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-upper04121nas a2200457 4500008004100000022001400041245010800055210006900163260001200232300001100244490000700255520290000262653001503162653001003177653002103187653001203208653001803220653001003238653002403248653002703272653001103299653000903310653001103319653000903330653001603339653001703355653001303372653001203385653002203397653002803419653001103447653002803458653001303486100002303499700002603522700001903548700001603567700001303583700001903596856004803615 2008 eng d a1524-462800aUnique cortical physiology associated with ipsilateral hand movements and neuroprosthetic implications.0 aUnique cortical physiology associated with ipsilateral hand move c12/2008 a3351-90 v393 a

BACKGROUND AND PURPOSE: 

Brain computer interfaces (BCIs) offer little direct benefit to patients with hemispheric stroke because current platforms rely on signals derived from the contralateral motor cortex (the same region injured by the stroke). For BCIs to assist hemiparetic patients, the implant must use unaffected cortex ipsilateral to the affected limb. This requires the identification of distinct electrophysiological features from the motor cortex associated with ipsilateral hand movements.

METHODS: 

In this study we studied 6 patients undergoing temporary placement of intracranial electrode arrays. Electrocorticographic (ECoG) signals were recorded while the subjects engaged in specific ipsilateral or contralateral hand motor tasks. Spectral changes were identified with regards to frequency, location, and timing.

RESULTS: 

Ipsilateral hand movements were associated with electrophysiological changes that occur in lower frequency spectra, at distinct anatomic locations, and earlier than changes associated with contralateral hand movements. In a subset of 3 patients, features specific to ipsilateral and contralateral hand movements were used to control a cursor on a screen in real time. In ipsilateral derived control this was optimal with lower frequency spectra.

CONCLUSIONS: 

There are distinctive cortical electrophysiological features associated with ipsilateral movements which can be used for device control. These findings have implications for patients with hemispheric stroke because they offer a potential methodology for which a single hemisphere can be used to enhance the function of a stroke induced hemiparesis.

10aAdolescent10aAdult10aArtificial Limbs10aBionics10aBrain Mapping10aChild10aDominance, Cerebral10aElectroencephalography10aFemale10aHand10aHumans10aMale10aMiddle Aged10aMotor Cortex10aMovement10aParesis10aProsthesis Design10aPsychomotor Performance10aStroke10aUser-Computer Interface10aVolition1 aWisneski, Kimberly1 aAnderson, Nicholas, R1 aSchalk, Gerwin1 aSmyth, Matt1 aMoran, D1 aLeuthardt, E C uhttp://www.ncbi.nlm.nih.gov/pubmed/18927456