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Title: Brain functional changes in stroke following rehabilitation using brain-computer interface-assisted motor imagery with and without tDCS: a pilot study
Authors: Hu, Mengjiao
Cheng, Hsiao-Ju
Ji, Fang
Chong, Joanna Su Xian
Lu, Zhongkang
Huang, Weimin
Ang, Kai Keng
Phua, Kok Soon
Chuang, Kai-Hsiang
Jiang, Xudong
Chew, Effie
Guan, Cuntai
Zhou, Helen Juan
Keywords: Engineering::Computer science and engineering
Engineering::Electrical and electronic engineering
Issue Date: 2021
Source: Hu, 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-.
Project: NMRC0088/2015 
Journal: Frontiers in Human Neuroscience 
Abstract: Brain-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.
ISSN: 1662-5161
DOI: 10.3389/fnhum.2021.692304
Schools: School of Computer Science and Engineering 
School of Electrical and Electronic Engineering 
Interdisciplinary Graduate School (IGS) 
Organisations: National University of Singapore
Institute for Infocomm Research, A*STAR
Research Centres: NTU Institute for Health Technologies 
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.
Fulltext Permission: open
Fulltext Availability: With Fulltext
Appears in Collections:EEE Journal Articles
IGS Journal Articles
SCSE Journal Articles

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