Brain Functional Changes in Stroke Following Rehabilitation Using Brain-Computer Interface-Assisted Motor Imagery With and Without tDCS: A Pilot Study

Frontiers in Human Neuroscience

Juan Helen Zhou²  Mengjiao Hu³  Joanna Su Xian Chong³  Fang Ji³  Hsiao-Ju Cheng⁴  Effie Chew⁵  Zhongkang Lu⁶  Weimin Huang⁶  Kok Soon Phua⁶  Kai-Hsiang Chuang⁸  Kai Keng Ang⁹  Cuntai Guan⁹  Xudong Jiang^1,10 

[1] 0Department of Electrical and Computer Engineering, National University of Singapore, Singapore, Singapore;1Integrative Sciences and Engineering Programme (ISEP), National University of Singapore, Singapore, Singapore;Center for Sleep and Cognition, Center for Translational MR Research, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore;Department of Biomedical Engineering, Faculty of Engineering, National University of Singapore, Singapore, Singapore;Division of Neurology, University Medicine Cluster, National University Health System, Singapore, Singapore;Institute for Infocomm Research, Agency for Science Technology and Research, Singapore, Singapore;NTU Institute for Health Technologies, Interdisciplinary Graduate Programme, Nanyang Technological University, Singapore, Singapore;Queensland Brain Institute and Centre for Advanced Imaging, The University of Queensland, Brisbane, QLD, Australia;School of Computer Science and Engineering, Nanyang Technological University, Singapore, Singapore;School of Electrical and Electronic Engineering, Nanyang Technological University, Singapore, Singapore;Singapore Bioimaging Consortium, Agency for Science Technology and Research, Singapore, Singapore;

关键词: functional magnetic resonance imaging;    stroke;    amplitude of low-frequency fluctuation;    regional homogeneity;    functional connectivity;    brain-computer interface-assisted motor imagery;   

DOI  :  10.3389/fnhum.2021.692304

来源: DOAJ

【 摘 要 】

Brain-computer interface-assisted motor imagery (MI-BCI) or transcranial direct current stimulation (tDCS) has been proven effective in post-stroke motor function enhancement, yet whether the combination of MI-BCI and tDCS may further benefit the rehabilitation of motor functions remains unknown. This study investigated brain functional activity and connectivity changes after a 2 week MI-BCI and tDCS combined intervention in 19 chronic subcortical stroke patients. Patients were randomized into MI-BCI with tDCS group and MI-BCI only group who underwent 10 sessions of 20 min real or sham tDCS followed by 1 h MI-BCI training with robotic feedback. We derived amplitude of low-frequency fluctuation (ALFF), regional homogeneity (ReHo), and functional connectivity (FC) from resting-state functional magnetic resonance imaging (fMRI) data pre- and post-intervention. At baseline, stroke patients had lower ALFF in the ipsilesional somatomotor network (SMN), lower ReHo in the contralesional insula, and higher ALFF/Reho in the bilateral posterior default mode network (DMN) compared to age-matched healthy controls. After the intervention, the MI-BCI only group showed increased ALFF in contralesional SMN and decreased ALFF/Reho in the posterior DMN. In contrast, no post-intervention changes were detected in the MI-BCI + tDCS group. Furthermore, higher increases in ALFF/ReHo/FC measures were related to better motor function recovery (measured by the Fugl-Meyer Assessment scores) in the MI-BCI group while the opposite association was detected in the MI-BCI + tDCS group. Taken together, our findings suggest that brain functional re-normalization and network-specific compensation were found in the MI-BCI only group but not in the MI-BCI + tDCS group although both groups gained significant motor function improvement post-intervention with no group difference. MI-BCI and tDCS may exert differential or even opposing impact on brain functional reorganization during post-stroke motor rehabilitation; therefore, the integration of the two strategies requires further refinement to improve efficacy and effectiveness.

【 授权许可】

Unknown