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. 2023 Aug;13(8):e3049.
doi: 10.1002/brb3.3049. Epub 2023 Jul 11.

Neurofunctional correlates of a neurorehabilitation system based on eye movements in chronic stroke impairment levels: A pilot study

Bárbara R García-Ramos  1 , Rebeca Villarroel  1 , José L González-Mora  1   2   3 , Consuelo Revert  4 , Cristián Modroño  1   2   3
Affiliations

Neurofunctional correlates of a neurorehabilitation system based on eye movements in chronic stroke impairment levels: A pilot study

Bárbara R García-Ramos et al. Brain Behav. 2023 Aug.

Abstract

Introduction: Rehabilitation after a stroke is widely considered fundamental to improve secondary functional impairments. Accessible methods based on motor learning, motor transfer and virtual environments are necessary to help to improve stroke patients' quality of life.

Objectives: Continuing the line of our previous studies, this work investigated the effect of our new and innovative game-based virtual reality training using the control of virtual objects with gaze in three chronic stroke survivors.

Methods: All participants performed an eye-controlled virtual training task for 4 weeks. Pre- and post-training evaluation were carried out with the Fugl-Meyer Assessment for upper extremity scale as well as performing a tracking task inside an MRI scanner with a MRI-compatible eye-tracker or a joystick.

Results: Neural results for each participant show the increase of activity in the motor cortex, basal ganglia and cerebellum for both effectors (hand or eye).

Conclusion: These promising results have a potential application as a new game-based neurorehabilitation approach to enhance the motor activity of stroke patients.

Keywords: eye movements; fMRI; neurorehabilitation; stroke; virtual training.

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Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

FIGURE 1
FIGURE 1
Axial anatomical images of brain damage in each participant. P1, participant 1; P2, participant 2; P3, participant 3.
FIGURE 2
FIGURE 2
Experimental environment where the participant practices with an eye‐tracker controlled by ocular movements in a PC with a virtual task.
FIGURE 3
FIGURE 3
Continuous tracking task performed during fMRI in the pre‐ and posttraining evaluation. All participants used the eye as an effector in the first run and the hand in the second run.
FIGURE 4
FIGURE 4
(a) Eye‐tracking accuracy during the posttraining evaluation for three stroke participants. (b) Hand‐tracking accuracy during the posttraining evaluation for three stroke participants.
FIGURE 5
FIGURE 5
The increases of neural activations in participants 1, 2, and 3 after the virtual training period. (a: In the first run, participants performed the tracking task with the eye. b: In the second run, participants performed the tracking task with the hand). Threshold: p < .05. FDR corrected at the voxel level. (Contrasts: eye‐tracking‐post > eye‐tracking‐pre and hand‐tracking‐post > hand‐tracking‐pre).
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