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dc.contributor.authorHu, Mengjiaoen_US
dc.contributor.authorCheng, Hsiao-Juen_US
dc.contributor.authorJi, Fangen_US
dc.contributor.authorChong, Joanna Su Xianen_US
dc.contributor.authorLu, Zhongkangen_US
dc.contributor.authorHuang, Weiminen_US
dc.contributor.authorAng, Kai Kengen_US
dc.contributor.authorPhua, Kok Soonen_US
dc.contributor.authorChuang, Kai-Hsiangen_US
dc.contributor.authorJiang, Xudongen_US
dc.contributor.authorChew, Effieen_US
dc.contributor.authorGuan, Cuntaien_US
dc.contributor.authorZhou, Helen Juanen_US
dc.identifier.citationHu, M., Cheng, H., Ji, F., Chong, J. S. X., Lu, Z., Huang, W., Ang, K. K., Phua, K. S., Chuang, K., Jiang, X., Chew, E., Guan, C. & Zhou, H. J. (2021). Brain functional changes in stroke following rehabilitation using brain-computer interface-assisted motor imagery with and without tDCS: a pilot study. Frontiers in Human Neuroscience, 15, 692304-.
dc.description.abstractBrain-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.en_US
dc.description.sponsorshipMinistry of Health (MOH)en_US
dc.description.sponsorshipNanyang Technological Universityen_US
dc.description.sponsorshipNational Medical Research Council (NMRC)en_US
dc.relation.ispartofFrontiers in Human Neuroscienceen_US
dc.rights© 2021 Hu, Cheng, Ji, Chong, Lu, Huang, Ang, Phua, Chuang, Jiang,Chew, Guan and Zhou. 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.en_US
dc.subjectEngineering::Computer science and engineeringen_US
dc.subjectEngineering::Electrical and electronic engineeringen_US
dc.titleBrain functional changes in stroke following rehabilitation using brain-computer interface-assisted motor imagery with and without tDCS: a pilot studyen_US
dc.typeJournal Articleen
dc.contributor.schoolSchool of Computer Science and Engineeringen_US
dc.contributor.schoolSchool of Electrical and Electronic Engineeringen_US
dc.contributor.schoolInterdisciplinary Graduate School (IGS)en_US
dc.contributor.organizationNational University of Singaporeen_US
dc.contributor.organizationInstitute for Infocomm Research, A*STARen_US
dc.contributor.researchNTU Institute for Health Technologiesen_US
dc.description.versionPublished versionen_US
dc.subject.keywordsFunctional Magnetic Resonance Imagingen_US
dc.description.acknowledgementThis research was supported by the National Medical Research Council NMRC0088/2015 and the Duke-NUS Medical School Signature Research Program funded by Ministry of Health, Singapore (JZ) and National Medical Research Council NMRC/NIG/1013/2010 (EC). The work was supported by NTU Institute for Health Technologies, Interdisciplinary Graduate Programme, Nanyang Technological University, Singapore.en_US
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