm Functions in Stroke Survivors

Neurorehabilitation and neural repair, Journal Year: 2021, Volume and Issue: 35(4), P. 334 - 345

Published: March 3, 2021

Robotic systems combined with Functional Electrical Stimulation (FES) showed promising results on upper-limb motor recovery after stroke, but adequately-sized randomized controlled trials (RCTs) are still missing.To evaluate whether arm training supported by RETRAINER, a passive exoskeleton integrated electromyograph-triggered functional electrical stimulation, is superior to advanced conventional therapy (ACT) of equal intensity in the functions, dexterity, strength, activities daily living, and quality life stroke.A single-blind RCT recruiting 72 patients was conducted. Patients, randomly allocated 2 groups, were trained for 9 weeks, 3 times per week: experimental group performed task-oriented exercises assisted RETRAINER 30 minutes plus ACT (60 minutes), whereas control only (90 minutes). Patients assessed before, soon after, 1 month end intervention. Outcome measures as follows: Action Research Arm Test (ARAT), Motricity Index, Motor Activity Log, Box Blocks (BBT), Stroke Specific Quality Life Scale (SSQoL), Muscle Council.All outcomes SSQoL significantly improved over time both groups (P < .001); significant interaction effect favor found ARAT BBT. between-group change 11.5 points = .010) at intervention, which increased 13.6 after. considered moderately usable (System Usability Score 61.5 ± 22.8).Hybrid robotic systems, allowing perform personalized, intensive, training, an enriched sensory feedback, improving functions dexterity stroke.

Language: Английский

---

Dynamic Functional Connectivity of Resting-State Spinal Cord fMRI Reveals Fine-Grained Intrinsic Architecture

Neuron, Journal Year: 2020, Volume and Issue: 108(3), P. 424 - 435.e4

Published: Sept. 9, 2020

Language: Английский

---

Restoring After Central Nervous System Injuries: Neural Mechanisms and Translational Applications of Motor Recovery

Neuroscience Bulletin, Journal Year: 2022, Volume and Issue: 38(12), P. 1569 - 1587

Published: Nov. 4, 2022

Abstract Central nervous system (CNS) injuries, including stroke, traumatic brain injury, and spinal cord are leading causes of long-term disability. It is estimated that more than half the survivors severe unilateral injury unable to use denervated limb. Previous studies have focused on neuroprotective interventions in affected hemisphere limit lesions neurorepair measures promote recovery. However, ability increase plasticity injured restricted difficult improve. Therefore, over several decades, researchers been prompted enhance compensation by unaffected hemisphere. Animal experiments revealed regrowth ipsilateral descending fibers from motor neurons plays a significant role restoration function. In addition, clinical treatments designed restore control, stimulation, nerve transfer surgery, brain–computer interface systems. Here, we comprehensively review neural mechanisms as well translational applications control upon rehabilitation after CNS injuries.

Language: Английский

---

Post-Stroke Rehabilitation: Challenges and New Perspectives

Journal of Clinical Medicine, Journal Year: 2023, Volume and Issue: 12(2), P. 550 - 550

Published: Jan. 10, 2023

A stroke is determined by insufficient blood supply to the brain due vessel occlusion (ischemic stroke) or rupture (hemorrhagic stroke), resulting in immediate neurological impairment differing degrees [...].

Language: Английский

---

Bilateral effect of acupuncture on cerebrum and cerebellum in ischaemic stroke patients with hemiparesis: a randomised clinical and neuroimaging trial

Stroke and Vascular Neurology, Journal Year: 2024, Volume and Issue: 9(3), P. 306 - 317

Published: Feb. 8, 2024

Background Acupuncture involving the limb region may be effective for stroke rehabilitation clinically, but visualised and explanatory evidence is limited. Our objectives were to assess specific effects of acupuncture ischaemic (IS) patients with hemiparesis investigate its therapy-driven modification in functional connectivity. Methods IS randomly assigned (2:1) receive 10 sessions hand-foot 12 needles (HA, n=30) or non-acupoint (NA) (n=16), enrolling gender-matched age-matched healthy controls (HCs, n=34). The clinical outcomes improved Fugl-Meyer Assessment scores including upper lower extremity (ΔFM, ΔFM-UE, ΔFM-LE). neuroimaging outcome was voxel-mirrored homotopic connectivity (VMHC). Static dynamic (sFC, DFC) analyses used study neuroplasticity reorganisation. Results 46 ISs (mean(SD) age, 59.37 (11.36) years) 34 HCs 52.88 (9.69) included per-protocol analysis neuroimaging. In clinical, ΔFM 5.00 HA group 2.50 NA group, a dual correlation between ΔVMHC (angular: r=0.696, p=0.000; cerebellum: r=−0.716, p=0.000) fitting linear regression model (R 2 =0.828). neuroimaging, demonstrated decreased VMHC bilateral postcentral gyrus cerebellum (Gaussian random field, GRF corrected, voxel p<0.001, cluster p<0.05), which fitted logistic (AUC=0.8413, accuracy=0.7500). Following acupuncture, superior frontal orbital part increased cerebro-cerebellar changes, higher sFC ipsilesional contralesional orbitofrontal cortex as well (GRF p<0.05). coefficient variation posterior cingulate (PPC) locally integration states transforming into segregation overall (p<0.05). There no acupuncture-related adverse event. Conclusions randomised trial could promote motor recovery modified via static reorganisations hemiparesis.

