Predicting Gains With Visuospatial Training After Stroke Using an EEG Measure of Frontoparietal Circuit Function

Zhou, Robert J.; Hondori, Hossein Mousavi; Khademi, Maryam; Cassidy, Jessica M.; Wu, Katherine; Yang, Dong-Chu; Kathuria, Nikhita; Erani, Fareshte; Dodakian, Lucy; McKenzie, Alison; Lopes, Cristina Videira; Scacchi, Walt; Srinivasan, Ramesh; Cramer, Steven C.

doi:10.3389/fneur.2018.00597

Cited by 27 publications

(25 citation statements)

References 65 publications

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“…The amplification of sensory experience through AR was found to be associated with a significant improvement of the ecological validity of treatments of various health disorders (60). AR-based treatment has been proposed for phobic disorders and stroke (61,62).…”

Section: Virtual Reality For Cognitive Rehabilitationmentioning

confidence: 99%

Telemedicine and Virtual Reality for Cognitive Rehabilitation: A Roadmap for the COVID-19 Pandemic

et al. 2020

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The current COVID-19 pandemic presents unprecedented new challenges to public health and medical care delivery. To control viral transmission, social distancing measures have been implemented all over the world, interrupting the access to routine medical care for many individuals with neurological diseases. Cognitive disorders are common in many neurological conditions, e.g., stroke, traumatic brain injury, Alzheimer's disease, and other types of dementia, Parkinson's disease and parkinsonian syndromes, and multiple sclerosis, and should be addressed by cognitive rehabilitation interventions. To be effective, cognitive rehabilitation programs must be intensive and prolonged over time; however, the current virus containment measures are hampering their implementation. Moreover, the reduced access to cognitive rehabilitation might worsen the relationship between the patient and the healthcare professional. Urgent measures to address issues connected to COVID-19 pandemic are, therefore, needed. Remote communication technologies are increasingly regarded as potential effective options to support health care interventions, including neurorehabilitation and cognitive rehabilitation. Among them, telemedicine, virtual reality, augmented reality, and serious games could be in the forefront of these efforts. We will briefly review current evidence-based recommendations on the efficacy of cognitive rehabilitation and offer a perspective on the role of tele-and virtual rehabilitation to achieve adequate cognitive stimulation in the era of social distancing related to COVID-19 pandemic. In particular, we will discuss issues related to their diffusion and propose a roadmap to address them. Methodological and technological improvements might lead to a paradigm shift to promote the delivery of cognitive rehabilitation to people with reduced mobility and in remote regions.

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Section: Virtual Reality For Cognitive Rehabilitationmentioning

confidence: 99%

Telemedicine and Virtual Reality for Cognitive Rehabilitation: A Roadmap for the COVID-19 Pandemic

et al. 2020

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“…That is, after training one’s brain activity using neurofeedback, the intrinsic, resting brain activity (i.e., EEG activity in the absence of a task) may also show changes. This resting brain activity can be used to assess more generalized brain changes, and baseline resting-state signatures may be used to predict recovery (Wu et al, 2015) or response to treatments (Zhou et al, 2018). When combined with neural injury information, resting EEG parameters can also help predict the efficacy of stroke therapy.…”

Section: Introductionmentioning

confidence: 99%

Effects of a Brain-Computer Interface With Virtual Reality (VR) Neurofeedback: A Pilot Study in Chronic Stroke Patients

Vourvopoulos

Pardo

Lefebvre

et al. 2019

Front. Hum. Neurosci.

105

104

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Rehabilitation for stroke patients with severe motor impairments (e.g., inability to perform wrist or finger extension on the affected side) is burdensome and difficult because most current rehabilitation options require some volitional movement to retrain the affected side. However, although these patients participate in therapy requiring volitional movement, previous research has shown that they may receive modest benefits from action observation, virtual reality (VR), and brain-computer interfaces (BCIs). These approaches have shown some success in strengthening key motor pathways thought to support motor recovery after stroke, in the absence of volitional movement. The purpose of this study was to combine the principles of VR and BCI in a platform called REINVENT and assess its effects on four chronic stroke patients across different levels of motor impairment. REINVENT acquires post-stroke EEG signals that indicate an attempt to move and drives the movement of a virtual avatar arm, allowing patient-driven action observation neurofeedback in VR. In addition, synchronous electromyography (EMG) data were also captured to monitor overt muscle activity. Here we tested four chronic stroke survivors and show that this EEG-based BCI can be safely used over repeated sessions by stroke survivors across a wide range of motor disabilities. Finally, individual results suggest that patients with more severe motor impairments may benefit the most from EEG-based neurofeedback, while patients with more mild impairments may benefit more from EMG-based feedback, harnessing existing sensorimotor pathways. We note that although this work is promising, due to the small sample size, these results are preliminary. Future research is needed to confirm these findings in a larger and more diverse population.

