Exploring the ability of stroke survivors in using the contralesional hemisphere to control a brain-computer interface.

Brain-computer interfaces (BCIs) have recently been shown to be clinically effective as a novel method of stroke rehabilitation. In many BCI-based studies, the activation of the ipsilesional hemisphere was considered a key factor required for motor recovery after stroke. However, emerging evidence suggests that the contralesional hemisphere also plays a role in motor function rehabilitation. The objective of this study is to investigate the effectiveness of the BCI in detecting motor imagery of the affected hand from contralesional hemisphere. We analyzed a large EEG dataset from 136 stroke patients who performed motor imagery of their stroke-impaired hand. BCI features were extracted from channels covering either the ipsilesional, contralesional or bilateral hemisphere, and the offline BCI accuracy was computed using 10 [Formula: see text] 10-fold cross-validations. Our results showed that most stroke patients can operate the BCI using either their contralesional or ipsilesional hemisphere. Those with the ipsilesional BCI accuracy of less than 60% had significantly higher motor impairments than those with the ipsilesional BCI accuracy above 80%. Interestingly, those with the ipsilesional BCI accuracy of less than 60% achieved a significantly higher contralesional BCI accuracy, whereas those with the ipsilesional BCI accuracy more than 80% had significantly poorer contralesional BCI accuracy. This study suggests that contralesional BCI may be a useful approach for those with a high motor impairment who cannot accurately generate signals from ipsilesional hemisphere to effectively operate BCI.

Scalp EEG-Based Pain Detection Using Convolutional Neural Network.

Pain is an integrative phenomenon coupled with dynamic interactions between sensory and contextual processes in the brain, often associated with detectable neurophysiological changes. Recent advances in brain activity recording tools and machine learning technologies have intrigued research and development of neurocomputing techniques for objective and neurophysiology-based pain detection. This paper proposes a pain detection framework based on Electroencephalogram (EEG) and deep convolutional neural networks (CNN). The feasibility of CNN is investigated for distinguishing induced pain state from resting state in the recruitment of 10 chronic back pain patients. The experimental study recorded EEG signals in two phases: 1. movement stimulation (MS), where induces back pain by executing predefined movement tasks; 2. video stimulation (VS), where induces back pain perception by watching a set of video clips. A multi-layer CNN classifies the EEG segments during the resting state and the pain state. The novel approach offers high and robust performance and hence is significant in building a powerful pain detection algorithm. The area under the receiver operating characteristic curve (AUC) of our approach is 0.83 ± 0.09 and 0.81 ± 0.15, in MS and VS, respectively, higher than the state-of-the-art approaches. The sub-brain-areas are also analyzed, to examine distinct brain topographies relevant for pain detection. The results indicate that MS-induced pain tends to evoke a generalized brain area, while the evoked area is relatively partial under VS-induced pain. This work may provide a new solution for researchers and clinical practitioners on pain detection.

Efficacy of Brain-Computer Interface and the Impact of Its Design Characteristics on Poststroke Upper-limb Rehabilitation: A Systematic Review and Meta-analysis of Randomized Controlled Trials.

Background. A number of recent randomized controlled trials reported the efficacy of brain-computer interface (BCI) for upper-limb stroke rehabilitation compared with other therapies. Despite the encouraging results reported, there is a significant variance in the reported outcomes. This paper aims to investigate the effectiveness of different BCI designs on poststroke upper-limb rehabilitation. Methods. The effect sizes of pooled and individual studies were assessed by computing Hedge's g values with a 95% confidence interval. Subgroup analyses were also performed to examine the impact of different BCI designs on the treatment effect. Results. The study included 12 clinical trials involving 298 patients. The analysis showed that the BCI yielded significant superior short-term and long-term efficacy in improving the upper-limb motor function compared to the control therapies (Hedge's g = 0.73 and 0.33, respectively). Based on our subgroup analyses, the BCI studies that used the intention of movement had a higher effect size compared to those used motor imagery (Hedge's g = 1.21 and 0.55, respectively). The BCI studies using band power features had a significantly higher effect size than those using filter bank common spatial patterns features (Hedge's g = 1.25 and - 0.23, respectively). Finally, the studies that used functional electrical stimulation as the BCI feedback had the highest effect size compared to other devices (Hedge's g = 1.2). Conclusion. This meta-analysis confirmed the effectiveness of BCI for upper-limb rehabilitation. Our findings support the use of band power features, the intention of movement, and the functional electrical stimulation in future BCI designs for poststroke upper-limb rehabilitation.

