Motor Imagery and Real-time Feedback in Stroke Rehabilitation
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 发起方
- 入组人数
- 16
- 试验地点
- 6
- 主要终点
- Change of EEG alpha and beta activity
研究概览
简要总结
This research project will investigate motor imagery training in stroke rehabilitation during which patients receive feedback in real time from their brain activity measured with ElectroEncephaloGraphy (EEG). The investigators hypothesize that the feedback training allows to internally stimulate brain motor networks in order to promote functional recovery of the hand.
详细描述
This study will be carried out as an explorative study in order to investigate the benefits of mental imagery training of hand movements guided through Brain-Computer Interface (BCI) feedback after stroke. Stroke patients will be trained to mentally imagine the opening and closing of the hand (hereafter named MI, Motor Imagery). During the training, the patients will receive visual feedback in real time that reflects the neural activity related to motor processes. The NeuroFeedback (NF) will be projected with minimal time delay to maximize the neural learning. This type of brain training with feedback is thought to have significant importance to stimulate the ability of the brain to reorganize and compensate for a damaged region.
Each participant will go through the following data collection procedure (total of 33 measurement sessions per RP):
Week 1-3:
Clinical baseline evaluations, 1 time/week MRI measurements, 1 time/week during 2 weeks. Baseline EEG recordings, 1 time/week Week 4-7 MI-neurofeedback training 3 times/week Clinical intervention evaluation, 1 time/week Week 8-10 Same as week 1-3
Magnetic Resonance Imaging (MRI) measurements. The MRI exam will be carried out on a Siemens MAGNETOM Prisma 3T scanner (head-coil with 20 channels) at baseline and at final assessment session at Stockholm University Brain Imaging Centre. The MRI protocol comprises i) anatomical whole brain spin-echo T1 and T2 weighted sequences for description of lesion size and location ii) acquisition of T2*-weighted gradient echo EPI-BOLD images of the whole brain for assessment of resting state functional connectivity of sensorimotor networks (resting-state functional MRI (fMRI)), and iii) the same sequence as the previous with rest interleaved by a motor imagery paradigm further described below.
研究设计
- 研究类型
- Interventional
- 分配方式
- Na
- 干预模型
- Single Group
- 主要目的
- Treatment
- 盲法
- None
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •> 6 months since first time stroke onset and with remaining hemiparesis in upper extremity; able to participate fully in the intervention, able to perform Functional Magnetic Resonance Imaging (fMRI); able to passively extend the wrist 15 degrees and extend fingers fully with a neutral position of the wrist.
- •In addition, participants need to be able to voluntarily control the power of their grip when requested according to the Visuomotor force tracking method and/or according to the clinical assessment of a therapist (while holding the patient´s hand). According to the Fugl- Meyer Upper Extremity (UE) scale participants should accomplish <14 points on the hand subscale and <2 points in finger flexion and extension (C) in addition to < 47 points on the total motor score (equivalent to moderate disability in the upper extremity.
排除标准
- •other neurological or musculoskeletal disease/injury, or contagious disease.
- •If the research person is regularly treated with botulinum toxin in the upper extremity, 3 weeks should have passed before the first baseline assessment.
- •current or history of epilepsy,
- •severe hearing or visual impairments,
- •metal implants in the brain/skull cochlear implants,
- •any implanted neurostimulator, cardiac pacemaker or cardiac implants of metal, infusion device,
- •any other neurological disorder,
- •pregnancy,
- •current or history of severe psychiatric disorder with need for pharmacological treatment
结局指标
主要结局
Change of EEG alpha and beta activity
时间窗: Up to 10 weeks
Brain motor network activity reflected in BCI feedback
Change of Fugl-Meyer Upper Extremity scale score (0-66 points)
时间窗: Up to 10 weeks
Arm and hand function
Change of fMRI BOLD activity
时间窗: Up to 10 weeks
Brain motor network activity
次要结局
- Change of monofilament test score(Up to 10 weeks)
- Change of box and block test score (0-150)(Up to 10 weeks)
- Change of stroke Impact Scale 16 scores (15-80 points)(Up to 10 weeks)
- Change of JAMAR® digital Hand Dynamometer scores (0-90)(Up to 10 weeks)
- Change of visuomotor force-tracking task scores(Up to 10 weeks)