Think to Move: a Neuromagnetic Brain-Computer Interface (BCI) System for Chronic Stroke
Background and Purpose— Stroke is a leading cause of long-term motor disability among adults. Present rehabilitative interventions are largely unsuccessful in improving the most severe cases of motor impairment, particularly in relation to hand function. Here we tested the hypothesis that patients e...
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| Published in | Stroke (1970) Vol. 39; no. 3; pp. 910 - 917 |
|---|---|
| Main Authors | , , , , , , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
Hagerstown, MD
Lippincott Williams & Wilkins
01.03.2008
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| Subjects | |
| Online Access | Get full text |
| ISSN | 0039-2499 1524-4628 1524-4628 |
| DOI | 10.1161/STROKEAHA.107.505313 |
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| Abstract | Background and Purpose—
Stroke is a leading cause of long-term motor disability among adults. Present rehabilitative interventions are largely unsuccessful in improving the most severe cases of motor impairment, particularly in relation to hand function. Here we tested the hypothesis that patients experiencing hand plegia as a result of a single, unilateral subcortical, cortical or mixed stroke occurring at least 1 year previously, could be trained to operate a mechanical hand orthosis through a brain-computer interface (BCI).
Methods—
Eight patients with chronic hand plegia resulting from stroke (residual finger extension function rated on the Medical Research Council scale=0/5) were recruited from the Stroke Neurorehabilitation Clinic, Human Cortical Physiology Section of the National Institute for Neurological Disorders and Stroke (NINDS) (n=5) and the Clinic of Neurology of the University of Tübingen (n=3). Diagnostic MRIs revealed single, unilateral subcortical, cortical or mixed lesions in all patients. A magnetoencephalography-based BCI system was used for this study. Patients participated in between 13 to 22 training sessions geared to volitionally modulate μ rhythm amplitude originating in sensorimotor areas of the cortex, which in turn raised or lowered a screen cursor in the direction of a target displayed on the screen through the BCI interface. Performance feedback was provided visually in real-time. Successful trials (in which the cursor made contact with the target) resulted in opening/closing of an orthosis attached to the paralyzed hand.
Results—
Training resulted in successful BCI control in 6 of 8 patients. This control was associated with increased range and specificity of μ rhythm modulation as recorded from sensors overlying central ipsilesional (4 patients) or contralesional (2 patients) regions of the array. Clinical scales used to rate hand function showed no significant improvement after training.
Conclusions—
These results suggest that volitional control of neuromagnetic activity features recorded over central scalp regions can be achieved with BCI training after stroke, and used to control grasping actions through a mechanical hand orthosis. |
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| AbstractList | Stroke is a leading cause of long-term motor disability among adults. Present rehabilitative interventions are largely unsuccessful in improving the most severe cases of motor impairment, particularly in relation to hand function. Here we tested the hypothesis that patients experiencing hand plegia as a result of a single, unilateral subcortical, cortical or mixed stroke occurring at least 1 year previously, could be trained to operate a mechanical hand orthosis through a brain-computer interface (BCI).BACKGROUND AND PURPOSEStroke is a leading cause of long-term motor disability among adults. Present rehabilitative interventions are largely unsuccessful in improving the most severe cases of motor impairment, particularly in relation to hand function. Here we tested the hypothesis that patients experiencing hand plegia as a result of a single, unilateral subcortical, cortical or mixed stroke occurring at least 1 year previously, could be trained to operate a mechanical hand orthosis through a brain-computer interface (BCI).Eight patients with chronic hand plegia resulting from stroke (residual finger extension function rated on the Medical Research Council scale=0/5) were recruited from the Stroke Neurorehabilitation Clinic, Human Cortical Physiology Section of the National Institute for Neurological Disorders and Stroke (NINDS) (n=5) and the Clinic of Neurology of the University of Tübingen (n=3). Diagnostic MRIs revealed single, unilateral subcortical, cortical or mixed lesions in all patients. A magnetoencephalography-based BCI system was used for this study. Patients participated in between 13 to 22 training sessions geared to volitionally modulate micro rhythm amplitude originating in sensorimotor areas of the cortex, which in turn raised or lowered a screen cursor in the direction of a target displayed on the screen through the BCI interface. Performance feedback was provided visually in real-time. Successful trials (in which the cursor made contact with the target) resulted in opening/closing of an orthosis attached to the paralyzed hand.METHODSEight patients with chronic hand plegia resulting from stroke (residual finger extension function rated on the Medical Research Council scale=0/5) were recruited from the Stroke Neurorehabilitation Clinic, Human Cortical Physiology Section of the National Institute for Neurological Disorders and Stroke (NINDS) (n=5) and the Clinic of Neurology of the University of Tübingen (n=3). Diagnostic MRIs revealed single, unilateral subcortical, cortical or mixed lesions in all patients. A magnetoencephalography-based BCI system was used for this study. Patients participated in between 13 to 22 training sessions geared to volitionally modulate micro rhythm amplitude originating in sensorimotor areas of the cortex, which in turn raised or lowered a screen cursor in the direction of a target displayed on the screen through the BCI interface. Performance feedback was provided visually in real-time. Successful trials (in which the cursor made contact with the target) resulted in opening/closing of an orthosis attached to the paralyzed hand.Training resulted in successful BCI control in 6 of 8 patients. This control was associated with increased range and specificity of mu rhythm modulation as recorded from sensors overlying central ipsilesional (4 patients) or contralesional (2 patients) regions of the array. Clinical scales used to rate hand function showed no significant improvement after training.RESULTSTraining resulted in successful BCI control in 6 of 8 patients. This control was associated with increased range and specificity of mu rhythm modulation as recorded from sensors overlying central ipsilesional (4 patients) or contralesional (2 patients) regions of the array. Clinical scales used to rate hand function showed no significant improvement after training.These results suggest that volitional control of neuromagnetic activity features recorded over central scalp regions can be achieved with BCI training after stroke, and used to control grasping actions through a mechanical hand orthosis.CONCLUSIONSThese results suggest that volitional control of neuromagnetic activity features recorded over central scalp regions can be achieved with BCI training after stroke, and used to control grasping actions through a mechanical hand orthosis. Background and Purpose— Stroke is a leading cause of long-term motor disability among adults. Present rehabilitative interventions are largely unsuccessful in improving the most severe cases of motor impairment, particularly in relation to hand function. Here we tested the hypothesis that patients experiencing hand plegia as a result of a single, unilateral subcortical, cortical or mixed stroke occurring at least 1 year previously, could be trained to operate a mechanical hand orthosis through a brain-computer interface (BCI). Methods— Eight patients with chronic hand plegia resulting from stroke (residual finger extension function rated on the Medical Research Council scale=0/5) were recruited from the Stroke Neurorehabilitation Clinic, Human Cortical Physiology Section of the National Institute for Neurological Disorders and Stroke (NINDS) (n=5) and the Clinic of Neurology of the