Brain Computer Interface-Based Action Observation Game Enhances Mu Suppression in Patients with Stroke

Choi, Hyoseon; Lim, Hyunmi; Kim, Joon‐Woo; Kang, Yong-Woo; Ku, Jeonghun

doi:10.3390/electronics8121466

Cited by 14 publications

(12 citation statements)

References 59 publications

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“…In a previous study, Lim and Ku introduced a new paradigm combining a BCI game and an AO [16]. This BCI-AO paradigm induced greater mu suppression than AO alone in healthy subjects and patients with stroke [16,17]. In line with previous work, the present study revealed that the BCI-AO + PES paradigm could significantly induce corticospinal plasticity compared to AO + PES or AO alone in both healthy and stroke groups.…”

Section: Bci-ao + Pes Induced Increase In Corticospinal Excitabilitysupporting

confidence: 88%

“…In the BCI-AO paradigm, attentive watching could be superiorly and robustly detected by steadystate visual evoked potential (SSVEP) evoked exogenously by the flickering action video compared to other methods utilizing endogenous factors of electroencephalogram (EEG) such as alpha and beta band amplitude of EEG. Proper feedback according to the state of patient engagement could induce stronger mu suppression than a paradigm simply showing an action video in healthy volunteers as well as in patients with stroke has been previously demonstrated [16,17]. The BCI-AO paradigm adopted the flickering action video scheme that could achieve robust detection and MNS activation at the same time, providing timely feedback and eliciting a stronger MNS.…”

Section: Introductionmentioning

confidence: 99%

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Brain–computer interface-based action observation combined with peripheral electrical stimulation enhances corticospinal excitability in healthy subjects and stroke patients

Kim¹,

Lim²,

Lee³

et al. 2022

J. Neural Eng.

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Objective: Action observation (AO) combined with brain computer interface (BCI) technology enhances the cortical activation. Peripheral electrical stimulation (PES) is known to increase the corticospinal excitability, thereby activating brain plasticity. To maximize motor recovery, we assessed the effects of BCI-AO combined with PES on corticospinal plasticity. Approach: Seventeen patients with chronic hemiplegic stroke and 17 healthy subjects were recruited. The participants watched a video of repetitive grasping actions with four different tasks for 15 mins: A) AO alone; B) AO + PES; C) BCI-AO + continuous PES; D) BCI-AO + triggered PES. PES was applied at the ulnar nerve of the wrist. The tasks were performed in a random order at least 3 days apart. We assessed the latency and amplitude of the motor evoked potentials (MEPs). We examined changes in MEP parameters pre-and post-exercise across the four tasks in the FDI muscle of the dominant hand (healthy subjects) and affected hand (stroke patients). Main results: The decrease in MEP latency and increase in MEP amplitude after the four tasks were significant in both groups. The increase in MEP amplitude was sustained for 20 mins after tasks B, C, and D in both groups. The increase in MEP amplitude was significant between tasks A vs B, B vs C, and C vs D. The estimated mean difference in MEP amplitude post-exercise was highest for A and D in both groups. Significance: The results indicate that BCI-AO combined with PES is superior to AO alone or AO + PES for facilitating corticospinal plasticity in both healthy subjects and stroke patients. Furthermore, this study supports the idea that synchronized activation of cortical and peripheral networks can enhance neuroplasticity after stroke. We suggest that the BCI-AO paradigm and PES could provide a novel neurorehabilitation strategy for stroke patients.

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Section: Bci-ao + Pes Induced Increase In Corticospinal Excitabilitysupporting

confidence: 88%

Section: Introductionmentioning

confidence: 99%

Brain–computer interface-based action observation combined with peripheral electrical stimulation enhances corticospinal excitability in healthy subjects and stroke patients

Kim¹,

Lim²,

Lee³

et al. 2022

J. Neural Eng.

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“…All channels were used to generate the real-time topography of the brain dynamic potential for surveillance. Alpha suppression reflects an event-related desynchronization (ERD) of the EEG caused by an increase in neural activity [ 26 ], which has been widely utilized in BCI training field and has promising outcome [ 27 , 28 ]. To compute

suppression, the C3 or C4 channel was chosen according to the subject’s lesion side.…”

