PMID- 33395991 OWN - NLM STAT- MEDLINE DCOM- 20210625 LR - 20210625 IS - 2213-1582 (Electronic) IS - 2213-1582 (Linking) VI - 28 DP - 2020 TI - Neural activity modulations and motor recovery following brain-exoskeleton interface mediated stroke rehabilitation. PG - 102502 LID - S2213-1582(20)30339-9 [pii] LID - 10.1016/j.nicl.2020.102502 [doi] LID - 102502 AB - Brain-machine interfaces (BMI) based on scalp EEG have the potential to promote cortical plasticity following stroke, which has been shown to improve motor recovery outcomes. However, the efficacy of BMI enabled robotic training for upper-limb recovery is seldom quantified using clinical, EEG-based, and kinematics-based metrics. Further, a movement related neural correlate that can predict the extent of motor recovery still remains elusive, which impedes the clinical translation of BMI-based stroke rehabilitation. To address above knowledge gaps, 10 chronic stroke individuals with stable baseline clinical scores were recruited to participate in 12 therapy sessions involving a BMI enabled powered exoskeleton for elbow training. On average, 132 +/- 22 repetitions were performed per participant, per session. BMI accuracy across all sessions and subjects was 79 +/- 18% with a false positives rate of 23 +/- 20%. Post-training clinical assessments found that FMA for upper extremity and ARAT scores significantly improved over baseline by 3.92 +/- 3.73 and 5.35 +/- 4.62 points, respectively. Also, 80% participants (7 with moderate-mild impairment, 1 with severe impairment) achieved minimal clinically important difference (MCID: FMA-UE >5.2 or ARAT >5.7) during the course of the study. Kinematic measures indicate that, on average, participants' movements became faster and smoother. Moreover, modulations in movement related cortical potentials, an EEG-based neural correlate measured contralateral to the impaired arm, were significantly correlated with ARAT scores (rho = 0.72, p < 0.05) and marginally correlated with FMA-UE (rho = 0.63, p = 0.051). This suggests higher activation of ipsi-lesional hemisphere post-intervention or inhibition of competing contra-lesional hemisphere, which may be evidence of neuroplasticity and cortical reorganization following BMI mediated rehabilitation therapy. CI - Copyright (c) 2020 The Author(s). Published by Elsevier Inc. All rights reserved. FAU - Bhagat, Nikunj A AU - Bhagat NA AD - Non-Invasive Brain Machine Interface Systems Laboratory, University of Houston, Houston, TX 77004, USA. Electronic address: nabhagat@uh.edu. FAU - Yozbatiran, Nuray AU - Yozbatiran N AD - Department of Physical Medicine and Rehabilitation, McGovern Medical School, NeuroRecovery Research Center at TIRR Memorial Hermann, University of Texas Health Science Center at Houston, TX 77030, USA. FAU - Sullivan, Jennifer L AU - Sullivan JL AD - Mechatronics and Haptic Interfaces Laboratory, Rice University, Houston, TX 77005, USA. FAU - Paranjape, Ruta AU - Paranjape R AD - Department of Physical Medicine and Rehabilitation, McGovern Medical School, NeuroRecovery Research Center at TIRR Memorial Hermann, University of Texas Health Science Center at Houston, TX 77030, USA. FAU - Losey, Colin AU - Losey C AD - Mechatronics and Haptic Interfaces Laboratory, Rice University, Houston, TX 77005, USA. FAU - Hernandez, Zachary AU - Hernandez Z AD - Non-Invasive Brain Machine Interface Systems Laboratory, University of Houston, Houston, TX 77004, USA. FAU - Keser, Zafer AU - Keser Z AD - Department of Physical Medicine and Rehabilitation, McGovern Medical School, NeuroRecovery Research Center at TIRR Memorial Hermann, University of Texas Health Science Center at Houston, TX 77030, USA. FAU - Grossman, Robert AU - Grossman R AD - Houston Methodist Research Institute, Houston, TX 77030, USA. FAU - Francisco, Gerard E AU - Francisco GE AD - Department of Physical Medicine and Rehabilitation, McGovern Medical School, NeuroRecovery Research Center at TIRR Memorial Hermann, University of Texas Health Science Center at Houston, TX 77030, USA. FAU - O'Malley, Marcia K AU - O'Malley MK AD - Department of Physical Medicine and Rehabilitation, McGovern Medical School, NeuroRecovery Research Center at TIRR Memorial Hermann, University of Texas Health Science Center at Houston, TX 77030, USA; Mechatronics and Haptic Interfaces Laboratory, Rice University, Houston, TX 77005, USA. FAU - Contreras-Vidal, Jose L AU - Contreras-Vidal JL AD - Non-Invasive Brain Machine Interface Systems Laboratory, University of Houston, Houston, TX 77004, USA; Houston Methodist Research Institute, Houston, TX 77030, USA; NSF IUCRC BRAIN, University of Houston, Houston, TX 77004, USA. LA - eng GR - R01 NS081854/NS/NINDS NIH HHS/United States PT - Journal Article PT - Research Support, N.I.H., Extramural PT - Research Support, Non-U.S. Gov't DEP - 20201119 PL - Netherlands TA - Neuroimage Clin JT - NeuroImage. Clinical JID - 101597070 SB - IM MH - Brain MH - *Exoskeleton Device MH - Humans MH - Recovery of Function MH - *Stroke MH - *Stroke Rehabilitation MH - Treatment Outcome MH - Upper Extremity PMC - PMC7749405 OTO - NOTNLM OT - Brain-machine interface OT - Clinical trial OT - Exoskeletons OT - Movement related cortical potentials OT - Stroke rehabilitation COIS- N.B. and J.C. have a patent issued (US10,092,205 granted October 9, 2018), which presents methods for detecting motor intentions from EEG signals, including MRCPs. All the remaining authors report no competing interests. EDAT- 2021/01/06 06:00 MHDA- 2021/06/29 06:00 PMCR- 2020/11/19 CRDT- 2021/01/05 01:07 PHST- 2020/06/14 00:00 [received] PHST- 2020/10/28 00:00 [revised] PHST- 2020/11/09 00:00 [accepted] PHST- 2021/01/05 01:07 [entrez] PHST- 2021/01/06 06:00 [pubmed] PHST- 2021/06/29 06:00 [medline] PHST- 2020/11/19 00:00 [pmc-release] AID - S2213-1582(20)30339-9 [pii] AID - 102502 [pii] AID - 10.1016/j.nicl.2020.102502 [doi] PST - ppublish SO - Neuroimage Clin. 2020;28:102502. doi: 10.1016/j.nicl.2020.102502. Epub 2020 Nov 19.