Efficacy of brain-computer interface training with motor imagery-contingent feedback in improving upper limb function and neuroplasticity among persons with chronic stroke: a double-blinded, parallel-group, randomized controlled trial
Abstract Background Brain-computer interface (BCI) technology can enhance neural plasticity and motor recovery in persons with stroke. However, the effects of BCI training with motor imagery (MI)-contingent feedback versus MI-independent feedback remain unclear. This study aimed to investigate wheth...
Saved in:
| Main Authors: | , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2025-01-01
|
| Series: | Journal of NeuroEngineering and Rehabilitation |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12984-024-01535-2 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1841544922720632832 |
|---|---|
| author | Myeong Sun Kim Hyunju Park Ilho Kwon Kwang-Ok An Hayeon Kim Gyulee Park Wooseok Hyung Chang-Hwan Im Joon-Ho Shin |
| author_facet | Myeong Sun Kim Hyunju Park Ilho Kwon Kwang-Ok An Hayeon Kim Gyulee Park Wooseok Hyung Chang-Hwan Im Joon-Ho Shin |
| author_sort | Myeong Sun Kim |
| collection | DOAJ |
| description | Abstract Background Brain-computer interface (BCI) technology can enhance neural plasticity and motor recovery in persons with stroke. However, the effects of BCI training with motor imagery (MI)-contingent feedback versus MI-independent feedback remain unclear. This study aimed to investigate whether the contingent connection between MI-induced brain activity and feedback influences functional and neural plasticity outcomes. We hypothesized that BCI training, with MI-contingent feedback, would result in greater improvements in upper limb function and neural plasticity compared to BCI training, with MI-independent feedback. Methods This randomized controlled trial included persons with chronic stroke who underwent BCI training involving functional electrical stimulation feedback on the affected wrist extensor. Primary outcomes included the Medical Research Council (MRC) scale score for muscle strength in the wrist extensor (MRC-WE) and active range of motion in wrist extension (AROM-WE). Resting-state electroencephalogram recordings were used to assess neural plasticity. Results Compared to the MI-independent feedback BCI group, the MI-contingent feedback BCI group showed significantly greater improvements in MRC-WE scores (mean difference = 0.52, 95% CI = 0.03–1.00, p = 0.036) and demonstrated increased AROM-WE at 4 weeks post-intervention (p = 0.019). Enhanced functional connectivity in the affected hemisphere was observed in the MI-contingent feedback BCI group, correlating with MRC-WE and Fugl-Meyer assessment-distal scores. Improvements were also observed in the unaffected hemisphere’s functional connectivity. Conclusions BCI training with MI-contingent feedback is more effective than MI-independent feedback in improving AROM-WE, MRC, and neural plasticity in individuals with chronic stroke. BCI technology could be a valuable addition to conventional rehabilitation for stroke survivors, enhancing recovery outcomes. Trial registration CRIS (KCT0009013). |
| format | Article |
| id | doaj-art-3386616ec454472ba8696893511711c1 |
| institution | Kabale University |
| issn | 1743-0003 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of NeuroEngineering and Rehabilitation |
| spelling | doaj-art-3386616ec454472ba8696893511711c12025-01-12T12:10:39ZengBMCJournal of NeuroEngineering and Rehabilitation1743-00032025-01-0122111310.1186/s12984-024-01535-2Efficacy of brain-computer interface training with motor imagery-contingent feedback in improving upper limb function and neuroplasticity among persons with chronic stroke: a double-blinded, parallel-group, randomized controlled trialMyeong Sun Kim0Hyunju Park1Ilho Kwon2Kwang-Ok An3Hayeon Kim4Gyulee Park5Wooseok Hyung6Chang-Hwan Im7Joon-Ho Shin8Translational Research Center for Rehabilitation Robots, National Rehabilitation Center, Ministry of Health and WelfareTranslational Research Center for Rehabilitation Robots, National Rehabilitation Center, Ministry of Health and WelfareTranslational Research Center for Rehabilitation Robots, National Rehabilitation Center, Ministry of Health and WelfareDepartment of Healthcare and Public Health Research, Rehabilitation Research Institute, National Rehabilitation Center, Ministry of Health and WelfareDepartment of Healthcare and Public Health Research, Rehabilitation Research Institute, National Rehabilitation Center, Ministry of Health and WelfareTranslational Research Center for Rehabilitation Robots, National Rehabilitation Center, Ministry of Health and WelfareDepartment of Artificial Intelligence, Hanyang UniversityDepartment of Biomedical Engineering, Hanyang UniversityTranslational Research Center for Rehabilitation Robots, National Rehabilitation Center, Ministry of Health and WelfareAbstract Background Brain-computer interface (BCI) technology can enhance neural plasticity and motor recovery in persons with stroke. However, the effects of BCI training with motor imagery (MI)-contingent feedback versus MI-independent feedback remain unclear. This study aimed to investigate whether the contingent connection between MI-induced brain activity and feedback influences functional and neural plasticity outcomes. We hypothesized that BCI training, with MI-contingent feedback, would result in greater improvements in upper limb function and neural plasticity compared to BCI training, with MI-independent feedback. Methods This randomized controlled trial included