Improving Motor Corticothalamic Communication After Stroke Using Real-Time fMRI Connectivity-Based Neurofeedback

Sook-Lei Liew; Mohit Rana; Sonja Cornelsen; Marcos Fortunato de Barros Filho; Niels Birbaumer; Ranganatha Sitaram; Leonardo G Cohen; Surjo R Soekadar

doi:10.1177/1545968315619699

Improving Motor Corticothalamic Communication After Stroke Using Real-Time fMRI Connectivity-Based Neurofeedback

Neurorehabil Neural Repair. 2016 Aug;30(7):671-5. doi: 10.1177/1545968315619699. Epub 2015 Dec 14.

Authors

Sook-Lei Liew¹, Mohit Rana², Sonja Cornelsen³, Marcos Fortunato de Barros Filho⁴, Niels Birbaumer⁵, Ranganatha Sitaram², Leonardo G Cohen⁶, Surjo R Soekadar⁷

Affiliations

¹ Human Cortical Physiology and Neurorehabilitation Section, NINDS, NIH, Bethesda, MD, USA Chan Division of Occupational Science and Occupational Therapy, Division of Physical Therapy and Biokinesiology, Department of Neurology, University of Southern California, Los Angeles, CA, USA sliew@usc.edu.
² Institute for Medical and Biological Engineering, and Department of Psychiatry and Section of Neuroscience, Schools of Engineering, Medicine and Biology, Pontificia Universidad Católica de Chile, Santiago, Chile Institute of Medical Psychology and Behavioral Neurobiology, University of Tübingen, Germany Department of Biomedical Engineering, University of Florida, Gainesville, FL, USA.
³ Center for Neurology, Division of Neuropsychology, Hertie-Institute for Clinical Brain Research, Eberhard Karls University, Tübingen, Germany.
⁴ Applied Neurotechnology Lab, Department of Psychiatry and Psychotherapy, University Hospital of Tübingen, Tübingen, Germany.
⁵ Institute of Medical Psychology and Behavioral Neurobiology, University of Tübingen, Germany IRCSS, Ospedale San Camillo, Venice, Italy.
⁶ Human Cortical Physiology and Neurorehabilitation Section, NINDS, NIH, Bethesda, MD, USA.
⁷ Institute of Medical Psychology and Behavioral Neurobiology, University of Tübingen, Germany Applied Neurotechnology Lab, Department of Psychiatry and Psychotherapy, University Hospital of Tübingen, Tübingen, Germany.

Abstract

Background: Two thirds of stroke survivors experience motor impairment resulting in long-term disability. The anatomical substrate is often the disruption of cortico-subcortical pathways. It has been proposed that reestablishment of cortico-subcortical communication relates to functional recovery.

Objective: In this study, we applied a novel training protocol to augment ipsilesional cortico-subcortical connectivity after stroke. Chronic stroke patients with severe motor impairment were provided online feedback of blood-oxygenation level dependent signal connectivity between cortical and subcortical regions critical for motor function using real-time functional magnetic resonance imaging neurofeedback.

Results: In this proof of principle study, 3 out of 4 patients learned to voluntarily modulate cortico-subcortical connectivity as intended.

Conclusions: Our results document for the first time the feasibility and safety for patients with chronic stroke and severe motor impairment to self-regulate and augment ipsilesional cortico-subcortical connectivity through neurofeedback using real-time functional magnetic resonance imaging.

Keywords: brain-machine interface (BMI); connectivity; neurofeedback; real-time functional magnetic resonance imaging (rtfMRI); stroke.

Publication types

Research Support, N.I.H., Extramural
Research Support, N.I.H., Intramural
Research Support, Non-U.S. Gov't

MeSH terms

Adult
Brain / diagnostic imaging*
Brain-Computer Interfaces
Female
Humans
Image Processing, Computer-Assisted
Magnetic Resonance Imaging*
Male
Middle Aged
Neural Pathways / diagnostic imaging*
Neurofeedback / methods*
Online Systems
Oxygen / blood
Stroke / diagnostic imaging*
Stroke Rehabilitation*

Substances

Oxygen

Abstract

Publication types

MeSH terms

Substances

Grants and funding