Motor Network Reorganization Induced in Chronic Stroke Patients with the Use of a Contralesionally-Controlled Brain Computer Interface

Joseph B. Humphries, Daniela J.S. Mattos, Jerrel Rutlin, Andy G.S. Daniel, Kathleen Rybczynski, Theresa Notestine, Joshua S. Shimony, Harold Burton, Alexandre Carter, Eric C. Leuthardt

Research output: Contribution to journalArticlepeer-review

Abstract

Upper extremity weakness in chronic stroke remains a problem not fully addressed by current therapies. Brain–computer interfaces (BCIs) engaging the unaffected hemisphere are a promising therapy that are entering clinical application, but the mechanism underlying recovery is not well understood. We used resting state functional MRI to assess the impact a contralesionally driven EEG BCI therapy had on motor system functional organization. Patients used a therapeutic BCI for 12 weeks at home. We acquired resting-state fMRI scans and motor function data before and after the therapy period. Changes in functional connectivity (FC) strength between motor network regions of interest (ROIs) and the topographic extent of FC to specific ROIs were analyzed. Most patients achieved clinically significant improvement. Motor FC strength and topographic extent decreased following BCI therapy. Motor recovery correlated with reductions in motor FC strength across the entire motor network. These findings suggest BCI-mediated interventions may reverse pathologic strengthening of dysfunctional network interactions.

Original languageEnglish
Pages (from-to)179-192
Number of pages14
JournalBrain-Computer Interfaces
Volume9
Issue number3
DOIs
StatePublished - 2022

Keywords

  • Rehabilitation
  • brain–computer interface
  • functional MRI
  • motor network
  • stroke

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