Cortico-Muscular Coherence Is Reduced Acutely Post-stroke and Increases Bilaterally During Motor Recovery: A Pilot Study.

Motor recovery following stroke is believed to necessitate alteration in functional connectivity between cortex and muscle. Cortico-muscular coherence has been proposed as a potential biomarker for post-stroke motor deficits, enabling a quantification of recovery, as well as potentially indicating the regions of cortex involved in recovery of function. We recorded simultaneous EEG and EMG during wrist extension from healthy participants and patients following ischaemic stroke, evaluating function at three time points post-stroke. EEG-EMG coherence increased over time, as wrist mobility recovered clinically, and by the final evaluation, coherence was higher in the patient group than in the healthy controls. Moreover, the cortical distribution differed between the groups, with coherence involving larger and more bilaterally scattered areas of cortex in the patients than in the healthy participants. The findings suggest that EEG-EMG coherence has the potential to serve as a biomarker for motor recovery and to provide information about the cortical regions that should be targeted in rehabilitation therapies based on real-time EEG.

Modulating functional connectivity after stroke with neurofeedback: Effect on motor deficits in a controlled cross-over study.

Synchronization of neural activity as measured with functional connectivity (FC) is increasingly used to study the neural basis of brain disease and to develop new treatment targets. However, solid evidence for a causal role of FC in disease and therapy is lacking. Here, we manipulated FC of the ipsilesional primary motor cortex in ten chronic human stroke patients through brain-computer interface technology with visual neurofeedback. We conducted a double-blind controlled crossover study to test whether manipulation of FC through neurofeedback had a behavioral effect on motor performance. Patients succeeded in increasing FC in the motor cortex. This led to improvement in motor function that was significantly greater than during neurofeedback training of a control brain area and proportional to the degree of FC enhancement. This result provides evidence that FC has a causal role in neurological function and that it can be effectively targeted with therapy.

Human EEG reveals distinct neural correlates of power and precision grasping types.

Hand grasping is a sophisticated motor task that has received much attention by the neuroscientific community, which demonstrated how grasping activates a network involving parietal, pre-motor and motor cortices using fMRI, ECoG, LFPs and spiking activity. Yet, there is a need for a more precise spatio-temporal analysis as it is still unclear how these brain activations over large cortical areas evolve at the sub-second level. In this study, we recorded ten human participants (1 female) performing visually-guided, self-paced reaching and grasping with precision or power grips. Following the results, we demonstrate the existence of neural correlates of grasping from broadband EEG in self-paced conditions and show how neural correlates of precision and power grasps differentially evolve as grasps unfold. 100 ms before the grasp is secured, bilateral parietal regions showed increasingly differential patterns. Afterwards, sustained differences between both grasps occurred over the bilateral motor and parietal regions, and medial pre-frontal cortex. Furthermore, these differences were sufficiently discriminable to allow single-trial decoding with 70% decoding performance. Functional connectivity revealed differences at the network level between grasps in fronto-parietal networks, in terms of upper-alpha cortical oscillatory power with a strong involvement of ipsilateral hemisphere. Our results supported the existence of fronto-parietal recurrent feedback loops, with stronger interactions for precision grips due to the finer motor control required for this grasping type.

Sensory threshold neuromuscular electrical stimulation fosters motor imagery performance.

Motor imagery (MI) has been largely studied as a way to enhance motor learning and to restore motor functions. Although it is agreed that users should emphasize kinesthetic imagery during MI, recordings of MI brain patterns are not sufficiently reliable for many subjects. It has been suggested that the usage of somatosensory feedback would be more suitable than standardly used visual feedback to enhance MI brain patterns. However, somatosensory feedback should not interfere with the recorded MI brain pattern. In this study we propose a novel feedback modality to guide subjects during MI based on sensory threshold neuromuscular electrical stimulation (St-NMES). St-NMES depolarizes sensory and motor axons without eliciting any muscular contraction. We hypothesize that St-NMES does not induce detectable ERD brain patterns and fosters MI performance. Twelve novice subjects were included in a cross-over design study. We recorded their EEG, comparing St-NMES with visual feedback during MI or resting tasks. We found that St-NMES not only induced significantly larger desynchronization over sensorimotor areas (p<0.05) but also significantly enhanced MI brain connectivity patterns. Moreover, classification accuracy and stability were significantly higher with St-NMES. Importantly, St-NMES alone did not induce detectable artifacts, but rather the changes in the detected patterns were due to an increased MI performance. Our findings indicate that St-NMES is a promising feedback in order to foster MI performance and cold be used for BMI online applications.

Neurofeedback training of alpha-band coherence enhances motor performance.

OBJECTIVE: Neurofeedback training of motor cortex activations with brain-computer interface systems can enhance recovery in stroke patients. Here we propose a new approach which trains resting-state functional connectivity associated with motor performance instead of activations related to movements. METHODS: Ten healthy subjects and one stroke patient trained alpha-band coherence between their hand motor area and the rest of the brain using neurofeedback with source functional connectivity analysis and visual feedback. RESULTS: Seven out of ten healthy subjects were able to increase alpha-band coherence between the hand motor cortex and the rest of the brain in a single session. The patient with chronic stroke learned to enhance alpha-band coherence of his affected primary motor cortex in 7 neurofeedback sessions applied over one month. Coherence increased specifically in the targeted motor cortex and in alpha frequencies. This increase was associated with clinically meaningful and lasting improvement of motor function after stroke. CONCLUSIONS: These results provide proof of concept that neurofeedback training of alpha-band coherence is feasible and behaviorally useful. SIGNIFICANCE: The study presents evidence for a role of alpha-band coherence in motor learning and may lead to new strategies for rehabilitation.