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Choy CS, Fang Q, Neville K, Ding B, Kumar A, Mahmoud SS, Gu X, Fu J, Jelfs B. Virtual reality and motor imagery for early post-stroke rehabilitation. Biomed Eng Online 2023; 22:66. [PMID: 37407988 PMCID: PMC10320905 DOI: 10.1186/s12938-023-01124-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Accepted: 06/05/2023] [Indexed: 07/07/2023] Open
Abstract
BACKGROUND Motor impairment is a common consequence of stroke causing difficulty in independent movement. The first month of post-stroke rehabilitation is the most effective period for recovery. Movement imagination, known as motor imagery, in combination with virtual reality may provide a way for stroke patients with severe motor disabilities to begin rehabilitation. METHODS The aim of this study is to verify whether motor imagery and virtual reality help to activate stroke patients' motor cortex. 16 acute/subacute (< 6 months) stroke patients participated in this study. All participants performed motor imagery of basketball shooting which involved the following tasks: listening to audio instruction only, watching a basketball shooting animation in 3D with audio, and also performing motor imagery afterwards. Electroencephalogram (EEG) was recorded for analysis of motor-related features of the brain such as power spectral analysis in the [Formula: see text] and [Formula: see text] frequency bands and spectral entropy. 18 EEG channels over the motor cortex were used for all stroke patients. RESULTS All results are normalised relative to all tasks for each participant. The power spectral densities peak near the [Formula: see text] band for all participants and also the [Formula: see text] band for some participants. Tasks with instructions during motor imagery generally show greater power spectral peaks. The p-values of the Wilcoxon signed-rank test for band power comparison from the 18 EEG channels between different pairs of tasks show a 0.01 significance of rejecting the band powers being the same for most tasks done by stroke subjects. The motor cortex of most stroke patients is more active when virtual reality is involved during motor imagery as indicated by their respective scalp maps of band power and spectral entropy. CONCLUSION The resulting activation of stroke patient's motor cortices in this study reveals evidence that it is induced by imagination of movement and virtual reality supports motor imagery. The framework of the current study also provides an efficient way to investigate motor imagery and virtual reality during post-stroke rehabilitation.
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Affiliation(s)
- Chi S. Choy
- School of Engineering, RMIT University, Melbourne, Australia
| | - Qiang Fang
- Department of Biomedical Engineering, Shantou University, Shantou, China
| | - Katrina Neville
- School of Engineering, RMIT University, Melbourne, Australia
| | - Bingrui Ding
- Department of Biomedical Engineering, Shantou University, Shantou, China
| | - Akshay Kumar
- Department of Biomedical Engineering, Shantou University, Shantou, China
| | | | - Xudong Gu
- Rehabilitation Center, Jiaxing 2nd Hospital, Jiaxing, 314000 China
| | - Jianming Fu
- Rehabilitation Center, Jiaxing 2nd Hospital, Jiaxing, 314000 China
| | - Beth Jelfs
- Department of Electrical, Electronic & Systems Engineering, University of Birmingham, Birmingham, UK
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Ma ZZ, Wu JJ, Hua XY, Zheng MX, Xing XX, Ma J, Li SS, Shan CL, Xu JG. Brain Function and Upper Limb Deficit in Stroke With Motor Execution and Imagery: A Cross-Sectional Functional Magnetic Resonance Imaging Study. Front Neurosci 2022; 16:806406. [PMID: 35663563 PMCID: PMC9160973 DOI: 10.3389/fnins.2022.806406] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Accepted: 04/19/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundMotor imagery training might be helpful in stroke rehabilitation. This study explored if a specific modulation of movement-related regions is related to motor imagery (MI) ability.MethodsTwenty-three patients with subcortical stroke and 21 age-matched controls were recruited. They were subjectively screened using the Kinesthetic and Visual Imagery Questionnaire (KVIQ). They then underwent functional magnetic resonance imaging (fMRI) while performing three repetitions of different motor tasks (motor execution and MI). Two separate runs were acquired [motor execution tasks (ME and rest) and motor imagery (MI and rest)] in a block design. For the different tasks, analyses of cerebral activation and the correlation of motor/imagery task-related activity and KVIQ scores were performed.ResultsDuring unaffected hand (UH) active grasp movement, we observed decreased