Language: Английский

---

A multimodal approach to capture post-stroke temporal dynamics of recovery

Journal of Neural Engineering, Journal Year: 2020, Volume and Issue: 17(4), P. 045002 - 045002

Published: June 9, 2020

Several training programs have been developed in the past to restore motor functions after stroke. Their efficacy strongly relies on possibility assess individual levels of impairment and recovery rate. However, commonly used clinical scales rely mainly subjective functional assessments are not able provide a complete description patients' neuro-biomechanical status. Therefore, current tests should be integrated with specific physiological measurements, i.e. kinematic, muscular, brain activities, obtain deep understanding condition its evolution through time rehabilitative intervention.We proposed multivariate approach for control assessment that simultaneously measures muscle activity combines main variables extracted from these signals using principal component analysis (PCA). We tested it group six sub-acute stroke subjects evaluated extensively before four-week training, an upper-limb exoskeleton while performing reaching task, along measurements.After all exhibited improvements correlating changes kinematics, synergies, spinal maps. Movements were smoother faster, synergies increased numbers became more similar those healthy controls. These findings coupled cortical oscillations depicted by EEG-topographies. When combining PCA, we found (i) kinematic maps parameters improved continuously during four assessments; (ii) coordination augmented treatment, (iii) recovered mostly pre-treatment as consequence short-term subacute changes.Although preliminary results, has potential identifying significant biomarkers patient stratification well design effective rehabilitation protocols.

Language: Английский

---

May Dual Transcranial Direct Current Stimulation Enhance the Efficacy of Robot-Assisted Therapy for Promoting Upper Limb Recovery in Chronic Stroke?

Neurorehabilitation and neural repair, Journal Year: 2022, Volume and Issue: 36(12), P. 800 - 809

Published: Dec. 1, 2022

To assess whether dual transcranial direct current stimulation (tDCS) may enhance the efficacy of exoskeleton robotic training on upper limb motor functions in patients with chronic stroke.A prospective, bi-center, double-blind, randomized clinical trial study was performed. Patients moderate-to-severe stroke (according to The National Institute Health Stroke Scale) were randomly assigned receive or sham tDCS immediately before therapy (10 sessions, 2 weeks). primary outcome Fugl-Meyer for Upper Extremity, assessed before, after, and at 12-week follow-up. Neurophysiological evaluation corticospinal projections muscles performed by recording evoked potentials (MEPs). ClinicalTrials.gov-NCT03026712.Two hundred sixty individuals tested eligibility, which 80 enrolled agreed participate. Excluding 14 dropouts, 66 into groups. Results showed that stable treatment significantly improved after that. records within subject improvements not different between However, a post-hoc analysis subdividing subgroups based presence absence MEPs baseline higher effect real without when compared (F = 4.6, P .007).The adjunction arm did further recovery treated sample stroke. significant improvement subgroup severe dysfunction (as suggested MEPs) suggests they could benefit from such combination.

Language: Английский

---

Mini-review: Transcranial Alternating Current Stimulation and the Cerebellum

The Cerebellum, Journal Year: 2022, Volume and Issue: 22(1), P. 120 - 128

Published: Jan. 20, 2022

Language: Английский

---

Excitatory Repetitive Transcranial Magnetic Stimulation Over the Ipsilesional Hemisphere for Upper Limb Motor Function After Stroke: A Systematic Review and Meta-Analysis

Frontiers in Neurology, Journal Year: 2022, Volume and Issue: 13

Published: June 20, 2022

Repetitive transcranial magnetic stimulation (rTMS) is a promising therapy to promote recovery of the upper limb after stroke. According regulation cortical excitability, rTMS can be divided into excitatory and inhibitory rTMS, includes high-frequency (HF-rTMS) or intermittent theta-burst (iTBS). We aimed evaluate effects over ipsilesional hemisphere on motor stroke.Databases PubMed, Embase, ISI Web Science, Cochrane Library were searched for randomized controlled trials published before 31 December 2021. RCTs HF-rTMS iTBS function in patients diagnosed with stroke included. Two researchers independently screened literature, extracted data, assessed quality. The meta-analysis was performed by using Review Manager Version 5.4 software.Fifteen studies 449 participants included this meta-analysis. This found that had significant efficacy (MD = 5.88, 95% CI, 3.32-8.43, P < 0.001), hand strength (SMD 0.53, 0.04-1.01, 0.03), dexterity 0.76, 0.39-1.14, 0.001). Subgroup analyses based different types showed both significantly promoted (iTBS, 0.001; HF-rTMS, 0.001) 0.01; but not 0.07; 0.12). Further subgroup analysis duration illness demonstrated applying during first 3 months (<1 month, 1-3 months, brought improvement longer than (P 0.06). enhanced evoked potential (MEP) amplitude affected 0.82, 0.32-1.33, 0.001).Our study could improve function, strength, Both which dexterity, beneficial only when applied enhance MEP hemisphere. High-quality large-scale future are required confirm our conclusions.www.crd.york.ac.uk/prospero/, identifier: CRD42022312288.

Language: Английский

---