Abstract
Action observation (AO), based on the mirror neuron theory, is a promising strategy to promote motor cortical activation in neurorehabilitation. Brain computer interface (BCI) can detect a user’s intention and provide them with brain state-dependent feedback to assist with patient rehabilitation. We investigated the effects of a combined BCI-AO game on power of mu band attenuation in stroke patients. Nineteen patients with subacute stroke were recruited. A BCI-AO game provided real-time feedback to participants regarding their attention to a flickering action video using steady-state visual-evoked potentials. All participants watched a video of repetitive grasping actions under two conditions: (1) BCI-AO game and (2) conventional AO, in random order. In the BCI-AO game, feedback on participants’ observation scores and observation time was provided. In conventional AO, a non-flickering video and no feedback were provided. The magnitude of mu suppression in the central motor, temporal, parietal, and occipital areas was significantly higher in the BCI-AO game than in the conventional AO. The magnitude of mu suppression was significantly higher in the BCI-AO game than in the conventional AO both in the affected and unaffected hemispheres. These results support the facilitatory effects of the BCI-AO game on mu suppression over conventional AO.
Highlights
Stroke is a leading cause of long-term disability and is often associated with persistent impairment of the upper extremities [1]
We demonstrated that mu suppression and state visual-evoked potential (SSVEP) expression were simultaneously observed during Action observation (AO) training with a flickering action video and it was possible to confirm whether the user was watching the flickering action video [30]
We demonstrated that compared to conventional AO, the Brain computer interface (BCI)-AO game induced greater mu suppression in both affected and unaffected hemispheres
Summary
Stroke is a leading cause of long-term disability and is often associated with persistent impairment of the upper extremities [1]. 70–80% of patients with stroke experience upper extremity impairments, and 5 years after stroke onset, approximately 56% of patients continue to report pronounced hemiparesis [2,3]. This loss of functionality can lead to difficulties in activities of daily living (ADLs) and participation in the community [1]. Providing effective and efficient training to restore upper limb function is important in patients with stroke to enable them to perform. Brain plasticity refers to the ability of the brain to modify and reorganize its structure and function, in response to injury, and as a result of external stimuli and experiences [5]
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