Section: Methodsmentioning

confidence: 99%

BCI Training Effects on Chronic Stroke Correlate with Functional Reorganization in Motor-Related Regions: A Concurrent EEG and fMRI Study

et al. 2021

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Brain–computer interface (BCI)-guided robot-assisted training strategy has been increasingly applied to stroke rehabilitation, while few studies have investigated the neuroplasticity change and functional reorganization after intervention from multimodality neuroimaging perspective. The present study aims to investigate the hemodynamic and electrophysical changes induced by BCI training using functional magnetic resonance imaging (fMRI) and electroencephalography (EEG) respectively, as well as the relationship between the neurological changes and motor function improvement. Fourteen chronic stroke subjects received 20 sessions of BCI-guided robot hand training. Simultaneous EEG and fMRI data were acquired before and immediately after the intervention. Seed-based functional connectivity for resting-state fMRI data and effective connectivity analysis for EEG were processed to reveal the neuroplasticity changes and interaction between different brain regions. Moreover, the relationship among motor function improvement, hemodynamic changes, and electrophysical changes derived from the two neuroimaging modalities was also investigated. This work suggested that (a) significant motor function improvement could be obtained after BCI training therapy, (b) training effect significantly correlated with functional connectivity change between ipsilesional M1 (iM1) and contralesional Brodmann area 6 (including premotor area (cPMA) and supplementary motor area (SMA)) derived from fMRI, (c) training effect significantly correlated with information flow change from cPMA to iM1 and strongly correlated with information flow change from SMA to iM1 derived from EEG, and (d) consistency of fMRI and EEG results illustrated by the correlation between functional connectivity change and information flow change. Our study showed changes in the brain after the BCI training therapy from chronic stroke survivors and provided a better understanding of neural mechanisms, especially the interaction among motor-related brain regions during stroke recovery. Besides, our finding demonstrated the feasibility and consistency of combining multiple neuroimaging modalities to investigate the neuroplasticity change.

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“…Shu et al (2017Shu et al ( , 2018 and Ren et al (2020) improved the SMR-BCI performance via proprioceptive stimulation before the motor imagery (MI) task. Choi et al (2019), Nagai andTanaka (2019), andFujiwara et al (2021) found users' ERD/ERS was enhanced when they performed MI task with motor observation. It is recognized that enhanced ERD/ERS of stroke patients, meaning enhanced motor-related cortical activation (Pfurtscheller and Lopes da Silva, 1999;Pfurtscheller et al, 2006b), can improve users' engagement and decoding accuracy for BCI system, which could help maximize brain plasticity and restore motor and cognitive function for stroke patients (Bundy et al, 2017;Nagai and Tanaka, 2019).…”

Section: Introductionmentioning

confidence: 99%

Sensorimotor Rhythm-Brain Computer Interface With Audio-Cue, Motor Observation and Multisensory Feedback for Upper-Limb Stroke Rehabilitation: A Controlled Study

Wang

Miao

et al. 2022

Front. Neurosci.

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Several studies have shown the positive clinical effect of brain computer interface (BCI) training for stroke rehabilitation. This study investigated the efficacy of the sensorimotor rhythm (SMR)-based BCI with audio-cue, motor observation and multisensory feedback for post-stroke rehabilitation. Furthermore, we discussed the interaction between training intensity and training duration in BCI training. Twenty-four stroke patients with severe upper limb (UL) motor deficits were randomly assigned to two groups: 2-week SMR-BCI training combined with conventional treatment (BCI Group, BG, n = 12) and 2-week conventional treatment without SMR-BCI intervention (Control Group, CG, n = 12). Motor function was measured using clinical measurement scales, including Fugl-Meyer Assessment-Upper Extremities (FMA-UE; primary outcome measure), Wolf Motor Functional Test (WMFT), and Modified Barthel Index (MBI), at baseline (Week 0), post-intervention (Week 2), and follow-up week (Week 4). EEG data from patients allocated to the BG was recorded at Week 0 and Week 2 and quantified by mu suppression means event-related desynchronization (ERD) in mu rhythm (8–12 Hz). All functional assessment scores (FMA-UE, WMFT, and MBI) significantly improved at Week 2 for both groups (p < 0.05). The BG had significantly higher FMA-UE and WMFT improvement at Week 4 compared to the CG. The mu suppression of bilateral hemisphere both had a positive trend with the motor function scores at Week 2. This study proposes a new effective SMR-BCI system and demonstrates that the SMR-BCI training with audio-cue, motor observation and multisensory feedback, together with conventional therapy may promote long-lasting UL motor improvement.Clinical Trial Registration: [http://www.chictr.org.cn], identifier [ChiCTR2000041119].

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Brain Computer Interface-Based Action Observation Game Enhances Mu Suppression in Patients with Stroke

Cited by 14 publications

References 59 publications

Brain–computer interface-based action observation combined with peripheral electrical stimulation enhances corticospinal excitability in healthy subjects and stroke patients

Brain–computer interface-based action observation combined with peripheral electrical stimulation enhances corticospinal excitability in healthy subjects and stroke patients

BCI Training Effects on Chronic Stroke Correlate with Functional Reorganization in Motor-Related Regions: A Concurrent EEG and fMRI Study

Sensorimotor Rhythm-Brain Computer Interface With Audio-Cue, Motor Observation and Multisensory Feedback for Upper-Limb Stroke Rehabilitation: A Controlled Study

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