A Transfer Learning Algorithm to Reduce Brain-Computer Interface Calibration Time for Long-Term Users.

Current motor imagery-based brain-computer interface (BCI) systems require a long calibration time at the beginning of each session before they can be used with adequate levels of classification accuracy. In particular, this issue can be a significant burden for long term BCI users. This article proposes a novel transfer learning algorithm, called r-KLwDSA, to reduce the BCI calibration time for long-term users. The proposed r-KLwDSA algorithm aligns the user's EEG data collected in previous sessions to the few EEG trials collected in the current session, using a novel linear alignment method. Thereafter, the aligned EEG trials from the previous sessions and the few EEG trials from the current sessions are fused through a weighting mechanism before they are used for calibrating the BCI model. To validate the proposed algorithm, a large dataset containing the EEG data from 11 stroke patients, each performing 18 BCI sessions, was used. The proposed framework demonstrated a significant improvement in the classification accuracy, of over 4% compared to the session-specific algorithm, when there were as few as two trials per class available from the current session. The proposed algorithm was particularly successful in improving the BCI accuracy of the sessions that had initial session-specific accuracy below 60%, with an average improvement of around 10% in the accuracy, leading to more stroke patients having meaningful BCI rehabilitation.

Infant EEG Band Power Analysis at 6 Months and 18 Months.

Neural development of infants has drawn increasing research interests from the community. In this paper, we investigated the frequency band power of 112 infants who participated in an auditory oddball experiment, and the visual expectation (VE) score of 177 infants who went through a visual expectation paradigm test. Analysis found that the frequency band power decreases in the delta and theta bands, and increases in the alpha and beta bands when the infants grow up from 6 months old to 18 months old. We also proposed a sustainability index to measure the capability of a subject to maintain their band power in the auditory oddball experiment when infants grow up from 6 months old to 18 months old. Analysis shows that the sustainability index increased significantly in the alpha and beta band, decreased in the delta and theta bands. Correlation between the VE score and frequency band power was investigated on 47 infants who participated in both auditory oddball experiment and visual expectation paradigm test. Analysis shows that the reaction speed to stimulus have statistical a significant correlation with the changes of band power and sustainability index in posterior and temporal section, and in the higher frequency bands.

Brain Functional Changes in Stroke Following Rehabilitation Using Brain-Computer Interface-Assisted Motor Imagery With and Without tDCS: A Pilot Study.

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.

Corrigendum: Using Transcranial Direct Current Stimulation to Augment the Effect of Motor Imagery-Assisted Brain-Computer Interface Training in Chronic Stroke Patients-Cortical Reorganization Considerations.

[This corrects the article DOI: 10.3389/fneur.2020.00948.].

Using Transcranial Direct Current Stimulation to Augment the Effect of Motor Imagery-Assisted Brain-Computer Interface Training in Chronic Stroke Patients-Cortical Reorganization Considerations.

Introduction: Transcranial direct current stimulation (tDCS) has been shown to modulate cortical plasticity, enhance motor learning and post-stroke upper extremity motor recovery. It has also been demonstrated to facilitate activation of brain-computer interface (BCI) in stroke patients. We had previously demonstrated that BCI-assisted motor imagery (MI-BCI) can improve upper extremity impairment in chronic stroke participants. This study was carried out to investigate the effects of priming with tDCS prior to MI-BCI training in chronic stroke patients with moderate to severe upper extremity paresis and to investigate the cortical activity changes associated with training. Methods: This is a double-blinded randomized clinical trial. Participants were randomized to receive 10 sessions of 20-min 1 mA tDCS or sham-tDCS before MI-BCI, with the anode applied to the ipsilesional, and the cathode to the contralesional primary motor cortex (M1). Upper extremity sub-scale of the Fugl-Meyer Assessment (UE-FM) and corticospinal excitability measured by transcranial magnetic stimulation (TMS) were assessed before, after and 4 weeks after intervention. Results: Ten participants received real tDCS and nine received sham tDCS. UE-FM improved significantly in both groups after intervention. Of those with unrecordable motor evoked potential (MEP-) to the ipsilesional M1, significant improvement in UE-FM was found in the real-tDCS group, but not in the sham group. Resting motor threshold (RMT) of ipsilesional M1 decreased significantly after intervention in the real-tDCS group. Short intra-cortical inhibition (SICI) in the contralesional M1 was reduced significantly following intervention in the sham group. Correlation was found between baseline UE-FM score and changes in the contralesional SICI for all, as well as between changes in UE-FM and changes in contralesional RMT in the MEP- group. Conclusion: MI-BCI improved the motor function of the stroke-affected arm in chronic stroke patients with moderate to severe impairment. tDCS did not confer overall additional benefit although there was a trend toward greater benefit. Cortical activity changes in the contralesional M1 associated with functional improvement suggests a possible role for the contralesional M1 in stroke recovery in more severely affected patients. This has important implications in designing neuromodulatory interventions for future studies and tailoring treatment. Clinical Trial Registration: The study was registered at https://clinicaltrials.gov (NCT01897025).

