Hebbian plasticity induced by temporally coincident BCI enhances post-stroke motor recovery.
Johanna KruegerRichard KrauthChristoph ReichertSerafeim PerdikisSusanne VogtTessa HuchtemannStefan DürschmidAlmut SickertJuliane LamprechtAlmir HuremovicMichael GörtlerSlawomir J NasutoI-Chin TsaiRobert T KnightHermann HinrichsHans-Jochen HeinzeSabine LindquistMichael SailerJose Del R MillánCatherine M Sweeney-ReedPublished in: Scientific reports (2024)
Functional electrical stimulation (FES) can support functional restoration of a paretic limb post-stroke. Hebbian plasticity depends on temporally coinciding pre- and post-synaptic activity. A tight temporal relationship between motor cortical (MC) activity associated with attempted movement and FES-generated visuo-proprioceptive feedback is hypothesized to enhance motor recovery. Using a brain-computer interface (BCI) to classify MC spectral power in electroencephalographic (EEG) signals to trigger FES-delivery with detection of movement attempts improved motor outcomes in chronic stroke patients. We hypothesized that heightened neural plasticity earlier post-stroke would further enhance corticomuscular functional connectivity and motor recovery. We compared subcortical non-dominant hemisphere stroke patients in BCI-FES and Random-FES (FES temporally independent of MC movement attempt detection) groups. The primary outcome measure was the Fugl-Meyer Assessment, Upper Extremity (FMA-UE). We recorded high-density EEG and transcranial magnetic stimulation-induced motor evoked potentials before and after treatment. The BCI group showed greater: FMA-UE improvement; motor evoked potential amplitude; beta oscillatory power and long-range temporal correlation reduction over contralateral MC; and corticomuscular coherence with contralateral MC. These changes are consistent with enhanced post-stroke motor improvement when movement is synchronized with MC activity reflecting attempted movement.
Keyphrases
- functional connectivity
- resting state
- high density
- transcranial magnetic stimulation
- high frequency
- white matter
- magnetic resonance imaging
- type diabetes
- insulin resistance
- adipose tissue
- spinal cord injury
- multiple sclerosis
- blood brain barrier
- metabolic syndrome
- risk assessment
- drug induced
- loop mediated isothermal amplification
- computed tomography
- oxidative stress
- endothelial cells
- label free
- sensitive detection
- diabetic rats
- subarachnoid hemorrhage