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Targeted Up-Conditioning of Contralesional Corticospinal Pathways Promotes Motor Recovery in Poststroke Patients with Severe Chronic Hemiplegia

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Brain-Computer Interface Research

Part of the book series: SpringerBriefs in Electrical and Computer Engineering ((BRIEFSELECTRIC))

Abstract

Impairment of shoulder elevation in poststroke hemiplegia is a debilitating condition with no evidence-based, accessible treatment. This study evaluated the safety and efficacy of direct brain control of advanced exoskeleton robotics as a physiotherapeutic intervention. Poststroke patients with severe chronic hemiplegia participated in a physiotherapeutic intervention with movement support aided by online decoding of contralesional primary motor cortex activity and exoskeleton shoulder robotics. Participants engaged in 1 h of daily exercise for 7 consecutive days, which promoted lateralized motor-related electroencephalogram (EEG) responses to the contralesional side and the appearance of a transcranial magnetic stimulation-evoked potential in the paralyzed shoulder muscle. Participants gained active range-of-motion in the affected arm, with a flexion movement beyond the standardized minimal clinically important difference. These results suggest that an EEG-based brain-machine interface could facilitate targeted up-conditioning of contralesional corticospinal pathways, resulting in the clinically relevant functional recovery of movement.

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Acknowledgements

An original study on shoulder movement restoration by using BMI in poststroke hemiplegia was submitted to the Annual BCI Award 2017 hosted by g.tec., Austria, and was nominated among the top 12 research projects. This article is a reprinted version of the nominated article, with some supplementary explanation. A short summary of this study was previously introduced in IEEE eNewsLetter in 2018.

This study was partially supported by the Strategic Research Program for Brain Sciences from the Ministry of Education, Culture, Sports, Science, and Technology of Japan.

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Authors and Affiliations

  1. Graduate School of Science and Technology, Keio University, Kanagawa, Japan

    K. Takasaki

  2. Department of Rehabilitation Medicine, Keio University, Tokyo, Japan

    F. Liu, M. Ogura, K. Okuyama, M. Kawakami, K. Mizuno & M. Liu

  3. Faculty of Science and Technology, Keio Institute of Pure and Applied Science (KiPAS), Keio University, Kanagawa, Japan

    S. Kasuga & J. Ushiba

  4. Department of Brain Robot Interface, Advanced Telecommunications Research Institute International, Kyoto, Japan

    T. Noda & J. Morimoto

Authors
  1. K. Takasaki
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  2. F. Liu
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  4. K. Okuyama
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  5. M. Kawakami
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  6. K. Mizuno
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  7. S. Kasuga
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  8. T. Noda
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  9. J. Morimoto
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  10. M. Liu
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  11. J. Ushiba
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Corresponding author

Correspondence to J. Ushiba .

Editor information

Editors and Affiliations

  1. g.tec Medical Engineering GmbH, Schiedlberg, Austria

    Christoph Guger

  2. Department of Health Science and Technology, Aalborg University, Aalborg, Denmark

    Natalie Mrachacz-Kersting

  3. Department of Cognitive Science, University of California, San Diego, CA, USA

    Brendan Z. Allison

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Takasaki, K. et al. (2019). Targeted Up-Conditioning of Contralesional Corticospinal Pathways Promotes Motor Recovery in Poststroke Patients with Severe Chronic Hemiplegia. In: Guger, C., Mrachacz-Kersting, N., Allison, B. (eds) Brain-Computer Interface Research. SpringerBriefs in Electrical and Computer Engineering. Springer, Cham. https://doi.org/10.1007/978-3-030-05668-1_7

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  • DOI: https://doi.org/10.1007/978-3-030-05668-1_7

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-05667-4

  • Online ISBN: 978-3-030-05668-1

  • eBook Packages: Computer ScienceComputer Science (R0)

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