Brain-Computer Interface-Based Soft Robotic Glove Rehabilitation for Stroke.

OBJECTIVE: This randomized controlled feasibility study investigates the ability for clinical application of the Brain-Computer Interface-based Soft Robotic Glove (BCI-SRG) incorporating activities of daily living (ADL)-oriented tasks for stroke rehabilitation. METHODS: Eleven recruited chronic stroke patients were randomized into BCI-SRG or Soft Robotic Glove (SRG) group. Each group underwent 120-minute intervention per session comprising 30-minute standard arm therapy and 90-minute experimental therapy (BCI-SRG or SRG). To perform ADL tasks, BCI-SRG group used motor imagery-BCI and SRG, while SRG group used SRG without motor imagery-BCI. Both groups received 18 sessions of intervention over 6 weeks. Fugl-Meyer Motor Assessment (FMA) and Action Research Arm Test (ARAT) scores were measured at baseline (week 0), post- intervention (week 6), and follow-ups (week 12 and 24). In total, 10/11 patients completed the study with 5 in each group and 1 dropped out. RESULTS: Though there were no significant intergroup differences for FMA and ARAT during 6-week intervention, the improvement of FMA and ARAT seemed to sustain beyond 6-week intervention for BCI-SRG group, as compared with SRG control. Incidentally, all BCI-SRG subjects reported a sense of vivid movement of the stroke-impaired upper limb and 3/5 had this phenomenon persisting beyond intervention while none of SRG did. CONCLUSION: BCI-SRG suggested probable trends of sustained functional improvements with peculiar kinesthetic experience outlasting active intervention in chronic stroke despite the dire need for large-scale investigations to verify statistical significance. SIGNIFICANCE: Addition of BCI to soft robotic training for ADL-oriented stroke rehabilitation holds promise for sustained improvements as well as elicited perception of motor movements.

Assessment of the Efficacy of EEG-Based MI-BCI With Visual Feedback and EEG Correlates of Mental Fatigue for Upper-Limb Stroke Rehabilitation.

OBJECTIVE: This single-arm multisite trial investigates the efficacy of the neurostyle brain exercise therapy towards enhanced recovery (nBETTER) system, an electroencephalogram (EEG)-based motor imagery brain-computer interface (MI-BCI) employing visual feedback for upper-limb stroke rehabilitation, and the presence of EEG correlates of mental fatigue during BCI usage. METHODS: A total of 13 recruited stroke patients underwent thrice-weekly nBETTER therapy coupled with standard arm therapy over six weeks. Upper-extremity Fugl-Meyer motor assessment (FMA) scores were measured at baseline (week 0), post-intervention (week 6), and follow-ups (weeks 12 and 24). In total, 11/13 patients (mean age 55.2 years old, mean post-stroke duration 333.7 days, mean baseline FMA 35.5) completed the study. RESULTS: Significant FMA gains relative to baseline were observed at weeks 6 and 24. Retrospectively comparing to the standard arm therapy (SAT) control group and BCI with haptic knob (BCI-HK) intervention group from a previous similar study, the SAT group had no significant gains, whereas the BCI-HK group had significant gains at weeks 6, 12, and 24. EEG analysis revealed significant positive correlations between relative beta power and BCI performance in the frontal and central brain regions, suggesting that mental fatigue may contribute to poorer BCI performance. CONCLUSION: nBETTER, an EEG-based MI-BCI employing only visual feedback, helps stroke survivors sustain short-term FMA improvement. Analysis of EEG relative beta power indicates that mental fatigue may be present. SIGNIFICANCE: This study adds nBETTER to the growing literature of safe and effective stroke rehabilitation MI-BCI, and suggests an additional fatigue-monitoring role in future such BCI.

Prognostic and Monitory EEG-Biomarkers for BCI Upper-Limb Stroke Rehabilitation.

