Please use this identifier to cite or link to this item: https://doi.org/10.3389/fnhum.2021.692304
Title: Brain Functional Changes in Stroke Following Rehabilitation Using Brain-Computer Interface-Assisted Motor Imagery With and Without tDCS: A Pilot Study
Authors: Hu, M
Cheng, HJ 
Ji, F 
Chong, JSX 
Lu, Z
Huang, W
Ang, KK
Phua, KS
Chuang, KH 
Jiang, X
Chew, E 
Guan, C
Zhou, JH
Keywords: amplitude of low-frequency fluctuation
brain-computer interface-assisted motor imagery
functional connectivity
functional magnetic resonance imaging
regional homogeneity
stroke
transcranial direct current stimulation
Issue Date: 16-Jul-2021
Publisher: Frontiers Media SA
Citation: Hu, M, Cheng, HJ, Ji, F, Chong, JSX, Lu, Z, Huang, W, Ang, KK, Phua, KS, Chuang, KH, Jiang, X, Chew, E, Guan, C, Zhou, JH (2021-07-16). Brain Functional Changes in Stroke Following Rehabilitation Using Brain-Computer Interface-Assisted Motor Imagery With and Without tDCS: A Pilot Study. Frontiers in Human Neuroscience 15 : 692304-. ScholarBank@NUS Repository. https://doi.org/10.3389/fnhum.2021.692304
Abstract: Brain-computer interface-assisted motor imagery (MI-BCI) or transcranial direct current stimulation (tDCS) has been proven effective in post-stroke motor function enhancement, yet whether the combination of MI-BCI and tDCS may further benefit the rehabilitation of motor functions remains unknown. This study investigated brain functional activity and connectivity changes after a 2 week MI-BCI and tDCS combined intervention in 19 chronic subcortical stroke patients. Patients were randomized into MI-BCI with tDCS group and MI-BCI only group who underwent 10 sessions of 20 min real or sham tDCS followed by 1 h MI-BCI training with robotic feedback. We derived amplitude of low-frequency fluctuation (ALFF), regional homogeneity (ReHo), and functional connectivity (FC) from resting-state functional magnetic resonance imaging (fMRI) data pre- and post-intervention. At baseline, stroke patients had lower ALFF in the ipsilesional somatomotor network (SMN), lower ReHo in the contralesional insula, and higher ALFF/Reho in the bilateral posterior default mode network (DMN) compared to age-matched healthy controls. After the intervention, the MI-BCI only group showed increased ALFF in contralesional SMN and decreased ALFF/Reho in the posterior DMN. In contrast, no post-intervention changes were detected in the MI-BCI + tDCS group. Furthermore, higher increases in ALFF/ReHo/FC measures were related to better motor function recovery (measured by the Fugl-Meyer Assessment scores) in the MI-BCI group while the opposite association was detected in the MI-BCI + tDCS group. Taken together, our findings suggest that brain functional re-normalization and network-specific compensation were found in the MI-BCI only group but not in the MI-BCI + tDCS group although both groups gained significant motor function improvement post-intervention with no group difference. MI-BCI and tDCS may exert differential or even opposing impact on brain functional reorganization during post-stroke motor rehabilitation; therefore, the integration of the two strategies requires further refinement to improve efficacy and effectiveness.
Source Title: Frontiers in Human Neuroscience
URI: https://scholarbank.nus.edu.sg/handle/10635/206097
ISSN: 16625161
DOI: 10.3389/fnhum.2021.692304
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