activations in the contralateral precentral gyrus (PreCG), contralateral postcentral gyrus (PoCG) [p < 0.05, family wise error (FWE) corrected] and a positive correlation with the ability of FMA-UE (PreCG: r = 0.46, p = 0.028; PoCG: r = 0.44, p = 0.040). During active grasp of the affected hand (AH), decreased activation in the contralateral PoCG was observed (p < 0.05, FWE corrected). MI of the UH induced significant activations of the contralateral superior frontal gyrus, opercular region of the inferior frontal gyrus, and ipsilateral ACC and deactivation in the ipsilateral supplementary motor area (p < 0.05, AlphaSim correction). Ipsilateral anterior cingulate cortex (ACC) activity negatively correlated with MI ability (r = =–0.49, p = 0.022). Moreover, we found significant activation of the contralesional middle frontal gyrus (MFG) during MI of the AH.ConclusionOur results proved the dominant effects of MI dysfunction that exist in stroke during the processing of motor execution. In the motor execution task, the enhancement of the contralateral PreCG and PoCG contributed to reversing the motor dysfunction, while in the MI task, inhibition of the contralateral ACC can increase the impaired KVIQ ability. The bimodal balance recovery model can explain our results well. Recognizing neural mechanisms is critical to helping us formulate precise strategies when intervening with electrical or magnetic stimulation.
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Affiliation(s)
- Zhen-Zhen Ma
- Department of Rehabilitation Medicine, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Jia-Jia Wu
- Center of Rehabilitation Medicine, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Xu-Yun Hua
- Department of Trauma and Orthopedics, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Mou-Xiong Zheng
- Department of Trauma and Orthopedics, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Xiang-Xin Xing
- Center of Rehabilitation Medicine, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Jie Ma
- Center of Rehabilitation Medicine, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Si-Si Li
- Center of Rehabilitation Medicine, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Chun-Lei Shan
- Center of Rehabilitation Medicine, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Chun-Lei Shan,
| | - Jian-Guang Xu
- Center of Rehabilitation Medicine, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- *Correspondence: Jian-Guang Xu,
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Zhao Y, Yao J, Wu X, Chen L, Wang X, Zhang X, Hou W. Event-Related Beta EEG Changes Induced by Various Neuromuscular Electrical Stimulation: A Pilot Study. IEEE Trans Neural Syst Rehabil Eng 2021; 29:1206-1212. [PMID: 34129499 DOI: 10.1109/tnsre.2021.3089478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Previous results demonstrated that neuromuscular electrical stimulation (NMES) with various configurations could induce different activity at both the central and peripheral levels. Although NMES generating different peripheral movements have been studied, it is still unclear whether the difference in NMES-induced cortical activity is due to movement- or stimulation- related differences. Because NMES-induced cortical activity impacts motor function recovery, it is essential to know when NMES with various configurations evoke the same movement, whether the induced cortical activity is still different. Four NMES configurations: 1) Eight-let Frequency Trains, 2) Doublet frequency trains (DFT), 3) Constant-frequency trains with narrow-pulse, and 4) wide-pulse, were delivered to the right biceps brachii muscle in nine healthy young adults. We adjusted the intensities of these NMES to evoke the same elbow flexion and compared the cortical activities over sensorimotor regions. Our results showed that the four NMES patterns induced different beta-band Event-Related Desynchronization (ERD), with the DFT providing the strongest ERD value given the same NMES-induced elbow flexion (p < 0.05). This difference is possibly due to NMES with different configuration activated in the amount of afferent proprioceptive fibers. Our pilot study suggests that the NMES-induced beta-band ERD may be an additional factor to consider when selecting the NMES configuration for a better motor function recovery.
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Ye Q, Zhang L, Shao ZL, Zhang W, Li C, Ye XM. Two Cu(II)-organic frameworks: Effective CO2 fixation and protective activity on the motor function after stroke by increasing neural stem cells differentiation. Inorganica Chim Acta 2020. [DOI: 10.1016/j.ica.2020.119880] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
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