With the availability of multiple rehabilitative interventions, identifying the one that elicits the best motor outcome based on the unique neuro-clinical profile of the stroke survivor is a challenging task. Predicting the potential of recovery using biomarkers specific to an intervention hence becomes important. To address this, we investigate intervention-specific prognostic and monitory biomarkers of motor function improvements using quantitative electroencephalography (QEEG) features in 19 chronic stroke patients following two different upper extremity rehabilitative interventions viz. Brain-computer interface (BCI) and transcranial direct current stimulation coupled BCI (tDCS-BCI). Brain symmetry index was found to be the best prognostic QEEG for clinical gains following BCI intervention ( r = -0.80 , p = 0.02 ), whereas power ratio index (PRI) was observed to be the best predictor for tDCS-BCI ( r = -0.96 , p = 0.004 ) intervention. Importantly, statistically significant between-intervention differences observed in the predictive capabilities of these features suggest that intervention-specific biomarkers can be identified. This approach can be further pursued to distinctly predict the expected response of a patient to available interventions. The intervention with the highest predicted gains may then be recommended to the patient, thereby enabling a personalized rehabilitation regime.

Quantitative EEG as Biomarkers for the Monitoring of Post-Stroke Motor Recovery in BCI and tDCS Rehabilitation.

This study investigates the neurological changes in the brain activity of chronic stroke patients undergoing different types of motor rehabilitative interventions and their relationship with the clinical recovery using the Quantitative Electroencephalography (QEEG) features. Over a period of two weeks, 19 hemiplegic chronic stroke patients underwent 10 sessions of upper extremity motor rehabilitation using a brain-computer interface paradigm (BCI group, n=9) and transcranial direct current stimulation coupled BCI paradigm (tDCS group, n=10). The pre- and post-treatment brain activations, as well as the intervention-induced changes in the neuronal activity, were quantified using 11 QEEG features and their relationship with clinical motor improvement was investigated. Significant treatment-induced change in the relative theta power was observed in the BCI group and the change was significantly correlated with the clinical improvements. Also, in the BCI group, the relative theta power and interactions between the theta, alpha, and beta power were identified as monitory biomarkers of motor recovery. On the contrary, the tDCS group was characterized by the significant change in brain asymmetry. Furthermore, we observed significant intergroup differences in the predictive capabilities of post-intervention QEEG features between the BCI and tDCS group. Based on the intergroup differences observed in this study and convergent results from the other neuroimaging analysis performed on the same cohort, we suggest that distinctly different mechanisms of neuronal recovery were facilitated by tDCS and BCI interventions and these treatment specific mechanisms can be encapsulated using QEEG.

Differential Amplitude of Low-Frequency Fluctuations in brain networks after BCI Training with and without tDCS in Stroke.

Mapping the brain alterations post stroke and post intervention is important for rehabilitation therapy development. Previous work has shown changes in functional connectivity based on resting-state fMRI, structural connectivity derived from diffusion MRI and perfusion as a result of brain-computer interface-assisted motor imagery (MI-BCI) and transcranial direct current stimulation (tDCS) in upper-limb stroke rehabilitation. Besides functional connectivity, regional amplitude of local low-frequency fluctuations (ALFF) may provide complementary information on the underlying neural mechanism in disease. Yet, findings on spontaneous brain activity during resting-state in stroke patients after intervention are limited and inconsistent. Here, we sought to investigate the different brain alteration patterns induced by tDCS compared to MI-BCI for upper-limb rehabilitation in chronic stroke patients using resting-state fMRI-based ALFF method. Our results suggested that stroke patients have lower ALFF in the ipsilesional somatomotor network compared to controls at baseline. Increased ALFF at contralesional somatomotor network and alterations in higher-level cognitive networks such as the default mode network (DMN) and salience networks accompany motor recovery after intervention; though the MI-BCI alone group and MI-BCI combined with tDCS group exhibit differential patterns.

Increased Theta Oscillations During Motor Imagery in a Subject with Late-stage ALS.

Non-invasive brain computer interface (BCI) has been successfully used to control cursors, helicopters and robotic arms. However, this technology is not widely adopted by people with late-stage amyotrophic lateral sclerosis (ALS) due to poor effectiveness. In this study, we attempt to assess the cognitive state of a completely locked-in ALS subject, and her ability to use motor imagery-based BCI for control. The subject achieves above chance level accuracies for both open loop (62.2%) and closed-loop (68.7%) 2-class movement vs. idle decoding. We also observe a prominent theta oscillation with peak frequency at 4.5 Hz during the experiments. Quantification shows that the theta oscillatory power increases during motor imagery tasks compared to idle tasks for both open-loop as well as closed-loop BCI tasks. Furthermore, for closed-loop sessions, theta oscillation power correlates positively with feedback accuracy during movement tasks, and negatively with feedback accuracy during idle tasks. Our study demonstrates the feasibility of motor imagery-based BCI for late-stage ALS subjects, and highlights the importance of feedback during BCI implementation.

