Application of fMRI and Simultaneous fMRI-EEG Neurofeedback in Post-Stroke Motor Rehabilitation.

This article discusses the contribution of fMRI- and fMRI-EEG-neurofeedback into recovery of motor function in two subacute stroke patients during the early post-stroke period. Premotor and supplementary motor zones of the cortex were chosen as the targets of voluntary control. Patient 1 received 6 sessions of motor imagery-based fMRI neurofeedback of secondary motor areas activity and Patient 2 received a similar course with the addition of µ- and ß-EEG activity suppression. Both reduced the motor deficit severity, improved on the quality of life, and increased the C3/C4 coherence to other central leads within EEG µ-band. Patient 1 reliably increased the fMRI signal in target areas and improved on the strength and speed of hand movements. Patient 2 (fMRI-EEG) mastered the EEG activity regulation to a greater degree. The authors conclude that pure fMRI neurofeedback and bi-modal fMRI-EEG neurofeedback produce different clinical effects in motor rehabilitation, which confirms the prospect of the closed-loop stroke treatment.

EEG Alpha-Rhythm-Related Changes in BOLD fMRI Signal in Neurofeedback Training.

Interaction of EEG and BOLD brain activity was studied in subjects during EEG-biofeedback training course (20 sessions). Healthy male subjects aged 20-35 underwent a training course of sound-reinforced upregulation of alpha- (20 participants) or beta-activity (9 participants). Pretraining, intermediate (after 10 sessions), and post-training fMRI-EEG recordings were conducted in resting state and during the participants' attempts to upregulate the power of target EEG activity. Regression analysis was carried out on three sessions in total; the main changes in BOLD signal connected with alpha rhythm power were related to the subjects who performed alpha training "good enough" (were able to increase alpha power at least at one stage). Maximum changes in BOLD response connected with alpha rhythm power were observed in the form of deactivation at T8 lead in the right hemisphere, and at F7 in the left hemisphere, and involved middle frontal gyrus, triangular part of inferior frontal gyrus, superior temporal gyrus, parietal lobule, and insula. The identified areas correspond to the executive control network (ECN) and anterior salience network (ASN).

Prospects of Synchronous fMRI-EEG Recording as the Basis for Neurofeedback (Exemplified on Patient with Stroke Sequelae).

Synchronous fMRI-EEG mapping of cerebral activity in stroke patients made it possible to implement neurofeedback, a novel and promising therapeutic technology. This method integrates a real-time monitoring of cerebral activity by EEG and fMRI signals and training of the patients to control this activity simultaneously or alternatively via neurofeedback. The targets of such cerebral stimulation are cortical regions controlling arbitrary movements (Brodmann area 4), whereas its aim is optimization of activity in these regions in order to achieve better rehabilitation of stroke patients. The paper discusses the methodical details, advantages, and promise of bimodal neurofeedback treatment.

Dynamics of fMRI and EEG Parameters in a Stroke Patient Assessed during a Neurofeedback Course Focused on Brodmann Area 4 (M1).

A course of interactive stimulation of primary motor cortex (Brodmann area 4) in the brain of a stroke patient resulted in recovery of locomotion volume in the paretic extremities and in improvement of general health accompanied with diverse changes in cerebral activity. During the training course, the magnitude of response in the visual fields of Brodmann areas 17 and 18 decreased; in parallel, the motor areas were supplemented with other ones such as area 24 (the ventral surface of anterior cingulate gyrus responsible for self-regulation of human brain activity and implicated into synthesis of tactile and special information) in company with Brodmann areas 40, 41, 43, 44, and 45. EEG data showed that neurofeedback sessions persistently increased the θ rhythm power in Brodmann areas 7, 39, 40, and 47, while the corresponding powers progressively decreased during a real motion. Both real motion and its virtual sibling constructed by interactive stimulation via neurofeedback were characterized with decreasing powers of the EEG ß rhythm in Brodmann areas 6 and 8. The neurofeedback course decreased the coherence between the left Brodmann area 6 and some other ones examined in α and θ ranges. In the context of real motions, the coherence assessed in the EEG ß range generally increased. Overall, the EEG and fMRI parameters attest to growing similarity between the moieties of functional communications effected in real and imaginary movements during neurofeedback course. The data open the vista for interactive stimulation to rehabilitate stroke patients; they highlight the important role of Brodmann areas in rearrangement of the brain in such patients; finally, the present results revealed the "common nervous pathway" that can be used to restore the capability for imaginary and real movements by a neurofeedback course after stroke.

Dynamics of Interaction of Neural Networks in the Course of EEG Alpha Biofeedback.

Brain EEG-fMRI activity was studied in subjects, who had successfully completed the EEG alpha stimulating training course (20 sessions): for 14 healthy men (20-35 years) three records were obtained in the feedback loop (biofeedback with EEG alpha rhythm with sound reinforcement): in the beginning, middle and at the end of the course. During alpha training, increased functional connectivity was revealed between precuneus network and anterior salience network, left executive control network, default mode network, primary visual network; anterior salience network and executive control network, visual-spatial network. The most prominent changes were found for precuneus network and anterior salience network, which could be due to their key role in the biofeedback phenomenon. Significant changes in functional connectivity were recorded for anterior salience network and precuneus network (synchronicity increased from the first to the third trial) and right and left executive control networks (weakening from the first to the second session.

[Real Time Fuctional Magnetic Resonance Imaging Biofeedback: a New Generation of Neurotherapy].

