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Randomized Controlled Trial
. 2020 Dec 13:2020:8882764.
doi: 10.1155/2020/8882764. eCollection 2020.

BCI-Based Rehabilitation on the Stroke in Sequela Stage

Yangyang Miao  1 , Shugeng Chen  2 , Xinru Zhang  1 , Jing Jin  1 , Ren Xu  3 , Ian Daly  4 , Jie Jia  2 , Xingyu Wang  1 , Andrzej Cichocki  5   6   7 , Tzyy-Ping Jung  8
Affiliations
Randomized Controlled Trial

BCI-Based Rehabilitation on the Stroke in Sequela Stage

Yangyang Miao et al. Neural Plast. .

Abstract

Background: Stroke is the leading cause of serious and long-term disability worldwide. Survivors may recover some motor functions after rehabilitation therapy. However, many stroke patients missed the best time period for recovery and entered into the sequela stage of chronic stroke.

Method: Studies have shown that motor imagery- (MI-) based brain-computer interface (BCI) has a positive effect on poststroke rehabilitation. This study used both virtual limbs and functional electrical stimulation (FES) as feedback to provide patients with a closed-loop sensorimotor integration for motor rehabilitation. An MI-based BCI system acquired, analyzed, and classified motor attempts from electroencephalogram (EEG) signals. The FES system would be activated if the BCI detected that the user was imagining wrist dorsiflexion on the instructed side of the body. Sixteen stroke patients in the sequela stage were randomly assigned to a BCI group and a control group. All of them participated in rehabilitation training for four weeks and were assessed by the Fugl-Meyer Assessment (FMA) of motor function.

Results: The average improvement score of the BCI group was 3.5, which was higher than that of the control group (0.9). The active EEG patterns of the four patients in the BCI group whose FMA scores increased gradually became centralized and shifted to sensorimotor areas and premotor areas throughout the study.

Conclusions: Study results showed evidence that patients in the BCI group achieved larger functional improvements than those in the control group and that the BCI-FES system is effective in restoring motor function to upper extremities in stroke patients. This study provides a more autonomous approach than traditional treatments used in stroke rehabilitation.

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Conflict of interest statement

The authors confirm that there are no known conflicts of interest.

Figures

Figure 1
Figure 1
The electrode distribution used in this study.
Figure 2
Figure 2
(a) The schematic of the BCI-FES system. (b) The timing of a trial of the motor imagery paradigm. Each trial consisted of task and rest periods. A patient started to execute motor imagery tasks upon the appearance of the cue (“left” or “right”). A virtual avatar of one patient's upper limbs was used to provide virtual reality feedback. (c) This picture shows the scene of BCI-FES rehabilitation training for one patient.
Figure 3
Figure 3
The accuracies across 12 sessions for all participants in the BCI group. The red line indicates the average accuracy.
Figure 4
Figure 4
The power spectral density maps from electrodes C3 and C4 for four participants in the BCI group (blue: right motor imagery, black: left motor imagery).
Figure 5
Figure 5
Topographic maps from four participants illustrating the first and last spatial patterns extracted by the CSP method.
See this image and copyright information in PMC

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