Modeling EEG-based Motor Imagery with Session to Session Online Adaptation.

Subject-specific calibration plays an important role in electroencephalography (EEG)-based Brain-Computer Interface (BCI) for Motor Imagery (MI) detection. A calibration session is often introduced to build a subject specific model, which then can be deployed into BCI system for MI detection in the following rehabilitation sessions. The model is termed as a fixed calibration model. Progressive adaptive models can also be built by using data not only from calibration session, but also from available rehabilitation sessions. It was reported that the progressive adaptive model yielded significant improved MI detection compared to the fixed model in a retrospective clinical study. In this work, we deploy the progressive adaptation model in a BCI-based stroke rehabilitation system and bring it online. We dub this system nBETTER (Neurostyle Brain Exercise Therapy Towards Enhanced Recovery). A clinical trial using the nBETTER system was conducted to evaluate the performance of 11 stroke patients who underwent a calibration session followed by 18 rehabilitation sessions over 6 weeks. We conduct retrospective analysis to compare the performance of various modeling strategies: the fixed calibration model, the online progressive adaptation model and a light-weight adaptation model, where the second one is generated online by nBETTER system and the other two models are obtained retrospectively. The mean accuracy of the three models across 11 subjects are 68.17%, 74.04% and 74.53% respectively. Statistical test conducted on the three groups using ANOVA yields a p-value of 9.83-e06. The test result shows that the two adaptation models both have significant different mean from fixed mode. Hence our study confirmed the effectiveness of using the progressive adaptive model for EEGbased BCI to detect MI in an online setting.

EEG Channel Selection Based on Correlation Coefficient for Motor Imagery Classification: A Study on Healthy Subjects and ALS Patient.

Brain-Computer Interface (BCI) provides an alternate channel of interaction for people with severe motor disabilities. The Common Spatial Pattern (CSP) algorithm is effective in extracting discriminative features from EEG data for motor imagery-based Brain-Computer Interface (BCI). CSP yields signal from various locations for better performance. In this study, we selected a subset of EEG channels using correlation coefficient of spectral entropy and compared the classification performance using the Filter Bank Common Spatial Pattern (FBCSP) algorithm. We conducted experiments on 4 healthy subjects and one Amyotrophic Lateral Sclerosis (ALS) patient. The results showed that the proposed channel selection method increased classification accuracy of all subjects from 1.25% to 8.22%. Optimal performance was obtained using between 13 to 24 channels, and channels located over the motor cortex zone possess higher probabilities of being selected. Comparing with the channels manually selected to over the motor cortex area, the correlation coefficient method is able to identify the optimal channel combination and improve the motor imagery decoding accuracy of Healthy and ALS subjects.

Facilitating motor imagery-based brain-computer interface for stroke patients using passive movement.

Motor imagery-based brain-computer interface (MI-BCI) has been proposed as a rehabilitation tool to facilitate motor recovery in stroke. However, the calibration of a BCI system is a time-consuming and fatiguing process for stroke patients, which leaves reduced time for actual therapeutic interaction. Studies have shown that passive movement (PM) (i.e., the execution of a movement by an external agency without any voluntary motions) and motor imagery (MI) (i.e., the mental rehearsal of a movement without any activation of the muscles) induce similar EEG patterns over the motor cortex. Since performing PM is less fatiguing for the patients, this paper investigates the effectiveness of calibrating MI-BCIs from PM for stroke subjects in terms of classification accuracy. For this purpose, a new adaptive algorithm called filter bank data space adaptation (FB-DSA) is proposed. The FB-DSA algorithm linearly transforms the band-pass-filtered MI data such that the distribution difference between the MI and PM data is minimized. The effectiveness of the proposed algorithm is evaluated by an offline study on data collected from 16 healthy subjects and 6 stroke patients. The results show that the proposed FB-DSA algorithm significantly improved the classification accuracies of the PM and MI calibrated models (p < 0.05). According to the obtained classification accuracies, the PM calibrated models that were adapted using the proposed FB-DSA algorithm outperformed the MI calibrated models by an average of 2.3 and 4.5 % for the healthy and stroke subjects respectively. In addition, our results suggest that the disparity between MI and PM could be stronger in the stroke patients compared to the healthy subjects, and there would be thus an increased need to use the proposed FB-DSA algorithm in BCI-based stroke rehabilitation calibrated from PM.