University of Tübingen (n=3). Diagnostic MRIs revealed single, unilateral subcortical, cortical or mixed lesions in all patients. A magnetoencephalography-based BCI system was used for this study. Patients participated in between 13 to 22 training sessions geared to volitionally modulate μ rhythm amplitude originating in sensorimotor areas of the cortex, which in turn raised or lowered a screen cursor in the direction of a target displayed on the screen through the BCI interface. Performance feedback was provided visually in real-time. Successful trials (in which the cursor made contact with the target) resulted in opening/closing of an orthosis attached to the paralyzed hand. Results— Training resulted in successful BCI control in 6 of 8 patients. This control was associated with increased range and specificity of μ rhythm modulation as recorded from sensors overlying central ipsilesional (4 patients) or contralesional (2 patients) regions of the array. Clinical scales used to rate hand function showed no significant improvement after training. Conclusions— These results suggest that volitional control of neuromagnetic activity features recorded over central scalp regions can be achieved with BCI training after stroke, and used to control grasping actions through a mechanical hand orthosis. BACKGROUND: and Purpose- Stroke is a leading cause of long-term motor disability among adults. Present rehabilitative interventions are largely unsuccessful in improving the most severe cases of motor impairment, particularly in relation to hand function. Here we tested the hypothesis that patients experiencing hand plegia as a result of a single, unilateral subcortical, cortical or mixed stroke occurring at least 1 year previously, could be trained to operate a mechanical hand orthosis through a brain-computer interface (BCI). METHODS: Eight patients with chronic hand plegia resulting from stroke (residual finger extension function rated on the Medical Research Council scale=0/5) were recruited from the Stroke Neurorehabilitation Clinic, Human Cortical Physiology Section of the National Institute for Neurological Disorders and Stroke (NINDS) (n=5) and the Clinic of Neurology of the University of Tuebingen (n=3). Diagnostic MRIs revealed single, unilateral subcortical, cortical or mixed lesions in all patients. A magnetoencephalography-based BCI system was used for this study. Patients participated in between 13 to 22 training sessions geared to volitionally modulate mu rhythm amplitude originating in sensorimotor areas of the cortex, which in turn raised or lowered a screen cursor in the direction of a target displayed on the screen through the BCI interface. Performance feedback was provided visually in real-time. Successful trials (in which the cursor made contact with the target) resulted in opening/closing of an orthosis attached to the paralyzed hand. RESULTS: Training resulted in successful BCI control in 6 of 8 patients. This control was associated with increased range and specificity of mu rhythm modulation as recorded from sensors overlying central ipsilesional (4 patients) or contralesional (2 patients) regions of the array. Clinical scales used to rate hand function showed no significant improvement after training. CONCLUSIONS: These results suggest that volitional control of neuromagnetic activity features recorded over central scalp regions can be achieved with BCI training after stroke, and used to control grasping actions through a mechanical hand orthosis. Stroke is a leading cause of long-term motor disability among adults. Present rehabilitative interventions are largely unsuccessful in improving the most severe cases of motor impairment, particularly in relation to hand function. Here we tested the hypothesis that patients experiencing hand plegia as a result of a single, unilateral subcortical, cortical or mixed stroke occurring at least 1 year previously, could be trained to operate a mechanical hand orthosis through a brain-computer interface (BCI). Eight patients with chronic hand plegia resulting from stroke (residual finger extension function rated on the Medical Research Council scale=0/5) were recruited from the Stroke Neurorehabilitation