Modulation of Functional Connectivity and Low-Frequency Fluctuations After Brain-Computer Interface-Guided Robot Hand Training in Chronic Stroke: A 6-Month Follow-Up Study
Hand function improvement in stroke survivors in the chronic stage usually plateaus by 6 months. Brain-computer interface (BCI)-guided robot-assisted training has been shown to be effective for facilitating upper-limb motor function recovery in chronic stroke. However, the underlying neuroplasticity...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Frontiers Media S.A.
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7855586/ https://www.ncbi.nlm.nih.gov/pubmed/33551777 http://dx.doi.org/10.3389/fnhum.2020.611064 |
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author | Lau, Cathy C. Y. Yuan, Kai Wong, Patrick C. M. Chu, Winnie C. W. Leung, Thomas W. Wong, Wan-wa Tong, Raymond K. Y. |
author_facet | Lau, Cathy C. Y. Yuan, Kai Wong, Patrick C. M. Chu, Winnie C. W. Leung, Thomas W. Wong, Wan-wa Tong, Raymond K. Y. |
author_sort | Lau, Cathy C. Y. |
collection | PubMed |
description | Hand function improvement in stroke survivors in the chronic stage usually plateaus by 6 months. Brain-computer interface (BCI)-guided robot-assisted training has been shown to be effective for facilitating upper-limb motor function recovery in chronic stroke. However, the underlying neuroplasticity change is not well understood. This study aimed to investigate the whole-brain neuroplasticity changes after 20-session BCI-guided robot hand training, and whether the changes could be maintained at the 6-month follow-up. Therefore, the clinical improvement and the neurological changes before, immediately after, and 6 months after training were explored in 14 chronic stroke subjects. The upper-limb motor function was assessed by Action Research Arm Test (ARAT) and Fugl-Meyer Assessment for Upper-Limb (FMA), and the neurological changes were assessed using resting-state functional magnetic resonance imaging. Repeated-measure ANOVAs indicated that long-term motor improvement was found by both FMA (F([2,26]) = 6.367, p = 0.006) and ARAT (F([2,26]) = 7.230, p = 0.003). Seed-based functional connectivity analysis exhibited that significantly modulated FC was observed between ipsilesional motor regions (primary motor cortex and supplementary motor area) and contralesional areas (supplementary motor area, premotor cortex, and superior parietal lobule), and the effects were sustained after 6 months. The fALFF analysis showed that local neuronal activities significantly increased in central, frontal and parietal regions, and the effects were also sustained after 6 months. Consistent results in FC and fALFF analyses demonstrated the increase of neural activities in sensorimotor and fronto-parietal regions, which were highly involved in the BCI-guided training. Clinical Trial Registration: This study has been registered at ClinicalTrials.gov with clinical trial registration number NCT02323061. |
format | Online Article Text |
id | pubmed-7855586 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-78555862021-02-04 Modulation of Functional Connectivity and Low-Frequency Fluctuations After Brain-Computer Interface-Guided Robot Hand Training in Chronic Stroke: A 6-Month Follow-Up Study Lau, Cathy C. Y. Yuan, Kai Wong, Patrick C. M. Chu, Winnie C. W. Leung, Thomas W. Wong, Wan-wa Tong, Raymond K. Y. Front Hum Neurosci Human Neuroscience Hand function improvement in stroke survivors in the chronic stage usually plateaus by 6 months. Brain-computer interface (BCI)-guided robot-assisted training has been shown to be effective for facilitating upper-limb motor function recovery in chronic stroke. However, the underlying neuroplasticity change is not well understood. This study aimed to investigate the whole-brain neuroplasticity changes after 20-session BCI-guided robot hand training, and whether the changes could be maintained at the 6-month follow-up. Therefore, the clinical improvement and the neurological changes before, immediately after, and 6 months after training were explored in 14 chronic stroke subjects. The upper-limb motor function was assessed by Action Research Arm Test (ARAT) and Fugl-Meyer Assessment for Upper-Limb (FMA), and the neurological changes were assessed using resting-state functional magnetic resonance imaging. Repeated-measure ANOVAs indicated that long-term motor improvement was found by both FMA (F([2,26]) = 6.367, p = 0.006) and ARAT (F([2,26]) = 7.230, p = 0.003). Seed-based functional connectivity analysis exhibited that significantly modulated FC was observed between ipsilesional motor regions (primary motor cortex and supplementary motor area) and contralesional areas (supplementary motor area, premotor cortex, and superior parietal lobule), and the effects were sustained after 6 months. The fALFF analysis showed that local neuronal activities significantly increased in central, frontal and parietal regions, and the effects were also sustained after 6 months. Consistent results in FC and fALFF analyses demonstrated the increase of neural activities in sensorimotor and fronto-parietal regions, which were highly involved in the BCI-guided training. Clinical Trial Registration: This study has been registered at ClinicalTrials.gov with clinical trial registration number NCT02323061. Frontiers Media S.A. 2021-01-20 /pmc/articles/PMC7855586/ /pubmed/33551777 http://dx.doi.org/10.3389/fnhum.2020.611064 Text en Copyright © 2021 Lau, Yuan, Wong, Chu, Leung, Wong and Tong. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Human Neuroscience Lau, Cathy C. Y. Yuan, Kai Wong, Patrick C. M. Chu, Winnie C. W. Leung, Thomas W. Wong, Wan-wa Tong, Raymond K. Y. Modulation of Functional Connectivity and Low-Frequency Fluctuations After Brain-Computer Interface-Guided Robot Hand Training in Chronic Stroke: A 6-Month Follow-Up Study |
title | Modulation of Functional Connectivity and Low-Frequency Fluctuations After Brain-Computer Interface-Guided Robot Hand Training in Chronic Stroke: A 6-Month Follow-Up Study |
title_full | Modulation of Functional Connectivity and Low-Frequency Fluctuations After Brain-Computer Interface-Guided Robot Hand Training in Chronic Stroke: A 6-Month Follow-Up Study |
title_fullStr | Modulation of Functional Connectivity and Low-Frequency Fluctuations After Brain-Computer Interface-Guided Robot Hand Training in Chronic Stroke: A 6-Month Follow-Up Study |
title_full_unstemmed | Modulation of Functional Connectivity and Low-Frequency Fluctuations After Brain-Computer Interface-Guided Robot Hand Training in Chronic Stroke: A 6-Month Follow-Up Study |
title_short | Modulation of Functional Connectivity and Low-Frequency Fluctuations After Brain-Computer Interface-Guided Robot Hand Training in Chronic Stroke: A 6-Month Follow-Up Study |
title_sort | modulation of functional connectivity and low-frequency fluctuations after brain-computer interface-guided robot hand training in chronic stroke: a 6-month follow-up study |
topic | Human Neuroscience |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7855586/ https://www.ncbi.nlm.nih.gov/pubmed/33551777 http://dx.doi.org/10.3389/fnhum.2020.611064 |
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