The review summarizes the data related to the potential of the real time fMRI biofeedback (the rt-fMRI), a novel technology implementing instructing patients to modify the neural activity in the certain brain regions related to the disordered function. The recent positive results were gained for a treatment of the post-stroke impairments, the Parkinson disease, the pain syndrome, the tinnitus, the alcohol and nicotine abuse, the major depression, and phobias of contamination and spiders. The intervention Was found to be less promising for schizophrenia and nearly ineffective for the criminal antisocial personality disorder. The reliability of the results is mostly poor due to suboptimal study designs, lack of the control groups, and insufficient sample sizes. The article deals with biological basis of the technology, its current applications and perspectives; and also its method- ologicdl and methodical problems.

[Experience of the Continuous Real Time fMRI Biofeedback of the Primary Motor Cortex Using a 1.5 T MR Scanner].

The neurofeedback based on the motor areas fMRI signal may be a promising treatment for improving motor impairment in post-stroke conditions and Parkinson's disease. In the majority of the studies has been conducted using the 3 T MR machines, and the region of interest has been placed to the secondary motor areas. The current study attempted to perform an fMRI neurofeeback based on response of the right hand projection locus within primary motor cortex utilizing the 1.5 T MR scanner and using the optimal parameters for the named magnetic field strength. The subjects were 16 healthy participants who underwent a 30-minute imaging session comprised 1) individual func- tional localization of the region of interest (using the hand clinging task) and attempts to control its activity with 2) motor imagery and 3) any cognitive strategy chosen by participant. In both self-regulation conditions subjects activated G. precentralis, G. cinguli anterior, G. frontalis superior, G. parietalis inferior, and 6-th Brodman area. Activation maps for these two tasks didn't differ one from another significantly, and the involved area had only a few overlays with the region of interest map which signifies that training was unsucessful. The limitations of the study and factors influenc- ing the biofeedback efficacy negatively are discussed.

EEG-fMRI Study of Alpha-Stimulation Neurobiofeedback Training Course.

fMRI-EEG dynamics of brain activity in volunteers was studied during the course of EEG alpha-stimulation training (20 sessions). Twenty-three healthy men (20-35 years) were subjected to 3-fold mapping in a feedback loop (EEG alpha-rhythm biofeedback with acoustic reinforcement). This procedure was performed at the beginning, middle, and end of the course. During the first neurofeedback training session, deactivation (p<0.001) was found in the right angular gyrus, supramarginal, and superior temporal gyri, Brodmann area 39, and cerebellum. Activation (p<0.001) was observed in the medial frontal and cingulate gyri, motor areas of both hemispheres, and Brodmann area 32. During final (third) neurofeedback training session, we observed strong deactivation (p<0.05 with FDR) of zones responsible for spatial thinking and motor functions: left medial frontal and left medial temporal gyri; right postcentral, lingual, and superior frontal gyri; insula and right side of the cerebellum; and precuneus and cuneus (Brodmann areas 6, 9, 7, 31, 8, 13, and 22). Changes in the alpha wave power were most pronounced in the primary and secondary somatosensory cortex of the left hemisphere (Brodmann areas 2L and 5L).

Possible role and application of fMRI in the screening of release-active drugs.

Functional magnetic resonance imaging (fMRI) of the brain was applied for preclinical evaluation of the efficiency of Divaza preparation intended for the treatment of cerebrovascular disorders. Psychological testing (Stroop task) in the magnetic field of fMRI was performed before and after 12-week treatment course using a double blind placebo-controlled protocol. It was shown that standard psychological and neuropsychological protocols do not allow fully estimate the results of treatment, whereas fMRI targeted the pool of cerebral structures activated during task solution. In the treatment group (in contrast to placebo), active zones in these structures were found only during task solution. Thus, resolution capability of fMRI significantly extends the range of rational screening by identifying active zones and can radically change the procedure of selection and clinical trials.

Trace effects of game biofeedback: functional MRI study.

We studied the intracerebral dynamics of developing skills for self-regulation of psychophysiological functions in the biofeedback game model via functional MRI. Multiple game plots managed by physiological characteristics leave a trace in the form of activity zones in the middle occipital gyrus, middle temporal gyrus, middle frontal gyrus, inferior parietal lobule, and declive functionally related to cognitive actions and operations. During the development of self-regulation skills, the gradual shift of the localization of areas of activity is observed towards sensory projection fields (e.g., thalamus, superior parietal lobule), which indicates distribution of the load toward the perceptual areas.

Neurovisualization of the dynamics of real and simulation biofeedback: functional magnetic resonance imaging study.

On-line brain mapping in subjects operating a competitive virtual gameplay was performed using functional magnetic resonance imaging. The interaction between the brain and visceral systems was studied on the model of real and simulated adaptive biofeedback. The immersion into a virtual story leads to a large-scale activation of cortical regions characterized by high values of voxels in the midtemporal, occipital, and frontal areas as well as in cingulate gyrus, cuneus, and precuneus (Brodmann areas 6, 7, 9, 10, 19, 24, 32, 39, 40, 45). The maximum increase in activity was observed during stage 2 of the game biofeedback, when the volumes of activated voxels increased several times in comparison with the starting phase. Qualitative characteristics of real and imitation game periods are discussed.

Dynamic mapping of brain and cognitive control of virtual gameplay (study by functional magnetic resonance imaging).

Using functional magnetic resonance imaging technique, we performed online brain mapping of gamers, practiced to voluntary (cognitively) control their heart rate, the parameter that operated a competitive virtual gameplay in the adaptive feedback loop. With the default start picture, the regions of interest during the formation of optimal cognitive strategy were as follows: Brodmann areas 19, 37, 39 and 40, i.e. cerebellar structures (vermis, amygdala, pyramids, clivus). "Localization" concept of the contribution of the cerebellum to cognitive processes is discussed.