Motor Imagery-Based Brain-Computer Interface Combined with Multimodal Feedback to Promote Upper Limb Motor Function after Stroke: A Preliminary Study

Abstract

Background. Recently, the brain-computer interface (BCI) has seen rapid development, which may promote the recovery of motor function in chronic stroke patients. Methods. Twelve stroke patients with severe upper limb and hand motor impairment were enrolled and randomly assigned into two groups: motor imagery (MI)-based BCI training with multimodal feedback (BCI group, n = 7) and classical motor imagery training (control group, n = 5). Motor function and electrophysiology were evaluated before and after the intervention. The Fugl-Meyer assessment-upper extremity (FMA-UE) is the primary outcome measure. Secondary outcome measures include an increase in wrist active extension or surface electromyography (the amplitude and cocontraction of extensor carpi radialis during movement), the action research arm test (ARAT), the motor status scale (MSS), and Barthel index (BI). Time-frequency analysis and power spectral analysis were used to reflect the electroencephalogram (EEG) change before and after the intervention. Results. Compared with the baseline, the FMA-UE score increased significantly in the BCI group ( p = 0.006). MSS scores improved significantly in both groups, while ARAT did not improve significantly. In addition, before the intervention, all patients could not actively extend their wrists or just had muscle contractions. After the intervention, four patients regained the ability to extend their paretic wrists (two in each group). The amplitude and area under the curve of extensor carpi radialis improved to some extent, but there was no statistical significance between the groups. Conclusion. MI-based BCI combined with sensory and visual feedback might improve severe upper limb and hand impairment in chronic stroke patients, showing the potential for application in rehabilitation medicine.

Exploring Methodological Issues in Mental Practice for Upper-Extremity Function Following Stroke-Related Paralysis: A Scoping Review

“…Other methods included using BCI, reported in five papers [ 34 , 38 , 39 , 47 , 63 ], and VR, reported in three papers [ 57 , 62 , 66 ].…”

“…The most common method of conducting an MP intervention was the use of an audio guide to facilitate MI with verbal instructions, and it is important to know how MI can be performed to maximize the effectiveness of MP [ 79 ]. Several recent studies have begun to use VR and BCI to enhance MI clarity [ 34 , 38 , 39 , 47 , 57 , 62 , 63 , 66 ], and we believe that it will be important to apply MI clarifying techniques to optimize MP efficacy in the future. One treatment method whose effectiveness is being enhanced by this VR technology is mirror therapy (MT).…”

Exploring Methodological Issues in Mental Practice for Post-stroke Paralytic Lateral Upper Limb Function: A Scoping Review

“…Other methods included using BCI in 5 papers using BCI [23][24][25][26][27] and VR in 3 papers [28][29][30].…”

Theraputic Effects of Brain-Computer Interface on Motor Recovery of Stroke Patients: A Meta-analysis

“…Most of the included studies didn't report any adverse effect during trials. Ten of the studies reported that no serious adverse effects were found in the participants during and after BCI training or intervention s [13,14,24,28,31,38,42,45,50,52].…”