Brain plasticity following MI-BCI training combined with tDCS in a randomized trial in chronic subcortical stroke subjects: a preliminary study.

Brain-computer interface-assisted motor imagery (MI-BCI) or transcranial direct current stimulation (tDCS) has been used in stroke rehabilitation, though their combinatory effect is unknown. We investigated brain plasticity following a combined MI-BCI and tDCS intervention in chronic subcortical stroke patients with unilateral upper limb disability. Nineteen patients were randomized into tDCS and sham-tDCS groups. Diffusion and perfusion MRI, and transcranial magnetic stimulation were used to study structural connectivity, cerebral blood flow (CBF), and corticospinal excitability, respectively, before and 4 weeks after the 2-week intervention. After quality control, thirteen subjects were included in the CBF analysis. Eleven healthy controls underwent 2 sessions of MRI for reproducibility study. Whereas motor performance showed comparable improvement, long-lasting neuroplasticity can only be detected in the tDCS group, where white matter integrity in the ipsilesional corticospinal tract and bilateral corpus callosum was increased but sensorimotor CBF was decreased, particularly in the ipsilesional side. CBF change in the bilateral parietal cortices also correlated with motor function improvement, consistent with the increased white matter integrity in the corpus callosum connecting these regions, suggesting an involvement of interhemispheric interaction. The preliminary results indicate that tDCS may facilitate neuroplasticity and suggest the potential for refining rehabilitation strategies for stroke patients.

Facilitating effects of transcranial direct current stimulation on motor imagery brain-computer interface with robotic feedback for stroke rehabilitation.

OBJECTIVE: To investigate the efficacy and effects of transcranial direct current stimulation (tDCS) on motor imagery brain-computer interface (MI-BCI) with robotic feedback for stroke rehabilitation. DESIGN: A sham-controlled, randomized controlled trial. SETTING: Patients recruited through a hospital stroke rehabilitation program. PARTICIPANTS: Subjects (N=19) who incurred a stroke 0.8 to 4.3 years prior, with moderate to severe upper extremity functional impairment, and passed BCI screening. INTERVENTIONS: Ten sessions of 20 minutes of tDCS or sham before 1 hour of MI-BCI with robotic feedback upper limb stroke rehabilitation for 2 weeks. Each rehabilitation session comprised 8 minutes of evaluation and 1 hour of therapy. MAIN OUTCOME MEASURES: Upper extremity Fugl-Meyer Motor Assessment (FMMA) scores measured end-intervention at week 2 and follow-up at week 4, online BCI accuracies from the evaluation part, and laterality coefficients of the electroencephalogram (EEG) from the therapy part of the 10 rehabilitation sessions. RESULTS: FMMA score improved in both groups at week 4, but no intergroup differences were found at any time points. Online accuracies of the evaluation part from the tDCS group were significantly higher than those from the sham group. The EEG laterality coefficients from the therapy part of the tDCS group were significantly higher than those of the sham group. CONCLUSIONS: The results suggest a role for tDCS in facilitating motor imagery in stroke.

Combining EPI and motion correction for fMRI human brain images with big motion.

Motion correction is an important component in fMRI brain image analysis. Linear registration technique is mostly used in the process based on the assumption that there is not any shape changes of human brain during imaging process. Echo planar imaging (EPI) technique has been widely adapted in fMRI imaging to shorten encoding duration and increase temporal resolution. However, due to the magnetic field inhomogeneity caused by tissues, shape distortion and signal intensity lose are brought into fMRI images by the technique. On the other hand, subject's pose in scanner has a effect on magnetic field inhomogeneity, so the EPI distortions are subject to head movement, especially when the movement is big. As a result, most current motion correction techniques, which are based on rigid registration, cannot handle the problem. In this paper, a technique that combines EPI distortion correction and motion correction to handle the above-mentioned problem is proposed. Since it is almost impossible to obtain ground truth at present, a task-related fMRI BOLD time course image with big motion is selected as experimental material to test its performance. The image is pre-processed with the proposed EPI-motion correction scheme then analyzed by FSL feat tool. Compared with another process with only motion correction and FSL feat analysis, the experimental result using the proposed method has no false activation detection. It is suggested the proposed EPI-motion correction scheme has the ability to handle the fMRI human brain images with big motion.