Clinic, Human Cortical Physiology Section of the National Institute for Neurological Disorders and Stroke (NINDS) (n=5) and the Clinic of Neurology of the University of Tübingen (n=3). Diagnostic MRIs revealed single, unilateral subcortical, cortical or mixed lesions in all patients. A magnetoencephalography-based BCI system was used for this study. Patients participated in between 13 to 22 training sessions geared to volitionally modulate micro rhythm amplitude originating in sensorimotor areas of the cortex, which in turn raised or lowered a screen cursor in the direction of a target displayed on the screen through the BCI interface. Performance feedback was provided visually in real-time. Successful trials (in which the cursor made contact with the target) resulted in opening/closing of an orthosis attached to the paralyzed hand. Training resulted in successful BCI control in 6 of 8 patients. This control was associated with increased range and specificity of mu rhythm modulation as recorded from sensors overlying central ipsilesional (4 patients) or contralesional (2 patients) regions of the array. Clinical scales used to rate hand function showed no significant improvement after training. These results suggest that volitional control of neuromagnetic activity features recorded over central scalp regions can be achieved with BCI training after stroke, and used to control grasping actions through a mechanical hand orthosis. |
| Author | Weber, Cornelia Braun, Christoph Mellinger, Jurgen Dimyan, Michael A. Caria, Andrea Ard, Tyler Fourkas, Alissa Soekadar, Surjo Buch, Ethan Cohen, Leonardo G. Birbaumer, Niels |
| Author_xml | – sequence: 1 givenname: Ethan surname: Buch fullname: Buch, Ethan organization: From the Human Cortical Physiology Section and Stroke Neurorehabilitation Clinic (E.B., C.W., L.G.C., M.A.D., T.A., A.F.), NINDS, NIH, Bethesda, Md; Department of Experimental Psychology (E.B.), University of Oxford, UK; Institute of Medical Psychology and Behavioral Neurobiology (C.W., C.B., J.M., A.C., S.S., A.F., N.B.), MEG-Center, University of Tübingen, Germany – sequence: 2 givenname: Cornelia surname: Weber fullname: Weber, Cornelia organization: From the Human Cortical Physiology Section and Stroke Neurorehabilitation Clinic (E.B., C.W., L.G.C., M.A.D., T.A., A.F.), NINDS, NIH, Bethesda, Md; Department of Experimental Psychology (E.B.), University of Oxford, UK; Institute of Medical Psychology and Behavioral Neurobiology (C.W., C.B., J.M., A.C., S.S., A.F., N.B.), MEG-Center, University of Tübingen, Germany – sequence: 3 givenname: Leonardo G. surname: Cohen fullname: Cohen, Leonardo G. organization: From the Human Cortical Physiology Section and Stroke Neurorehabilitation Clinic (E.B., C.W., L.G.C., M.A.D., T.A., A.F.), NINDS, NIH, Bethesda, Md; Department of Experimental Psychology (E.B.), University of Oxford, UK; Institute of Medical Psychology and Behavioral Neurobiology (C.W., C.B., J.M., A.C., S.S., A.F., N.B.), MEG-Center, University of Tübingen, Germany – sequence: 4 givenname: Christoph surname: Braun fullname: Braun, Christoph organization: From the Human Cortical Physiology Section and Stroke Neurorehabilitation Clinic (E.B., C.W., L.G.C., M.A.D., T.A., A.F.), NINDS, NIH, Bethesda, Md; Department of Experimental Psychology (E.B.), University of Oxford, UK; Institute of Medical Psychology and Behavioral Neurobiology (C.W., C.B., J.M., A.C., S.S., A.F., N.B.), MEG-Center, University of Tübingen, Germany – sequence: 5 givenname: Michael A. surname: Dimyan fullname: Dimyan, Michael A. organization: From the Human Cortical Physiology Section and Stroke Neurorehabilitation Clinic (E.B., C.W., L.G.C., M.A.D., T.A., A.F.), NINDS, NIH, Bethesda, Md; Department of Experimental Psychology (E.B.), University of Oxford, UK; Institute of Medical Psychology and Behavioral Neurobiology (C.W., C.B., J.M., A.C., S.S., A.F., N.B.), MEG-Center, University of Tübingen, Germany – sequence: 6 givenname: Tyler surname: Ard fullname: Ard, Tyler organization: From the Human Cortical Physiology Section and Stroke Neurorehabilitation Clinic (E.B., C.W., L.G.C., M.A.D., T.A., A.F.), NINDS, NIH, Bethesda, Md; Department of Experimental