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Hebbian plasticity induced by temporally coincident BCI enhances post-stroke motor recovery
oleh: Johanna Krueger, Richard Krauth, Christoph Reichert, Serafeim Perdikis, Susanne Vogt, Tessa Huchtemann, Stefan Dürschmid, Almut Sickert, Juliane Lamprecht, Almir Huremovic, Michael Görtler, Slawomir J. Nasuto, I.-Chin Tsai, Robert T. Knight, Hermann Hinrichs, Hans-Jochen Heinze, Sabine Lindquist, Michael Sailer, Jose del R. Millán, Catherine M. Sweeney-Reed
Format: | Article |
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Diterbitkan: | Nature Portfolio 2024-08-01 |
Deskripsi
Abstract Functional electrical stimulation (FES) can support functional restoration of a paretic limb post-stroke. Hebbian plasticity depends on temporally coinciding pre- and post-synaptic activity. A tight temporal relationship between motor cortical (MC) activity associated with attempted movement and FES-generated visuo-proprioceptive feedback is hypothesized to enhance motor recovery. Using a brain–computer interface (BCI) to classify MC spectral power in electroencephalographic (EEG) signals to trigger FES-delivery with detection of movement attempts improved motor outcomes in chronic stroke patients. We hypothesized that heightened neural plasticity earlier post-stroke would further enhance corticomuscular functional connectivity and motor recovery. We compared subcortical non-dominant hemisphere stroke patients in BCI-FES and Random-FES (FES temporally independent of MC movement attempt detection) groups. The primary outcome measure was the Fugl-Meyer Assessment, Upper Extremity (FMA-UE). We recorded high-density EEG and transcranial magnetic stimulation-induced motor evoked potentials before and after treatment. The BCI group showed greater: FMA-UE improvement; motor evoked potential amplitude; beta oscillatory power and long-range temporal correlation reduction over contralateral MC; and corticomuscular coherence with contralateral MC. These changes are consistent with enhanced post-stroke motor improvement when movement is synchronized with MC activity reflecting attempted movement.