Stroke
Conditions
Keywords
Stroke, Sensorimotor rhyme, Brain-computer interface
Brief summary
It may be hard to acquire stable sensorimotor rhythm from the affected motor cortex for patient without a response of paretic hand. A few studies suggest two ways to approaching closed-loop therapy: peripherally extracting the residual signals, for example electromyogram (EMG) at proximal muscles (deltoids) and centrally extracting the activity patterns from unaffected hemisphere during attempting to move paretic hand. Therefore, understanding neural signatures of residual upper extremity movement among stroke patients might help in discovering potential therapeutic target and developing tailored brain-computer interface (BCI) therapy. Additionally, 59.4% of stroke patients in acute stage impair at least one somatosensory modality. It remains unclear whether the patient with somatosensory impairment hinder BCI effect.
Detailed description
Investigators will consecutively enroll subacute (1-4 weeks after stroke onset) patients with first-time, unilateral, subcortical stroke and age-matched healthy controls. All participants will carry on 2 sequential experiments. In the first experiment, participants will perform 2 motor tasks using either paretic/nondominant upper extremity or non-paretic/dominant upper extremity, called motor attempt (M) condition or calibration condition. The second experiment contains 3 conditions: cyclic functional electrical stimulation (cFES), cFES during motor attempt (M-cFES), and functional electrical stimulation during brain-computer interface (BCI-FES) in random order. The sensorimotor oscillations from the electroencephalography (EEG), upper extremity sensorimotor function score (Fugl-Meyer test, Action Research Arm test, and Revised Nottingham Sensation Assessment), corticospinal excitability from the transcranial magnetic stimulation (TMS), and resting-state functional and structural neuroimage from magnetic resonance imaging (MRI) will be assessed before and after the final experiment, as well as 3 months after stroke.
Interventions
None listed
Sponsors
Taipei Veterans General Hospital, Taiwan
Study design
Observational model
CASE_CROSSOVER
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
20 Years to 80 Years
Healthy volunteers
Yes
Inclusion criteria
* first-ever, unilateral infarction or hemorrhage at middle cerebral artery or posterior cerebral artery territory * early subacute phase of stroke (between 1 and 4 weeks after stroke onset)
Exclusion criteria
* electroencephagraphy feature is not usable * Fugl-Meyer Assessment of Upper Extremity score is over 50 * ataxia * global aphasia * concomitant neurological diseases * psychiatric diseases * participating in other interventional research during this period * other conditions might interfere with experiment
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Sensorimotor rhythms | Baseline, during experimental procedures | electroencephalography |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Action Research Arm test | At baseline (1-4 week of stroke) and at 3 months after stroke | Action Research Arm test (ARAT) measures specific upper-limb and hand function. The total score of ARAT ranges from 0 to 57, which higher score indicates better motor function. |
| Revised Nottingham Sensation Assessment | At baseline (1-4 week of stroke) and at 3 months after stroke | Revised Nottingham Sensation Assessment (rNSA) measures various upper-limb sensory function. The total score of rNSA ranges from 0 to 151, which higher score indicates better somatosensory function. |
| Motor Activity Log | At baseline (1-4 week of stroke) and at 3 months after stroke | Motor Activity Log (MAL) measures real-use of upper-limb. The averaged index of MAL ranges from 0 to 5, which higher index indicates more frequently use of paretic upper limb. |
| Fugl-Meyer Assessment | At baseline (1-4 week of stroke) and at 3 months after stroke | Fugl-Meyer Assessment (FMA) measures both upper-limb and lower-limb motor function. The total score of FMA ranges from 0 to 100, which higher score indicates better motor recovery. |
| Motor evoked potential | At baseline (1-4 week of stroke) and at 3 months after stroke | Transcranial magnetic stimulation test |
| Resting-state brain connectivity | At baseline (1-4 week of stroke) and at 3 months after stroke | Magnetic resonance imaging |
| Resting motor threshold | At baseline (1-4 week of stroke) and at 3 months after stroke | Transcranial magnetic stimulation test |
Countries
Taiwan
Outcome results
None listed