RT Journal Article
T1 Brain-machine interface in chronic stroke rehabilitation: 												A controlled study
A1 Ramos-Murguialday, Ander
A1 Broetz, Doris
A1 Rea, Massimiliano
A1 Läer, Leonhard
A1 Yilmaz, Özge
A1 Brasil, Fabricio L.
A1 Liberati, Giulia
A1 Curado, Marco R.
A1 Garcia-Cossio, Eliana
A1 Vyziotis, Alexandros
A1 Cho, Woosang
A1 Agostini, Manuel
A1 Soares, Ernesto
A1 Soekadar, Surjo
A1 Caria, Andrea
A1 Cohen, Leonardo G.
A1 Birbaumer, Niels
AB Objective Chronic stroke patients with severe hand weakness respond poorly to rehabilitation efforts. Here, we evaluated efficacy of daily brain-machine interface (BMI) training to increase the hypothesized beneficial effects of physiotherapy alone in patients with severe paresis in a double-blind sham-controlled design proof of concept study. Methods Thirty-two chronic stroke patients with severe hand weakness were randomly assigned to 2 matched groups and participated in 17.8 ± 1.4 days of training rewarding desynchronization of ipsilesional oscillatory sensorimotor rhythms with contingent online movements of hand and arm orthoses (experimental group, n = 16). In the control group (sham group, n = 16), movements of the orthoses occurred randomly. Both groups received identical behavioral physiotherapy immediately following BMI training or the control intervention. Upper limb motor function scores, electromyography from arm and hand muscles, placebo-expectancy effects, and functional magnetic resonance imaging (fMRI) blood oxygenation level-dependent activity were assessed before and after intervention. Results A significant group × time interaction in upper limb (combined hand and modified arm) Fugl-Meyer assessment (cFMA) motor scores was found. cFMA scores improved more in the experimental than in the control group, presenting a significant improvement of cFMA scores (3.41 ± 0.563-point difference, p = 0.018) reflecting a clinically meaningful change from no activity to some in paretic muscles. cFMA improvements in the experimental group correlated with changes in fMRI laterality index and with paretic hand electromyography activity. Placebo-expectancy scores were comparable for both groups. Interpretation The addition of BMI training to behaviorally oriented physiotherapy can be used to induce functional improvements in motor function in chronic stroke patients without residual finger movements and may open a new door in stroke neurorehabilitation. NEUROL 2013;74:100-108
SN 0364-5134
YR 2013
FD 2013-07
LK https://hdl.handle.net/11556/3154
UL https://hdl.handle.net/11556/3154
LA eng
NO Ramos-Murguialday , A , Broetz , D , Rea , M , Läer , L , Yilmaz , Ö , Brasil , F L , Liberati , G , Curado , M R , Garcia-Cossio , E , Vyziotis , A , Cho , W , Agostini , M , Soares , E , Soekadar , S , Caria , A , Cohen , L G & Birbaumer , N 2013 , ' Brain-machine interface in chronic stroke rehabilitation : A controlled study ' , Annals of Neurology , vol. 74 , no. 1 , pp. 100-108 . https://doi.org/10.1002/ana.23879
DS TECNALIA Publications
RD 26 jul 2024