Neural activity modulations and motor recovery following brain-exoskeleton interface mediated stroke rehabilitation.

Autor:	Bhagat NA; Non-Invasive Brain Machine Interface Systems Laboratory, University of Houston, Houston, TX 77004, USA. Electronic address: nabhagat@uh.edu., Yozbatiran N; Department of Physical Medicine and Rehabilitation, McGovern Medical School, NeuroRecovery Research Center at TIRR Memorial Hermann, University of Texas Health Science Center at Houston, TX 77030, USA., Sullivan JL; Mechatronics and Haptic Interfaces Laboratory, Rice University, Houston, TX 77005, USA., Paranjape R; Department of Physical Medicine and Rehabilitation, McGovern Medical School, NeuroRecovery Research Center at TIRR Memorial Hermann, University of Texas Health Science Center at Houston, TX 77030, USA., Losey C; Mechatronics and Haptic Interfaces Laboratory, Rice University, Houston, TX 77005, USA., Hernandez Z; Non-Invasive Brain Machine Interface Systems Laboratory, University of Houston, Houston, TX 77004, USA., Keser Z; Department of Physical Medicine and Rehabilitation, McGovern Medical School, NeuroRecovery Research Center at TIRR Memorial Hermann, University of Texas Health Science Center at Houston, TX 77030, USA., Grossman R; Houston Methodist Research Institute, Houston, TX 77030, USA., Francisco GE; Department of Physical Medicine and Rehabilitation, McGovern Medical School, NeuroRecovery Research Center at TIRR Memorial Hermann, University of Texas Health Science Center at Houston, TX 77030, USA., O'Malley MK; Department of Physical Medicine and Rehabilitation, McGovern Medical School, NeuroRecovery Research Center at TIRR Memorial Hermann, University of Texas Health Science Center at Houston, TX 77030, USA; Mechatronics and Haptic Interfaces Laboratory, Rice University, Houston, TX 77005, USA., Contreras-Vidal JL; Non-Invasive Brain Machine Interface Systems Laboratory, University of Houston, Houston, TX 77004, USA; Houston Methodist Research Institute, Houston, TX 77030, USA; NSF IUCRC BRAIN, University of Houston, Houston, TX 77004, USA.
Jazyk:	angličtina
Zdroj:	NeuroImage. Clinical [Neuroimage Clin] 2020; Vol. 28, pp. 102502. Date of Electronic Publication: 2020 Nov 19.
DOI:	10.1016/j.nicl.2020.102502
Abstrakt:	Brain-machine interfaces (BMI) based on scalp EEG have the potential to promote cortical plasticity following stroke, which has been shown to improve motor recovery outcomes. However, the efficacy of BMI enabled robotic training for upper-limb recovery is seldom quantified using clinical, EEG-based, and kinematics-based metrics. Further, a movement related neural correlate that can predict the extent of motor recovery still remains elusive, which impedes the clinical translation of BMI-based stroke rehabilitation. To address above knowledge gaps, 10 chronic stroke individuals with stable baseline clinical scores were recruited to participate in 12 therapy sessions involving a BMI enabled powered exoskeleton for elbow training. On average, 132 ± 22 repetitions were performed per participant, per session. BMI accuracy across all sessions and subjects was 79 ± 18% with a false positives rate of 23 ± 20%. Post-training clinical assessments found that FMA for upper extremity and ARAT scores significantly improved over baseline by 3.92 ± 3.73 and 5.35 ± 4.62 points, respectively. Also, 80% participants (7 with moderate-mild impairment, 1 with severe impairment) achieved minimal clinically important difference (MCID: FMA-UE >5.2 or ARAT >5.7) during the course of the study. Kinematic measures indicate that, on average, participants' movements became faster and smoother. Moreover, modulations in movement related cortical potentials, an EEG-based neural correlate measured contralateral to the impaired arm, were significantly correlated with ARAT scores (ρ = 0.72, p < 0.05) and marginally correlated with FMA-UE (ρ = 0.63, p = 0.051). This suggests higher activation of ipsi-lesional hemisphere post-intervention or inhibition of competing contra-lesional hemisphere, which may be evidence of neuroplasticity and cortical reorganization following BMI mediated rehabilitation therapy. (Copyright © 2020 The Author(s). Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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