03376nas a2200409 4500008004100000022001400041245011600055210006900171260001300240300001000253490000700263520216200270653001002432653000902442653003002451653002002481653002702501653001102528653001702539653001102556653000902567653001602576653001902592653001202611653002402623653002502647653001102672653002602683653001702709653002002726100001902746700002002765700002002785700002202805700002302827856011602850 2025 eng d a1552-684400aIpsiHand Brain-Computer Interface Therapy Induces Broad Upper Extremity Motor Rehabilitation in Chronic Stroke.0 aIpsiHand BrainComputer Interface Therapy Induces Broad Upper Ext c2025 Jan a74-860 v393 a

BACKGROUND: Chronic hemiparetic stroke patients have very limited benefits from current therapies. Brain-computer interface (BCI) engaging the unaffected hemisphere has emerged as a promising novel therapeutic approach for chronic stroke rehabilitation.

OBJECTIVES: This study investigated the effectiveness of contralesionally-controlled BCI therapy in chronic stroke patients with impaired upper extremity motor function. We further explored neurophysiological features of motor recovery driven by BCI. We hypothesized that BCI therapy would induce a broad motor recovery in the upper extremity, and there would be corresponding changes in baseline theta and gamma oscillations, which have been shown to be associated with motor recovery.

METHODS: Twenty-six prospectively enrolled chronic hemiparetic stroke patients performed a therapeutic BCI task for 12 weeks. Motor function assessment data and resting state electroencephalogram signals were acquired before initiating BCI therapy and across BCI therapy sessions. The Upper Extremity Fugl-Meyer assessment served as a primary motor outcome assessment tool. Theta-gamma cross-frequency coupling (CFC) was computed and correlated with motor recovery.

RESULTS: Chronic stroke patients achieved significant motor improvement in both proximal and distal upper extremity with BCI therapy. Motor function improvement was independent of Botox application. Theta-gamma CFC enhanced bilaterally over the C3/C4 motor electrodes and positively correlated with motor recovery across BCI therapy sessions.

CONCLUSIONS: BCI therapy resulted in significant motor function improvement across the proximal and distal upper extremities of patients, which significantly correlated with theta-gamma CFC increases in the motor regions. This may represent rhythm-specific cortical oscillatory mechanism for BCI-driven rehabilitation in chronic stroke patients.

TRIAL REGISTRATION: Advarra Study: https://classic.clinicaltrials.gov/ct2/show/NCT04338971 and Washington University Study: https://classic.clinicaltrials.gov/ct2/show/NCT03611855.

10aAdult10aAged10abrain-computer interfaces10aChronic Disease10aElectroencephalography10aFemale10aGamma Rhythm10aHumans10aMale10aMiddle Aged10aMotor Activity10aParesis10aProspective Studies10aRecovery of Function10aStroke10aStroke Rehabilitation10aTheta Rhythm10aUpper Extremity1 aRustamov, Nabi1 aSouders, Lauren1 aSheehan, Lauren1 aCarter, Alexandre1 aLeuthardt, Eric, C uhttps://www.neurotechcenter.org/publications/2025/ipsihand-brain-computer-interface-therapy-induces-broad-upper03130nas a2200313 4500008004100000022001400041245013900055210006900194260001500263520206900278653002002347653002602367653002102393653002202414653001302436653001102449653002702460653002502487100001702512700001702529700001902546700002402565700002302589700002102612700001402633700002402647700002202671856012302693 2022 eng d a1940-087X00aThe Evoked Potential Operant Conditioning System (EPOCS): A Research Tool and an Emerging Therapy for Chronic Neuromuscular Disorders.0 aEvoked Potential Operant Conditioning System EPOCS A Research To c2022 08 253 a

The Evoked Potential Operant Conditioning System (EPOCS) is a software tool that implements protocols for operantly conditioning stimulus-triggered muscle responses in people with neuromuscular disorders, which in turn can improve sensorimotor function when applied appropriately. EPOCS monitors the state of specific target muscles-e.g., from surface electromyography (EMG) while standing, or from gait cycle measurements while walking on a treadmill-and automatically triggers calibrated stimulation when pre-defined conditions are met. It provides two forms of feedback that enable a person to learn to modulate the targeted pathway's excitability. First, it continuously monitors ongoing EMG activity in the target muscle, guiding the person to produce a consistent level of activity suitable for conditioning. Second, it provides immediate feedback of the response size following each stimulation and indicates whether it has reached the target value. To illustrate its use, this article describes a protocol through which a person can learn to decrease the size of the Hoffmann reflex-the electrically-elicited analog of the spinal stretch reflex-in the soleus muscle. Down-conditioning this pathway's excitability can improve walking in people with spastic gait due to incomplete spinal cord injury. The article demonstrates how to set up the equipment; how to place stimulating and recording electrodes; and how to use the free software to optimize electrode placement, measure the recruitment curve of direct motor and reflex responses, measure the response without operant conditioning, condition the reflex, and analyze the resulting data. It illustrates how the reflex changes over multiple sessions and how walking improves. It also discusses how the system can be applied to other kinds of evoked responses and to other kinds of stimulation, e.g., motor evoked potentials to transcranial magnetic stimulation; how it can address various clinical problems; and how it can support research studies of sensorimotor function in health and disease.

10aChronic Disease10aConditioning, Operant10aElectromyography10aEvoked Potentials10aH-Reflex10aHumans10aNeuromuscular Diseases10aSpinal Cord Injuries1 aHill, Jeremy1 aGupta, Disha1 aEftekhar, Amir1 aBrangaccio, Jodi, A1 aNorton, James, J S1 aMcLeod, Michelle1 aFake, Tim1 aWolpaw, Jonathan, R1 aThompson, Aiko, K uhttps://www.neurotechcenter.org/publications/2022/evoked-potential-operant-conditioning-system-epocs-research-tool-and