persons with chronic stroke who underwent BCI training involving functional electrical stimulation feedback on the affected wrist extensor. Primary outcomes included the Medical Research Council (MRC) scale score for muscle strength in the wrist extensor (MRC-WE) and active range of motion in wrist extension (AROM-WE). Resting-state electroencephalogram recordings were used to assess neural plasticity. Results Compared to the MI-independent feedback BCI group, the MI-contingent feedback BCI group showed significantly greater improvements in MRC-WE scores (mean difference = 0.52, 95% CI = 0.03–1.00, p = 0.036) and demonstrated increased AROM-WE at 4 weeks post-intervention (p = 0.019). Enhanced functional connectivity in the affected hemisphere was observed in the MI-contingent feedback BCI group, correlating with MRC-WE and Fugl-Meyer assessment-distal scores. Improvements were also observed in the unaffected hemisphere’s functional connectivity. Conclusions BCI training with MI-contingent feedback is more effective than MI-independent feedback in improving AROM-WE, MRC, and neural plasticity in individuals with chronic stroke. BCI technology could be a valuable addition to conventional rehabilitation for stroke survivors, enhancing recovery outcomes. Trial registration CRIS (KCT0009013).https://doi.org/10.1186/s12984-024-01535-2StrokeRehabilitationBrain-machine interfaceBrain-computer interfaceRandomized clinical trial |
| spellingShingle | Myeong Sun Kim Hyunju Park Ilho Kwon Kwang-Ok An Hayeon Kim Gyulee Park Wooseok Hyung Chang-Hwan Im Joon-Ho Shin Efficacy of brain-computer interface training with motor imagery-contingent feedback in improving upper limb function and neuroplasticity among persons with chronic stroke: a double-blinded, parallel-group, randomized controlled trial Journal of NeuroEngineering and Rehabilitation Stroke Rehabilitation Brain-machine interface Brain-computer interface Randomized clinical trial |
| title | Efficacy of brain-computer interface training with motor imagery-contingent feedback in improving upper limb function and neuroplasticity among persons with chronic stroke: a double-blinded, parallel-group, randomized controlled trial |
| title_full | Efficacy of brain-computer interface training with motor imagery-contingent feedback in improving upper limb function and neuroplasticity among persons with chronic stroke: a double-blinded, parallel-group, randomized controlled trial |
| title_fullStr | Efficacy of brain-computer interface training with motor imagery-contingent feedback in improving upper limb function and neuroplasticity among persons with chronic stroke: a double-blinded, parallel-group, randomized controlled trial |
| title_full_unstemmed | Efficacy of brain-computer interface training with motor imagery-contingent feedback in improving upper limb function and neuroplasticity among persons with chronic stroke: a double-blinded, parallel-group, randomized controlled trial |
| title_short | Efficacy of brain-computer interface training with motor imagery-contingent feedback in improving upper limb function and neuroplasticity among persons with chronic stroke: a double-blinded, parallel-group, randomized controlled trial |
| title_sort | efficacy of brain computer interface training with motor imagery contingent feedback in improving upper limb function and neuroplasticity among persons with chronic stroke a double blinded parallel group randomized controlled trial |
| topic | Stroke Rehabilitation Brain-machine interface Brain-computer interface Randomized clinical trial |
| url | https://doi.org/10.1186/s12984-024-01535-2 |
| work_keys_str_mv | AT myeongsunkim efficacyofbraincomputerinterfacetrainingwithmotorimagerycontingentfeedbackinimprovingupperlimbfunctionandneuroplasticityamongpersonswithchronicstrokeadoubleblindedparallelgrouprandomizedcontrolledtrial AT hyunjupark efficacyofbraincomputerinterfacetrainingwithmotorimagerycontingentfeedbackinimprovingupperlimbfunctionandneuroplasticityamongpersonswithchronicstrokeadoubleblindedparallelgrouprandomizedcontrolledtrial AT ilhokwon efficacyofbraincomputerinterfacetrainingwithmotorimagerycontingentfeedbackinimprovingupperlimbfunctionandneuroplasticityamongpersonswithchronicstrokeadoubleblindedparallelgrouprandomizedcontrolledtrial AT kwangokan efficacyofbraincomputerinterfacetrainingwithmotorimagerycontingentfeedbackinimprovingupperlimbfunctionandneuroplasticityamongpersonswithchronicstrokeadoubleblindedparallelgrouprandomizedcontrolledtrial AT hayeonkim efficacyofbraincomputerinterfacetrainingwithmotorimagerycontingentfeedbackinimprovingupperlimbfunctionandneuroplasticityamongpersonswithchronicstrokeadoubleblindedparallelgrouprandomizedcontrolledtrial AT gyuleepark efficacyofbraincomputerinterfacetrainingwithmotorimagerycontingentfeedbackinimprovingupperlimbfunctionandneuroplasticityamongpersonswithchronicstrokeadoubleblindedparallelgrouprandomizedcontrolledtrial AT wooseokhyung efficacyofbraincomputerinterfacetrainingwithmotorimagerycontingentfeedbackinimprovingupperlimbfunctionandneuroplasticityamongpersonswithchronicstrokeadoubleblindedparallelgrouprandomizedcontrolledtrial AT changhwanim efficacyofbraincomputerinterfacetrainingwithmotorimagerycontingentfeedbackinimprovingupperlimbfunctionandneuroplasticityamongpersonswithchronicstrokeadoubleblindedparallelgrouprandomizedcontrolledtrial AT joonhoshin efficacyofbraincomputerinterfacetrainingwithmotorimagerycontingentfeedbackinimprovingupperlimbfunctionandneuroplasticityamongpersonswithchronicstrokeadoubleblindedparallelgrouprandomizedcontrolledtrial |