Psychology (E.B.), University of Oxford, UK; Institute of Medical Psychology and Behavioral Neurobiology (C.W., C.B., J.M., A.C., S.S., A.F., N.B.), MEG-Center, University of Tübingen, Germany – sequence: 7 givenname: Jurgen surname: Mellinger fullname: Mellinger, Jurgen organization: From the Human Cortical Physiology Section and Stroke Neurorehabilitation Clinic (E.B., C.W., L.G.C., M.A.D., T.A., A.F.), NINDS, NIH, Bethesda, Md; Department of Experimental Psychology (E.B.), University of Oxford, UK; Institute of Medical Psychology and Behavioral Neurobiology (C.W., C.B., J.M., A.C., S.S., A.F., N.B.), MEG-Center, University of Tübingen, Germany – sequence: 8 givenname: Andrea surname: Caria fullname: Caria, Andrea organization: From the Human Cortical Physiology Section and Stroke Neurorehabilitation Clinic (E.B., C.W., L.G.C., M.A.D., T.A., A.F.), NINDS, NIH, Bethesda, Md; Department of Experimental Psychology (E.B.), University of Oxford, UK; Institute of Medical Psychology and Behavioral Neurobiology (C.W., C.B., J.M., A.C., S.S., A.F., N.B.), MEG-Center, University of Tübingen, Germany – sequence: 9 givenname: Surjo surname: Soekadar fullname: Soekadar, Surjo organization: From the Human Cortical Physiology Section and Stroke Neurorehabilitation Clinic (E.B., C.W., L.G.C., M.A.D., T.A., A.F.), NINDS, NIH, Bethesda, Md; Department of Experimental Psychology (E.B.), University of Oxford, UK; Institute of Medical Psychology and Behavioral Neurobiology (C.W., C.B., J.M., A.C., S.S., A.F., N.B.), MEG-Center, University of Tübingen, Germany – sequence: 10 givenname: Alissa surname: Fourkas fullname: Fourkas, Alissa organization: From the Human Cortical Physiology Section and Stroke Neurorehabilitation Clinic (E.B., C.W., L.G.C., M.A.D., T.A., A.F.), NINDS, NIH, Bethesda, Md; Department of Experimental Psychology (E.B.), University of Oxford, UK; Institute of Medical Psychology and Behavioral Neurobiology (C.W., C.B., J.M., A.C., S.S., A.F., N.B.), MEG-Center, University of Tübingen, Germany – sequence: 11 givenname: Niels surname: Birbaumer fullname: Birbaumer, Niels organization: From the Human Cortical Physiology Section and Stroke Neurorehabilitation Clinic (E.B., C.W., L.G.C., M.A.D., T.A., A.F.), NINDS, NIH, Bethesda, Md; Department of Experimental Psychology (E.B.), University of Oxford, UK; Institute of Medical Psychology and Behavioral Neurobiology (C.W., C.B., J.M., A.C., S.S., A.F., N.B.), MEG-Center, University of Tübingen, Germany |
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| Keywords | motor Stroke Nervous system diseases brain-computer interface Cardiovascular disease MEG Cerebral disorder Encephalon Vascular disease Chronic Central nervous system disease Plasticity Cerebrovascular disease |
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| PublicationTitle | Stroke (1970) |
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| Snippet | Background and Purpose—
Stroke is a leading cause of long-term motor disability among adults. Present rehabilitative interventions are largely unsuccessful in... Stroke is a leading cause of long-term motor disability among adults. Present rehabilitative interventions are largely unsuccessful in improving the most... BACKGROUND: and Purpose- Stroke is a leading cause of long-term motor disability among adults. Present rehabilitative interventions are largely unsuccessful in... |
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| SubjectTerms | Adolescent Adult Aged Biological and medical sciences Brain - physiopathology Chronic Disease Hand - physiopathology Hand Strength Headache. Facial pains. Syncopes. Epilepsia. Intracranial hypertension. Brain oedema. Cerebral palsy Humans Magnetic Resonance Imaging Magnetoencephalography Medical sciences Middle Aged Nervous system (semeiology, syndromes) Neurology Orthotic Devices Paralysis - etiology Stroke - complications Stroke - diagnosis Stroke - physiopathology Stroke Rehabilitation User-Computer Interface Vascular diseases and vascular malformations of the nervous system Volition |
| Title | Think to Move: a Neuromagnetic Brain-Computer Interface (BCI) System for Chronic Stroke |
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