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“…This VR/robotic system is wellsuited for the delivery of hand and arm training for more affected patients. Sensory and perceptual affordances provided by the integration of VR and robotics can target the unique hand deficits that one cannot address in real-world therapy (37), and thus possibly allow for functional improvement to move beyond the spontaneous recovery predicted in the literature (62).…”

Section: Discussionmentioning

confidence: 99%

“…We will quantify and relate neural reorganization of the corticospinal system and the cortical networks in both ipsilateral and contralateral hemispheres with behavioral (clinical and kinematic) recovery during the first 6 months post-stroke. While neurophysiological measures are considered promising biomarkers of corticospinal integrity and recovery, there are few studies utilizing these approaches to date (62,63) and there has been no single well-controlled study examining changes in the trajectory of neural recovery subsequent to intensive, progressive therapy initiated at different stages, early post-stroke.…”

Section: Discussionmentioning

confidence: 99%

Hand Focused Upper Extremity Rehabilitation in the Subacute Phase Post-stroke Using Interactive Virtual Environments

et al. 2020

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Introduction: Innovative motor therapies have attempted to reduce upper extremity impairment after stroke but have not made substantial improvement as over 50% of people post-stroke continue to have sensorimotor deficits affecting their self-care and participation in daily activities. Intervention studies have focused on the role of increased dosing, however recent studies have indicated that timing of rehabilitation interventions may be as important as dosing and importantly, that dosing and timing interact in mediating effectiveness. This study is designed to empirically test dosing and timing.Methods and Analysis: In this single-blinded, interventional study, subjects will be stratified on two dimensions, impairment level (Fugl-Meyer Upper Extremity Assessment (FM) and presence or absence of Motor Evoked Potentials (MEPs) as follows; (1) Severe, FM score 10–19, MEP+, (2) Severe, FM score 10–19, MEP–, (3) Moderate, FM score 20–49, MEP+, (4) Moderate, FM score 20–49, MEP–. Subjects not eligible for TMS will be assigned to either group 2 (if severe) or group 3 (if moderate). Stratified block randomization will then be used to achieve a balanced assignment. Early Robotic/VR Therapy (EVR) experimental group will receive in-patient usual care therapy plus an extra 10 h of intensive upper extremity therapy focusing on the hand using robotically facilitated rehabilitation interventions presented in virtual environments and initiated 5–30 days post-stroke. Delayed Robotic/VR Therapy (DVR) experimental group will receive the same intervention but initiated 30–60 days post-stroke. Dose-matched usual care group (DMUC) will receive an extra 10 h of usual care initiated 5–30 days post-stroke. Usual Care Group (UC) will receive the usual amount of physical/occupational therapy.Outcomes: There are clinical, neurophysiological, and kinematic/kinetic measures, plus measures of daily arm use and quality of life. Primary outcome is the Action Research Arm Test (ARAT) measured at 4 months post-stroke.Discussion: Outcome measures will be assessed to determine whether there is an early time period in which rehabilitation will be most effective, and whether there is a difference in the recapture of premorbid patterns of movement vs. the development of an efficient, but compensatory movement strategy.Ethical Considerations: The IRBs of New Jersey Institute of Technology, Rutgers University, Northeastern University, and Kessler Foundation reviewed and approved all study protocols. Study was registered in https://ClinicalTrials.gov (NCT03569059) prior to recruitment. Dissemination will include submission to peer-reviewed journals and professional presentations.

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Predicting Gains With Visuospatial Training After Stroke Using an EEG Measure of Frontoparietal Circuit Function

Cited by 27 publications

References 65 publications

Telemedicine and Virtual Reality for Cognitive Rehabilitation: A Roadmap for the COVID-19 Pandemic

Telemedicine and Virtual Reality for Cognitive Rehabilitation: A Roadmap for the COVID-19 Pandemic

Effects of a Brain-Computer Interface With Virtual Reality (VR) Neurofeedback: A Pilot Study in Chronic Stroke Patients

Hand Focused Upper Extremity Rehabilitation in the Subacute Phase Post-stroke Using Interactive Virtual Environments

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